What is Anakinra (Kineret)? 

Anakinra reduces the actions of chemicals in the body that are involved in inflammatory and immune responses. 

Anakinra is used to treat the symptoms of moderate to severe rheumatoid arthritis in patients who have had an inadequate response to one  or more antirheumatic drugs. Anakinra may be used  in combination with other antirheumatic medications. 

Anakinra may also be used for purposes other than those listed  in this medication guide. 

What are  the possible side effects  of anakinra (Kineret)? 

If you experience an allergic reaction (difficulty breathing; closing of the throat; swelling of your lips, tongue, or face; or hives), stop using anakinra, and seek emergency medical attention. 

In rare cases, people receiving anakinra have developed serious infections. Notify your doctor immediately if you develop a fever, flu-like symptoms, or any other sign of infection. 

Other less serious side effects may  be more likely to occur. Continue to use anakinra and notify your doctor if you experience 

• nausea or diarrhea; 
• a headache; 
• sinus irritation or infection; or 
• redness, bruising, pain, or swelling at the injection site. 

Side effects other than those listed here may also occur. Talk  to your doctor about any side effect that seems unusual or that  is especially bothersome. 

What should I discuss with my healthcare provider before using anakinra (Kineret)? 

In rare cases, people receiving anakinra have developed serious infections. Notify your doctor immediately if you develop a fever, flu-like symptoms, or any other sign  of infection. Treatment with anakinra should not be started  in patients with active infections or those taking other medicines that may suppress  the immune system. The use of anakinra  in combination with etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), or other medicines used to treat rheumatoid arthritis, may also increase  the risk  of a serious infection. 

Do NOT use anakinra without first talking  to your doctor if you
are currently taking etanercept (Enbrel), infliximab (Remicade),  or adalimumab (Humira)  to treat rheumatoid arthritis; 

• have an active infection or a history  of recurrent infection; 
• have recently been exposed to varicella (chickenpox) virus; 
• have a bone marrow disease; 
• have a suppressed immune system due to a medical condition or treatment with medication; 
• have recently received a live vaccine; or 
• have kidney disease. 

You may  not be able  to use anakinra, or you may require  a dosage adjustment or special monitoring during treatment. 

Anakinra is in the FDA pregnancy category B. This means that  it is not expected to harm an unborn baby.  Do not use anakinra without first talking to your doctor  if you are pregnant  or could become pregnant during treatment. 

It is not known whether anakinra passes into breast milk. Do not use anakinra without first talking to your doctor  if you are breast-feeding a baby. 

The safety and effectiveness of anakinra have not been established for pediatric patients. 

How should I use  anakinra (Kineret)? 

Use anakinra exactly as directed by your doctor.  If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you. 

Anakinra  is used as a subcutaneous (under the skin) injection only. Your doctor or nurse will give  you detailed instructions on how and where to inject anakinra. Do not inject this medication if you are unsure how. 

Anakinra is usually injected once a day. The dose should be injected at approximately  the same time every day. 

The medication may be allowed to reach room temperature by removing  it from the refrigerator about 60 to 90 minutes before administration. This may reduce discomfort during or following the injection. 

The medication  can be injected into the outer thighs, stomach,  back of the upper arms,  or buttocks. Rotate the injection site daily to  reduce the possibility of soreness or redness. The area of the body being injected does  not need to change daily, however each  injection site should be at least one inch from the previous day's injection site. 

Do not inject anakinra if it is discolored, cloudy, or if it has particles in it. Do not shake  the prefilled syringe and do not  use anakinra beyond the expiration date shown on  the carton. If  the solution appears foamy, allow it  to sit for a few minutes until it clears.  This medication does not contain  a preservative. Therefore, throw away any medication remaining in  the syringe after a dose.  Do not save the medication for later use.

Never reuse a needle or syringe. Dispose of all needles and syringes  in an appropriate, puncture-resistant disposal container. 

Your doctor may want  you to have blood tests or  other medical evaluations during treatment with anakinra  to monitor progress and side effects. 

Anakinra should be used on  a regular basis to get the most benefit. 

Store anakinra in the refrigerator (36 to 46 degrees Fahrenheit/2 to 8 degrees Celsius) away from moisture, heat and light.  Do not allow anakinra  to freeze. 

What happens if I miss a dose (Kineret)? 

Notify  your healthcare provider if  you miss  a dose of this medication. 

What happens if I overdose (Kineret)? 

Serious or life-threatening side effects are unlikely to occur from an overdose  of anakinra. Contact  your doctor or seek medical attention if an overdose of anakinra is suspected.

What should I avoid while using anakinra (Kineret)? 

Anakinra has been associated with an increased incidence of infection. Avoid contact with people who have colds,  the flu, or other contagious illnesses e.g., varicella (chickenpox)  and others and  do not receive vaccines that contain live strains of  a virus (e.g., live oral polio vaccine) during treatment with anakinra. In addition, avoid contact with individuals who have recently been vaccinated with a live vaccine. There is a chance that  the virus can be passed on to you. 

What other drugs will affect anakinra (Kineret)? 

Do not receive "live" vaccines during treatment with anakinra without first talking to your doctor. Administration of  a live vaccine  may result in an inadequate immune response or infection. 

Before using anakinra, talk to  your doctor if you  are taking 

• etanercept (Enbrel); 
• infliximab (Remicade); 
• adalimumab (Humira); or 
• a medicine that may decrease  the effects of the immune system. 

You may  not be able to  use anakinra, or you may require  a dosage adjustment or special monitoring during treatment if you are taking  any of the medicines listed above. 

Drugs  other than those listed here may also interact  with anakinra. Talk to  your doctor and pharmacist  before taking any prescription or over-the-counter medicines, including herbal products. 

Where can I get more information? 

Your  pharmacist has more information about anakinra written for health professionals that  you may read.