Kevzara

What sarilumab is and how it works

Sarilumab is an interleukin-6 (IL-6) receptor blocker that reduces inflammation. It is indicated to treat adult patients with moderately to severely active rheumatoid arthritis after at least one disease-modifying antirheumatic drug (DMARD) has been tried and did not work well or could not be tolerated. (1) (2)

Kevzara is given as a self-administered subcutaneous injection every two weeks. Treatment requires screening for tuberculosis and monitoring of blood counts, liver enzymes, and lipids.

Mechanism of action: how sarilumab works

Sarilumab is classified as an interleukin-6 (IL-6) receptor blocker. (1) (2)

What sarilumab is used for

Before taking sarilumab

Do not take / not appropriate for

• Low neutrophil count (ANC below 2,000/mm³), low platelet count (below 150,000/mm³), or elevated liver enzymes (ALT or AST above 1.5 times the upper limit of normal) are reasons the prescribing clinician determines Kevzara should not be started. (all indications) (1)
• Concurrent use with other biologic DMARDs is avoided because of increased immunosuppression/infection risk — tell your prescriber about all biologic treatments so they can review this. (all indications) (2)
• An active serious infection is a reason a clinician should determine Kevzara is not appropriate to start. If a serious or opportunistic infection develops during treatment, the treating clinician decides whether treatment is held. (all indications) (2)

Tell your clinician about

• If you have a history of infections, tuberculosis, or a positive TB test.
• If you have liver problems, low blood cell counts, or a history of diverticulitis or gastrointestinal perforation.
• If you are pregnant, planning pregnancy, or breastfeeding.
• About all other medicines you take, especially warfarin, statins, oral contraceptives, theophylline, or antidepressants, as Kevzara may affect their levels.

How to take sarilumab

• Kevzara is injected under the skin once every two weeks. The usual starting dose is 200 mg, but your dose may be adjusted by your healthcare provider based on blood test results.
• You will receive training on how to self-inject. Follow all instructions provided by your healthcare provider.
• Any change to the dose, frequency, or duration of treatment is a decision for your prescriber.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician.

Missed dose

Missed-dose guidance was not available in the research sources for this draft. Contact your healthcare provider for instructions if a dose is missed.

Overdose

If you suspect an overdose, seek emergency medical attention.

Side effects

The most common adverse reactions (occurring in at least 3% of patients) include neutropenia, increased ALT, injection site erythema, and upper respiratory infections. Serious infections, including those that may lead to hospitalization or death, have been reported.

Serious warnings

Interactions

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Screen for active and latent tuberculosis; the treating clinician assesses the result and advises on TB treatment and Kevzara initiation.
• Check absolute neutrophil count (ANC), platelet count, and liver enzymes (ALT/AST). The prescribing clinician determines whether to start Kevzara based on these results (ANC <2,000/mm³, platelets <150,000/mm³, or ALT/AST >1.5 times ULN are reasons not to start).
• Assess for active or chronic infections.
• Evaluate baseline lipid levels.

During treatment

• Your prescriber reviews ANC, platelets, and liver enzymes regularly and, as clinician-directed by these thresholds, decides on holding, reducing, resuming, or discontinuing treatment: for neutropenia, your prescriber holds treatment at ANC 500-1000 (resuming at reduced dose) and your prescriber discontinues treatment if ANC is below 500; for thrombocytopenia, your prescriber holds treatment at platelets 50,000-100,000 (resuming at reduced dose) and your prescriber discontinues treatment if platelets are below 50,000 (confirmed on repeat testing); for liver enzyme elevations, your prescriber considers DMARD modification for >ULN to 3x ULN, holds and resumes at reduced dose for >3x to 5x ULN, and your prescriber discontinues treatment if liver enzymes exceed 5x ULN.
• The prescriber monitors for signs and symptoms of infection and decides whether to hold treatment if a serious infection develops.
• Assess lipid parameters 4-8 weeks after starting and then every 6 months.
• Re-evaluate the continued need for treatment periodically.

Storage

Storage instructions were not reviewed in this research pass. Follow storage directions on the product carton and your pharmacist's guidance.

Frequently asked questions

References

1. Kevzara DosageDrugs.com · United States · dated 2026-08-05 · accessed 2026-08-05 · source 1
2. Kevzara prescribing information (search-aggregated summary, primary FDA label PDF could not be text-extracted)Search-aggregated summary of Kevzara prescribing information (secondary sources including Drugs.com and label-derived snippets) · United States · dated 2026-08-05 · accessed 2026-08-05 · source 2
3. KEVZARA (SARILUMAB) INJECTION, SOLUTION [SANOFI-AVENTIS U.S. LLC] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
4. Sarilumab Injection — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
5. KEVZARA — FDA approval record (Drugs@FDA BLA761037)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
6. sarilumab — RxNorm normalized drug concept (RXCUI 1923319)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6

Brand names by country

Single-ingredient sarilumab names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries