In this section : Covid-19
Molnupiravir
Sotrovimab
Conscious Proning
Covid-19 Basics
Remdesivir
Thromboprophylaxis
Identifying Patients in the Highest Risk Groups
Steroids for Patients with Covid-19 Infection
IL-6 Inhibitors – Tocilizumab or Sarilumab
Baricitinib
Paxlovid (Nirmatrelvir/Ritonavir)
Covid-19 Sick Day Rules for Patients with Primary Adrenal Insufficiency
IL-6 Inhibitors – Tocilizumab or Sarilumab
Last updated 18th July 2024
Please ensure you have read the information on the Covid-19 Basics page before proceeding.
Please note caution in use if on other immunosuppression or if there is a likelihood of severe co-existing bacterial infection.
Tocilizumab is recommended for inpatients with COVID pneumonia who meet the following criteria:
- New or increased oxygen requirement of any kind, due to Covid-19 infection
- On systemic corticosteroids
- Platelets > 50 x 109/L
- Baseline ALT or AST < 5 x upper limit of normal
- Neutrophils > 1 x 109/L
- Patient has NOT received either tocilizumab or sarilumab during this episode
Prescribers must discuss with ward pharmacist before prescribing. Discuss with relevant consultant also if there is a likelihood of severe co-existing bacterial infection.
Dose
- Tocilizumab (preferred option) – dose is 8mg/kg as a single dose up to maximum of 800mg.
- If insufficient supply of tocilizumab, prescribers may consider sarilumab but note this is not licensed. Dose is 400mg as a single dose. Platelets must be >150 x 109/L.
Availability
- Available from pharmacy during usual opening hours (0900 – 1700) or can be obtained urgently up until 2200 hours if necessary by contacting the on-call pharmacist.
Links
- NICE NG191 – COVID-19 rapid guideline: managing COVID-19
- SEHD Covid Therapeutic Alert 2023 1 – Publication of NICE Multiple Technology Appraisal (MTA) – Treatment Recommendations for Covid 19
- NICE TA878 – Nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19
Content by Alison Moore