AdultPediatricDosage Forms & Strengths prefilled syringes 100mg/0.67mL Rheumatoid Arthritis Indicated to reduce signs and symptoms, and slow structural damage progression in moderate-to-severe active rheumatoid arthritis in patients 18 years or older who have failed 1 or more disease modifying antirheumatic drugs (DMARDs) May use alone or in combo with DMARDs (not TNF-blocking agents) 100 mg SC qDay Cryopyrin-Associated Periodic Syndromes (CAPS) Indicated for treatment of Neonatal-Onset Multisystem Inflammatory Disease (NOMID), also known as chronic infantile neurologic cutaneous articular syndrome (CINCA) 1-2 mg/kg SC qDay (initially); may increase by 0.5-1 mg/kg increments to control active inflammation, not to exceed 8 mg/kg Once daily administration recommended; may be split into twice daily Deficiency of Interleukin-1 Receptor Antagonist Indicated for treatment of deficiency of interleukin-1 receptor antagonist (DIRA) 1-2 mg/kg SC qDay initially; may increase by 0.5- to 1-mg/kg increments to control active inflammation, not to exceed 8 mg/kg/day COVID-19 (EUA) November 9, 2023: Emergency use authorization (EUA) issued by the FDA for treatment of COVID-19 disease in hospitalized adults with positive results of direct SARS-CoV-2 viral testing with pneumonia requiring supplemental oxygen (low- or high-flow oxygen) who are at risk of progressing to severe respiratory failure and likely to have an elevated plasma soluble urokinase plasminogen activator receptor (suPAR) 100 mg SC qDay x 10 days Dosage Modifications Renal Impairment Mild-to-moderate (CrCl 30-80 mL/min): Mean plasma clearance was reduced by 16-50% Severe (CrCl <30 mL/min) or end-stage renal disease RA, CAPS, DIRA: Consider reducing frequency to every other day COVID-19: Consider reducing frequency to every other day for a total of 5 doses over 10 days Hepatic impairment Pharmacokinetic studies not conducted in this patient population Dosing Considerations Measure WBCs before initiating, then qMonth x3 months, then quarterly up to 1 year Still Disease (Orphan) Orphan designation for Still disease including systmic juvenile isiopathic arithritis and adult-onset Still disease Orphan sponsor Swedish Orphan Biovitrum AB, SE-112; 75 Stockholm Bronchiolitis Obliterans (Orphan) Orphan designation for treatment of bronchiolitis obliterans Orphan sponsor Onspira Therapeutics, Inc; 101 Lindenwood Drive, Suite 400; Malvern, PA Dosage Forms & Strengths prefilled syringes 100mg/0.67mL Cryopyrin-Associated Periodic Syndromes (CAPS) Indicated for treatment of Neonatal-Onset Multisystem Inflammatory Disease (NOMID), also known as chronic infantile neurologic cutaneous articular syndrome (CINCA) 1-2 mg/kg SC qDay (initially); may increase by 0.5-1 mg/kg increments to control active inflammation, not to exceed 8 mg/kg Once daily administration recommended; may be split into twice daily Rheumatoid Arthritis Safety and efficacy not established COVID-19 Safety and efficacy not established Renal Impairment CrCl <30 mL/min or ESRD: Consider every other day administration of prescribed dose Dosing Considerations Measure WBCs before initiating, then qMonth x3 months, then quarterly up to 1 year Still Disease (Orphan) Orphan designation for Still disease including systmic juvenile isiopathic arithritis and adult-onset Still disease Sponsor Swedish Orphan Biovitrum AB, SE-112; 75 Stockholm Interaction CheckerEnter a drug name and anakinraNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (2)lenalidomideanakinra increases toxicity of lenalidomide by Other (see comment). Contraindicated. Comment: Avoid concomitant use due to increased risk of infection.thalidomideanakinra increases toxicity of thalidomide by Other (see comment). Contraindicated. Comment: Avoid concomitant use due to increased risk of infection.Serious - Use Alternative (73)abataceptabatacept, anakinra. Mechanism: unspecified interaction mechanism. Contraindicated. Concomitant use not recommended (in mfr. info.).adalimumabadalimumab and anakinra both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.adenovirus types 4 and 7 live, oralanakinra decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy.alefaceptalefacept and anakinra both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.anthrax vaccineanakinra decreases effects of anthrax vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.antithymocyte globulin equineanakinra and antithymocyte globulin equine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.antithymocyte globulin rabbitanakinra and antithymocyte globulin rabbit both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.axicabtagene ciloleucelanakinra, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.azathioprineanakinra and azathioprine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.baricitinibbaricitinib, anakinra. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Baricitinib is not recommended in combination with other JAK inhibitors, biologic DMARDs, or potent immunosuppressives.basiliximabanakinra and basiliximab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.BCG vaccine liveanakinra decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.brexucabtagene autoleucelanakinra, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.canakinumabanakinra and canakinumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.certolizumab pegolanakinra and certolizumab pegol both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid combination because of an increased risk of serious infection.ciltacabtagene autoleucelanakinra, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.cyclosporineanakinra and cyclosporine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.diphtheria & tetanus toxoidsanakinra decreases effects of diphtheria & tetanus toxoids by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.diphtheria & tetanus toxoids/ acellular pertussis vaccineanakinra decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccineanakinra decreases effects of diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.etanerceptanakinra and etanercept both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.anakinra, etanercept. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive immunosuppression; risk of serious infection.everolimusanakinra and everolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.glatirameranakinra and glatiramer both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.golimumabanakinra and golimumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.hepatitis A vaccine inactivatedanakinra decreases effects of hepatitis A vaccine inactivated by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hepatitis a/b vaccineanakinra decreases effects of hepatitis a/b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hepatitis a/typhoid vaccineanakinra decreases effects of hepatitis a/typhoid vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hepatitis b vaccineanakinra decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.human papillomavirus vaccine, nonavalentanakinra decreases effects of human papillomavirus vaccine, nonavalent by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs, and corticosteroids (used in greater than physiologic doses), may reduce the immune responses to vaccines.human papillomavirus vaccine, quadrivalentanakinra decreases effects of human papillomavirus vaccine, quadrivalent by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs, and corticosteroids (used in greater than physiologic doses), may reduce the immune responses to vaccines.hydroxychloroquine sulfateanakinra and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.idecabtagene vicleucelanakinra, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.infliximabanakinra and infliximab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.influenza virus vaccine quadrivalentanakinra decreases effects of influenza virus vaccine quadrivalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.influenza virus vaccine quadrivalent, adjuvantedanakinra decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.influenza virus vaccine quadrivalent, cell-culturedanakinra decreases effects of influenza virus vaccine quadrivalent, cell-cultured by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.influenza virus vaccine quadrivalent, intranasalanakinra decreases effects of influenza virus vaccine quadrivalent, intranasal by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.influenza virus vaccine trivalentanakinra decreases effects of influenza virus vaccine trivalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.influenza virus vaccine trivalent, adjuvantedanakinra decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.Japanese encephalitis virus vaccineanakinra decreases effects of Japanese encephalitis virus vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.leflunomideanakinra and leflunomide both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.lisocabtagene maraleucelanakinra, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.measles (rubeola) vaccineanakinra decreases effects of measles (rubeola) vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.measles mumps and rubella vaccine, liveanakinra decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.measles, mumps, rubella and varicella vaccine, liveanakinra decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.meningococcal A C Y and W-135 polysaccharide vaccine combinedanakinra decreases effects of meningococcal A C Y and W-135 polysaccharide vaccine combined by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.muromonab CD3anakinra and muromonab CD3 both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.mycophenolateanakinra and mycophenolate both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.pneumococcal vaccine 13-valentanakinra decreases effects of pneumococcal vaccine 13-valent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.pneumococcal vaccine heptavalentanakinra decreases effects of pneumococcal vaccine heptavalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.pneumococcal vaccine polyvalentanakinra decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.procarbazineprocarbazine, anakinra. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.rabies vaccineanakinra decreases effects of rabies vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants may interfere with development of active immunity.rabies vaccine chick embryo cell derivedanakinra decreases effects of rabies vaccine chick embryo cell derived by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.rilonaceptanakinra and rilonacept both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.rotavirus oral vaccine, liveanakinra decreases effects of rotavirus oral vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.rubella vaccineanakinra decreases effects of rubella vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.sirolimusanakinra and sirolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.smallpox (vaccinia) vaccine, liveanakinra decreases effects of smallpox (vaccinia) vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tacrolimusanakinra and tacrolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.temsirolimusanakinra and temsirolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tetanus toxoid adsorbed or fluidanakinra decreases effects of tetanus toxoid adsorbed or fluid by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tick-borne encephalitis vaccineanakinra decreases effects of tick-borne encephalitis vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tisagenlecleucelanakinra, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.tongkat alianakinra and tongkat ali both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.travelers diarrhea and cholera vaccine inactivatedanakinra decreases effects of travelers diarrhea and cholera vaccine inactivated by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.typhoid polysaccharide vaccineanakinra decreases effects of typhoid polysaccharide vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.typhoid vaccine liveanakinra decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.upadacitinibanakinra, upadacitinib. Either increases effects of the other by immunosuppressive effects;