Adalimumab Injection

What is this medication?

ADALIMUMAB (ay da LIM yoo mab) is used to treat rheumatoid and psoriatic arthritis. It is also used to treat ankylosing spondylitis, Crohn's disease, ulcerative colitis, plaque psoriasis, hidradenitis suppurativa, and uveitis.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): CYLTEZO, Humira

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• cancer
• diabetes (high blood sugar)
• having surgery
• heart disease
• hepatitis B
• immune system problems
• infections, such as tuberculosis (TB) or other bacterial, fungal, or viral infections
• multiple sclerosis
• recent or upcoming vaccine
• an unusual reaction to adalimumab, mannitol, latex, rubber, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

This medicine is for injection under the skin. You will be taught how to prepare and give it. Take it as directed on the prescription label. Keep taking it unless your health care provider tells you to stop.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or health care provider to get one.

This medicine comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medicine. Read the information carefully. Talk to your pharmacist or health care provider if you have questions.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 2 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. It is important not to miss any doses. Talk to your health care provider about what to do if you miss a dose.

What may interact with this medication?

Do not take this medicine with any of the following medications:

• abatacept
• anakinra
• biologic medicines such as certolizumab, etanercept, golimumab, infliximab
• live virus vaccines

This medicine may also interact with the following medications:

• cyclosporine
• theophylline
• vaccines
• warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your health care provider for regular checks on your progress. Tell your health care provider if your symptoms do not start to get better or if they get worse.

You will be tested for tuberculosis (TB) before you start this medicine. If your doctor prescribes any medicine for TB, you should start taking the TB medicine before starting this medicine. Make sure to finish the full course of TB medicine.

This medicine may increase your risk of getting an infection. Call your health care provider for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.

Talk to your health care provider about your risk of cancer. You may be more at risk for certain types of cancer if you take this medicine.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• changes in vision
• chest pain
• dizziness
• heart failure (trouble breathing; fast, irregular heartbeat; sudden weight gain; swelling of the ankles, feet, hands; unusually weak or tired)
• infection (fever, chills, cough, sore throat, pain or trouble passing urine)
• liver injury (dark yellow or brown urine; general ill feeling or flu-like symptoms; loss of appetite, right upper belly pain; unusually weak or tired, yellowing of the eyes or skin)
• lump or swollen lymph nodes on the neck, groin, or underarm area
• muscle weakness
• pain, tingling, numbness in the hands or feet
• red, scaly patches or raised bumps on the skin
• trouble breathing
• unusual bleeding or bruising
• unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• headache
• nausea
• pain, redness, or irritation at site where injected
• stuffy or runny nose

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store in the refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Do not freeze. Keep this medicine in the original packaging until you are ready to take it. Protect from light. Get rid of any unused medicine after the expiration date.

This medicine may be stored at room temperature for up to 14 days. Keep this medicine in the original packaging. Protect from light. If it is stored at room temperature, get rid of any unused medicine after 14 days or after it expires, whichever is first.

To get rid of medicines that are no longer needed or have expired:

• Take the medicine to a medicine take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medicine, ask your pharmacist or health care provider how to get rid of this medicine safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What is Humira used for?

Humira® is the original version of adalimumab. The U.S. Food and Drug Administration (FDA) approved the use of Humira to relieve the symptoms of certain autoimmune diseases, including:

• Rheumatoid arthritis (RA) in adults. RA is a condition in which your immune system attacks the tissues lining your joints, causing pain and swelling.
• Juvenile idiopathic arthritis (JIA) in children ages 2 and older. JIA is a condition in which your child’s immune system attacks the tissues lining their joints, causing pain, swelling, and growth and developmental delays.
• Crohn‘s disease in adults and children ages 6 and older. Crohn’s is a condition in which your body attacks the lining of your digestive tract, causing diarrhea, abdominal pain, rectal bleeding and weight loss.
• Ulcerative colitis in adults and children ages 5 and older. Ulcerative colitis is an inflammatory condition that starts in your rectum and may spread to your colon, causing abdominal pain, weight loss and diarrhea with or without blood.
• Ankylosing spondylitis in adults. Ankylosing spondylitis is a condition in which your body attacks your spinal joints, causing low back pain.
• Psoriatic arthritis in adults. Psoriatic arthritis is a type of inflammatory arthritis that causes joint pain, swelling, morning stiffness and scaly skin.
• Hidradenitis suppurativa in adults and children ages 12 and older. Hidradenitis suppurativa is a condition that attacks hair follicles in areas with sweat glands, causing pimple-like bumps and scarring.
• Uveitis in adults and children ages 2 and older. Uveitis is a condition that causes redness, pain and inflammation of different areas of your eyes.
• Plaque psoriasis in adults. Plaque psoriasis is a chronic skin condition that causes red, scaly patches to form on your body, including your scalp.

How does Humira work?

Autoimmune diseases cause your immune system to attack healthy cells in your body instead of protecting them. When this occurs, your body overproduces a protein called tumor necrosis factor (TNF). Your body naturally produces TNF, but when it produces too much of it, it can lead to inflammation and the other symptoms of autoimmune diseases.

Humira is in a class of medications called tumor necrosis factor (TNF) blockers or inhibitors. It works by attaching to TNF-alpha and blocking the protein from attaching to its receptor, preventing it from attacking healthy cells and causing an inflammatory response. This reduces the inflammation and other effects of the TNF-alpha on healthy cells.

How long does it take for Humira to work?

It depends on certain factors, including which health condition you’re treating with the medication. Some people may start to see benefits in as little as two weeks after starting the medication. Most people may not see any noticeable effects for three months or more.

If you’re taking Humira for rheumatoid arthritis or psoriatic arthritis, your symptoms may start to improve within two to four weeks. You may not notice the full effect of the medication for up to three months.

If you’re taking the medication for conditions such as Crohn’s disease or ulcerative colitis, you may begin to see results within four weeks, but most people see an improvement of their symptoms within eight weeks.

Does Humira cause hair loss?

During the clinical trials for Humira, study participants didn’t report hair loss (alopecia) as a side effect. But after the FDA approved the drug, some people reported experiencing hair loss after taking the medication.

One small study found that people experienced different types of hair loss after taking a TNF blocker. These people reported losing small patches of hair while taking the medication. But they often recovered after they stopped taking the TNF blocker.

Due to the limited data that came out after the Humira trials, healthcare providers are uncertain if the medication causes hair loss. If you’re concerned about this side effect, speak with your provider.

A note from Cleveland Clinic

Humira has been shown to alleviate the symptoms of many different autoimmune conditions. It works by binding itself to tumor necrosis factor (TNF) proteins released by your immune system. If your healthcare provider has suggested the use of Humira, they’ve weighed the benefits against the risks and found that it may be a good option for you. Speak with your provider if you have any questions.

Note: Intro and FAQ sections written and reviewed by Cleveland Clinic professionals.