Brand Name(s):

• Kineret®

WHY is this medicine prescribed?

Anakinra is used, alone or in combination with other medications, to reduce the pain and swelling associated with rheumatoid arthritis. Anakinra is in a class of medications called interleukin antagonists. It works by blocking the activity of interleukin, a protein in the body that causes joint damage.

HOW should this medicine be used?

Anakinra comes as a solution to inject subcutaneously (under the skin). It is usually injected once a day, at the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use anakinra exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Anakinra comes in prefilled glass syringes. There are 7 syringes in each box, one for each day of the week. Use each syringe only once and inject all the solution in the syringe. Even if there is still some solution left in the syringe after you inject, do not inject again. Dispose of used syringes in a puncture-resistant container. Talk to your doctor or pharmacist about how to dispose of the puncture-resistant container.

Do not shake prefilled syringes. If the solution is foamy, allow the syringe to sit for a few minutes until it clears. Do not use a syringe if its contents look discolored or cloudy or if it has anything floating in it.

You can inject anakinra in the outer thigh or stomach. If someone else is giving you the injection, it can be injected in the back of the arms or buttocks. To reduce the chances of soreness or redness, use a different site for each injection. You do not have to change the part of the body every day, but the new injection should be given about 1 inch (2.5 centimeters) away from the previous injection. Do not inject close to a vein you can see under the skin.

Before you use anakinra for the first time, read the manufacturer's information for the patient that comes with it. Ask your doctor or pharmacist to show you how to inject anakinra.

To administer the injection, follow these steps:

• Clean the injection site with an alcohol wipe using a circular motion, starting from the middle and moving outwards. Let the area dry completely.
• Hold the syringe and pull the needle cover off by twisting the cover while pulling on it. Do not touch the needle.
• Hold the syringe in the hand you use to inject yourself. If possible, use your other hand to pinch a fold of skin at the injection site. Do not lay the syringe down or allow the needle to touch anything.
• Hold the syringe between your thumb and fingers so you have steady control. Insert the needle into the skin with a quick, short motion at a 45 to 90 degree angle. The needle should be inserted at least halfway.
• Gently let go of the skin, but make sure the needle remains in your skin. Slowly push the plunger down into the syringe until it stops.
• Remove the needle and do not recap it. Press dry gauze (NOT an alcohol wipe) over the injection site.
• You may apply a small adhesive bandage over the injection site.
• Place the entire used syringe in a puncture-resistant container.

It may take several weeks before you feel the full benefit of anakinra.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking anakinra,

• tell your doctor and pharmacist if you are allergic to anakinra, proteins made from bacterial cells (E. coli), latex, or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: etanercept (Enbrel); infliximab (Remicade); and medications that suppress the immune system such as azathioprine (Imuran), cyclosporine (Neoral, Sandimmune), methotrexate (Rheumatrex), sirolimus (Rapamune), and tacrolimus (Prograf). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have an infection, asthma, HIV infection or AIDS, or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using anakinra, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using anakinra.
• do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

What should I know about STORAGE and DISPOSAL of this medication?

Keep syringes and injection supplies out of the reach of children. Store anakinra syringes in the refrigerator. Do not freeze. Protect from light. Do not use a syringe that has been at room temperature for more than 24 hours. Throw away any medication left after the expiration date on the carton. Talk to your pharmacist about the proper disposal of your medication.

What should I do in case of OVERDOSE?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests before and during treatment to check your body's response to anakinra.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

AHFS® Consumer Medication Information. © Copyright, The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Last Reviewed: February 1, 2009.