Anakinra (Subcutaneous)

Anakinra (Kineret) is a biologic drug that decreases inflammation, slows joint damage and reduces joint pain and swelling caused by rheumatoid arthritis and neonatal-onset multisystem inflammatory disease (NOMID).


Anakinra (Kineret) is a prescription biologic drug used to treat moderate to severe rheumatoid arthritis in adults and neonatal-onset multisystem inflammatory disease (NOMID), which is a severe form of cryopyrin-associated periodic syndrome (CAPS). CAPS are rare, inherited autoinflammatory diseases that include Familial Cold Autoinflammatory Syndrome (FCAS), Muckle-Wells Syndrome (MWS), Neonatal-Onset Multisystem Inflammatory Disease (NOMID) or Chronic Infantile Neurologic Cutaneous Articular Syndrome(CINCA). Anakinra is prescribed alone or with other drugs to manage the symptoms of rheumatoid arthritis when other drugs have been unsuccessful.

This medication can be taken as an injection and should be used in different approved areas of the body with each use. Other medical conditions can be aggravated when taking Anakinra. This is particularly true if you have allergies to E. coli-derived proteins or have tuberculosis.

Condition(s) treated

  • Rheumatoid Arthritis
  • Neonatal-Onset Multisystem Inflammatory Disease (NOMID)
  • Cryopyrin-Associated Periodic Syndrome (CAPS)

Type of medicine

  • Biologic

Side Effects

Patients taking Anakinra (Kineret) may experience common side effects like nausea and vomiting, stomach pains, muscle aches, and stiffness, bleeding, diarrhea, chills, and fever. There are other side effects that may occur as well. They include itching, pain, redness, swelling, tenderness or warmth on the skin. Patients may experience these common side effects, however they may subside after your body gets used to the medication. In some instances, medical attention may be required.

Some side effects that occur can be managed with instruction from your physician. Your physician may be able to suggest different ways to alleviate some of the side effects, while others may resolve on their own. In some situations, side effects that are not listed or well-known may occur. If this happens, contact your physician as soon as possible.

Generally, the side effects of taking Anakinra (Kineret) are minimal, if present at all. Anakinra is designed to relieve the symptoms associated with rheumatoid arthritis as well as NOMID and CAPS. Typically, this medication is prescribed because the benefits of taking the medication generally out-weigh any side effects.

There are circumstances where less common side effects, such as difficulty swallowing, hives, extreme itching, rash, or swelling of the face or lips, may occur. Even unusual bruising or bleeding, as well as extreme tiredness or weakness, require medical attention. You may experience side effects that aren't listed or seem unrelated. However, if any of these side effects occur, it's best to contact your physician. You can even report certain side effects to the FDA (1-800-FDA-1088).

There are circumstances where taking Anakinra (Kineret) may create side effects that exacerbate other medical conditions. If you suffer from kidney disease, this medication may require that your doctor change your dose. Active chronic long-term infections, cancer, and tuberculosis may be adversely affected by taking this medication as well. If you have inactive tuberculosis, Anakinra may cause it to become active again. This is why any pre-existing discussions should be discussed with your physician before taking Anakinra (Kineret).


Your physician will prescribe a dosage of Anakinra based upon your body weight, and the strength of the medicine, the number of doses you take each day, the time between doses, and the medical problem its prescribed for. The length of time your physician has you take the medication for will depend on the illness you are being treated for. The average dosage for the injection of Anakinra is 100 milligrams (mg) per day. For the treatment of NOMID, the starting dose is an injection of 1 to 2 milligrams (mg) per kilogram (kg) of body weight per day. It's not uncommon for your does to be increased as needed, however, the dose usually won't exceed more than 8mg per kg of body weight per day.

In the event of a missed dose, take it as soon as you remember. However, take it at your normal time if it's close to the time you usually take it. However, never double up on a dose to compensate for missing it.

Anakinra is administered through injection and must be administered in different areas of the body each time it's taken. Your physician will inform you of which areas of the body are recommended for injection. However, make sure that you are following the patient instructions on the proper way to administer this medication and do not deviate from the instructions. It's recommended that you keep track of where you administer your shots. This is important because it helps you to rotate where you're injecting the medicine to prevent skin problems. Never reuse a needle, even if there's medicine left in the syringe. Safely discard it in a hard container away from children and pets. In addition, pay attention to the way the medication in the syringe looks. If it's cloudy or filled with particles, discard it. A new needle with an unopened prefilled syringe or syringe should be used each time you inject your medicine. It's also recommended that you take the medication at the same time every day.

Anakinra is not used to treat juvenile rheumatoid arthritis in children. However, it is used to treat babies who have a neonatal-onset multisystem inflammatory disease (NOMID). There have been no significant studies to determine the effects of Anakinra on breastfeeding women. As a result, the risks will need to be considered before taking this drug. Animal studies haven't proven this drug to be unsafe for pregnant women but there haven't been in substantial studies conducted on pregnant women. If an overdose is suspected, call 911 or the poison control center (1-800-222-1222).

Major Drug Interactions

There are occasions when certain medicines shouldn't be used together. However, there are situations when different medicines may be used together, even if an interaction might occur. In situations like these, your doctor will probably make an adjustment to your dose or take other precautions. It is particularly important that you tell your doctor if you are taking any of the medicines listed below. Anakinra combined with the following medications has been known to create adverse reactions. As a result, the following interactions were chosen based on their significance.

  • Abatacept
  • Adalimumab
  • Certolizumab Pegol
  • Etanercept
  • Golimumab
  • Infliximab
  • Rilonacept
  • Humira
  • Certolizumab pegol/ (Cimzia®)
  • Etanercept (Enbrel®)
  • Golimumab (Simponi®)
  • Infliximab (Remicade®)

Even certain food shouldn't be taken with certain medications because of possible interactions. Of course, alcohol and tobacco shouldn't be combined with medications, because they may also cause certain drug interactions to occur. Talk to your doctor about the use of other medications, alcohol, and foods which may not be recommended for use with Anakinra.


If your doctor prescribes Anakinra for you to use for a prolonged period of time it is extremely important that he or she checks the progress of the medication during regular visits. A blood test may be required to make an accurate assessment. Certain pre-existing medical conditions warrant you telling your doctor because Anakinra can have an adverse effect on certain conditions. Tuberculosis is one such illness that is negatively impacted by the use of Anakinra. If you have ever had a positive reaction to a tuberculosis skin test your doctor should be informed. Even if you are prone to infection, have recurring infections, or heal slowly, these are all conditions that can be worsened by taking Anakinra and your doctor should know about this before you begin taking this medication.

It should be noted that taking Anakinra may predispose you to infections and allergic reactions. As a result, it's important that you notify a position at the onset of any unusual symptoms or infections. Anakinra has been known to cause severe allergic reactions as well as anaphylaxis when paired with certain medications. Anaphylaxis can be life-threatening and immediate medical attention should be sought if this occurs. Your doctor should also be notified if you develop a rash, itching, trouble breathing and swelling in the face, throat, legs, or feet. Chest pains require medical attention as well.

It is possible to experience other symptoms of physical discomfort that would require medical attention as well. There have been circumstances where Anakinra caused severe tenderness and pain at the site of the injection. Other adverse symptoms associated with the injection site include bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth. If you experience any of these symptoms, contact your physician right away.

Although Anaskinra has not been found to be harmful to elderly patients, caution should still be exercised. Anakinra may predispose elderly patients to serious infections and kidney problems, more often than younger patients. This may require that adjustments be made to the dose for geriatric patients. While taking this medication, you shouldn't take any live immunizations. In fact, Anakinra shouldn't be taken in conjunction with any other medications until they are cleared by your doctor. Some reactions to drugs can be so severe that they are deadly. This is why you should inform your physician before taking any other medication in conjunction with Anakinra. In addition, if you have any of the adverse reactions listed below see your doctor right away:

  • Rash
  • Itching
  • Trouble Breathing
  • Swelling in the face, throat, legs, or feet
  • Chest pains
  • Inability to fight infection
  • Anaphylaxis
  • Severe reactions at the injection site
  • Bleeding
  • Blistering
  • Burning
  • Coldness
  • Discoloration of the skin
  • The feeling of pressure
  • Hives
  • Inflammation
  • Itching
  • Lumps
  • Numbness
  • Pain
  • Rash
  • Redness
  • Scarring
  • Soreness
  • Stinging
  • Swelling
  • Tenderness
  • Tingling
  • Ulceration
  • Warmth


Your medication should be kept in the refrigerator, not the freezer. It should not be shaken and it should be protected from exposure to light. Ask your physician how to dispose of any needles and unused medicine. Your medication should also be kept in a manner that makes it inaccessible to children. In addition, don't keep or use outdated medicine or medicine that you no longer need. Following the proper safety practices when discarding and storing your medicine will help keep it away from children and ensure that it's safe to use.


Anakinra (Kineret) is a medicine that is used in conjunction with or in lieu of other medications that have been unsuccessful in treating rheumatoid arthritis in adults. Although this medication is not recommended for children with juvenile rheumatoid arthritis, it is used to treat infants inflicted with Neonatal-Onset Multisystem Inflammatory Disease (NOMID), a rare genetic disorder that often occurs as a result of Cryopyrin-Associated Periodic Syndrome (CAPS). The dosage is dependent on the individual and the strength of the medication. Your physician will determine the amount, the number of doses per day, and the duration that you should take the drug. If your physician prescribes this medication for long-term use, the results of the medication are usually monitored through routine doctor visits and a blood test is usually required to assess the efficacy of the drug. There haven't been many substantial human studies conducted on the impact of this drug on pregnant or breastfeeding women. The studies conducted on animals didn't produce results that would indicate harm to a fetus and studies conducted on geriatric patients revealed no significant harm to elderly people, although a predisposition to infection was noted as a possible reaction.

This biologic medication is effective because it has the ability to decrease inflammation, slow joint damage and reduce joint pain and swelling caused by rheumatoid arthritis and neonatal-onset multisystem inflammatory disease (NOMID). This helps with mobility and decreases pain. However, pre-existing health conditions and other medications can make taking this medication risky. As a result, it's important that you discuss any health conditions you may have with your doctor before taking this medication. Some medications don't complement Anakinra at all and shouldn't be taken in conjunction, while others just have to be monitored and adjusted when taken with Anakinra. It should be noted that certain health conditions are made worse by taking this medication. Tuberculosis is one such illness. If you have inactive tuberculosis it is possible for the medication to aggravate your condition enough to make it active again. Even if you have no pre-existing health conditions, it's important to note that taking this medication may reduce your body's ability to fight infection. As a result, you should pay attention to any side effects or reactions that you may begin to experience. Typically speaking, however, the benefits of taking Anakinra have proven to be substantial enough to outweigh the side effects. Generally, adjustments to the medication can be made to offset negative reactions when they occur. In addition, proper storage and disposal of your medication will ensure that your medication is safe to use and kept away from children who could be harmed by it.

Last Reviewed:
December 23, 2017
Last Updated:
April 04, 2018
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