When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to anakinra or to E coli-derived proteins.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
• A nurse or other health provider will give you this medicine. The medicine may also be given by a home health caregiver.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
• Use a new needle and syringe each time you inject your medicine.
• You might not use all of the medicine in each prefilled syringe. Use each syringe only 1 time. Do not save an open syringe. Do not use the medicine in the syringe if it has changed color or you see particles in it.
• Use your medicine at the same time each day.
• Missed dose: Call your doctor or pharmacist for instructions.
• If you store this medicine at home, keep it in the refrigerator. Do not freeze. Take the medicine out of the refrigerator 30 minutes before use. Do not shake the medicine.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine, containers, and other supplies. Throw away old medicine after the expiration date has passed.
• Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use anakinra with adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab.
• This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding or if you have kidney disease, cancer, tuberculosis (TB), a weak immune system, or any kind of infection. Tell your doctor if you have ever had an infection that would not go away or kept coming back.
• Tell your doctor if you or anyone in your home has ever had a positive reaction to a skin test for TB.
• This medicine may cause the following problems:
  
  • Increased risk for infections, including TB
  • Worsening of rheumatoid arthritis
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Fever, chills, cough, sore throat, and body aches
• Sores or white patches in your mouth or throat

If you notice these less serious side effects, talk with your doctor:

• Mild rash
• Muscle pain
• Nausea, vomiting, diarrhea
• Pain, redness, bruising, swelling, or irritation where the shot was given

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088