Adult

Tocilizumab for in-patients

General Information

Drug class: Monoclonal antibody (Anti IL-6)

Restricted:  For patient with COVID-19 infection requiring oxygen and receiving corticosteroids. Patients should have no evidence of bacterial or viral infection (other than COVID-19). See Oxygen requirement for in-patient with COVID-19 pneumonia

Tocilizumab can be initiated by all consultants in acute general medicine areas, infectious diseases, respiratory HDU and Critical Care.

The first line tocilizumab product for the trust is Tyenne©. Prescribe Tyenne© on EPR.

A Blueteq form must be completed. This should be completed by clinical team or Micro/ID. This can be completed retrospectively. When completing the BlueTeq form, select the Tocilizumab (Tyenne©) option.

Refer to the Summary of Product Characteristics (SmPC) for tocilizumab for special warnings and precautions for use, although some may not be relevant for use in the acute setting, as the licensed indications address long-term use. 

Dosage

Standard Dose

  • The recommended dose is 8mg/kg STAT iv (use actual body weight). The maximum dose is 800mg.

Dosing in obesity

  • For individuals whose body weight is more than 100 kg, doses exceeding 800 mg per infusion are not recommended.

Renal Impairment

  • No dose adjustment required. Monitor renal function regularly post dose.

Use in hepatic impairment

  • Caution should be exercised when considering tocilizumab treatment in patients with elevated ALT or AST more than 1.5 x Upper Limit of Normal (ULN).
  • Not recommended for use if liver enzymes are 10 or more x ULN.

Interactions

A useful resource is University of Liverpool COVID-19 Drug Interactions website

Also use the BNF or Summary of Product Characteristics or speak to a pharmacist.

Avoid concurrent use with live vaccines and live attenuated vaccines. Live and live attenuated vaccines should also be avoided for 1 year after use of tocilizumab. Discuss with Micro/ID.

This is not a complete list. Please see the BNF, summary of product characteristics or speak to a pharmacist.

Contraception, pregnancy or breastfeeding

See BNF and Summary of Product Characteristics

A useful additional resource for Breastfeeding is Specialist Pharmacy Services: Managing COVID-19 and breastfeeding – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice

Additional information

  • Tocilizumab is not recommended in patients with COVID-19 where:
    • Absolute Neutrophil Count less than 1x109/L
    • Platelet Count less than 50x103/uL
  • The name and batch number of the administered product should be recorded for traceability of biological medicinal products.
  • Ensure that discharge letters to primary care, and other handovers between care settings, explicitly record the treatment that has been given, together with the dose and date of administration.

References

  1. Fresenius Kabi Ltd. Tyenne 20mg/ml concentrate for solution for infusion summary of product characteristics. Electronic Medicines Compendium. Last revision of the text 5/3/26  Available from: https://www.medicines.org.uk/emc Accessed 14/8/26
  2. National Institute for Health and Care Excellence. Nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19 (TA878) Available from: https://www.nice.org.uk/guidance/ta878 Accessed 14/8/26
  3. University of Liverpool. Covid-19 Drug Interactions [Internet]. 2026 [cited 2026 April 29].Available from: https://www.covid19-druginteractions.org/checker Accessed 14/8/26

Editorial Information

Last reviewed: 11 Sept 2026

Next review date: 20 Sept 2029

Author(s): AMST.