Adalimumab

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Generic Name: Adalimumab Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: N

Uses

What is Adalimumab used for?

Adalimumab is used to reduce pain and swelling due to certain types of arthritis (such as rheumatoid, psoriatic, juvenile idiopathic, ankylosing spondylitis). This medication is also used to treat certain skin disorders (such as plaque-type psoriasis, hidradenitis suppurativa). It works by blocking a protein (tumor necrosis factor or TNF) found in the body’s immune system that causes joint swelling and damage in arthritis as well as red scaly patches in psoriasis. Adalimumab belongs to a class of drugs known as TNF blockers. By reducing joint swelling, this medication helps to reduce further joint damage and preserve joint function.

Adalimumab is also used to treat certain bowel conditions (Crohn’s disease, ulcerative colitis) and a certain eye disease (uveitis).

How should I take Adalimumab?

If you are using this medication at home, learn all preparation and usage instructions from your health care professional and the product package.

Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Do not shake this product.

If you are removing this medication from the refrigerator, leave it at room temperature for 15 to 30 minutes before injecting. Do not warm up this medication any other way such as by heating in the microwave or placing in hot water.

Use this medication exactly as prescribed. Inject this medication under the skin on the thigh or abdomen as directed by your doctor, usually every other week or once a week in some cases. If you are using this medication to treat psoriasis, hidradenitis suppurativa, Crohn’s disease, ulcerative colitis, or uveitis, your doctor may prescribe a different schedule/higher dose at the start of your treatment. Carefully follow your doctor’s directions for using this medication.

Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin. New injections should be given at least 2.5 centimeter from an old site. Do not inject into any areas of the skin that are sore, bruised, red, or hard.

The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight.

Use this medication regularly to get the most benefit from it. To help you remember, mark the day on the calendar when you need to receive this medication. Do not increase your dose or use this drug more often or for longer than prescribed.

How do I store Adalimumab?

Adalimumab is best stored in the refrigerator. To prevent drug damage, do not freeze. There may be different brands of Adalimumab that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Adalimumab down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Adalimumab?

Before using adalimumab, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as natural rubber/latex), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: current/recent/repeated infections (such as hepatitis B, TB infection, histoplasmosis), blood/bone marrow problems (such as low red/white blood cells and platelets), seizures, certain brain/nerve disorders (such as multiple sclerosis, Guillain-Barre syndrome), cancer, heart disease (especially heart failure), lupus.

Adalimumab can make you more likely to get infections or may worsen any current infections. Wash your hands well to prevent the spread of infection. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.

Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be at greater risk for infections while using this drug.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Adalimumab during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Adalimumab. Adalimumab is pregnancy risk category N according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Adalimumab?

Redness, itching, pain, or swelling at the injection site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you develop signs of infection while using this drug, such as: sore throat that doesn’t go away, cough that doesn’t go away, fever, chills, night sweats, trouble breathing, painful or frequent urination, unusual vaginal discharge, white patches in the mouth (oral thrush).

Tell your doctor right away if you have any serious side effects, including: fast/irregular/pounding heartbeat, new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), blood in the stools, mental/mood changes, severe headache, easy bruising or bleeding, leg pain or swelling, numbness or tingling of the arms/hands/legs/feet, unsteadiness, unexplained muscle weakness, difficulty with speaking/chewing/swallowing/facial movements, vision changes, joint pain, butterfly-shaped rash on the nose and cheeks.

Adalimumab may rarely cause serious (possibly fatal) liver disease in people exposed to hepatitis B virus. Your doctor may order blood tests and watch for symptoms during treatment and for several months after your last treatment. Get medical help right away if you have any symptoms of liver damage, including: nausea/vomiting that doesn’t stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine.

Get medical help right away if you have any very serious side effects, including: seizures, chest pain.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Adalimumab?

Some products that may interact with this drug include: other TNF blockers (such as etanercept, infliximab), other drugs that weaken the immune system (such as abatacept, anakinra).

Adalimumab may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Adalimumab?

Adalimumab may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Adalimumab?

Adalimumab may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Adalimumab.

What is the dose of Adalimumab for an adult?

Usual Adult Dose for Rheumatoid Arthritis

40 mg subcutaneously every other week; some patients with RA not taking concomitant methotrexate may benefit from increasing the frequency to 40 mg every week

Usual Adult Dose for Ankylosing Spondylitis

40 mg subcutaneously every other week

Usual Adult Dose for Psoriatic Arthritis

40 mg subcutaneously every other week

Usual Adult Dose for Crohn’s Disease – Acute

-Initial dose: 160 mg subcutaneously on Day 1, followed by 80 mg subcutaneously 2 weeks later (Day 15)

-Maintenance dose: Starting 2 weeks later (Day 29): 40 mg subcutaneously every other week

Usual Adult Dose for Crohn’s Disease – Maintenance

-Initial dose: 160 mg subcutaneously on Day 1, followed by 80 mg subcutaneously 2 weeks later (Day 15)

-Maintenance dose: Starting 2 weeks later (Day 29): 40 mg subcutaneously every other week

Usual Adult Dose for Plaque Psoriasis

80 mg subcutaneously once, followed by 40 mg subcutaneously every other week, starting one week after the initial dose

Usual Adult Dose for Uveitis

80 mg subcutaneously once, followed by 40 mg subcutaneously every other week, starting one week after the initial dose

Usual Adult Dose for Hidradenitis Suppurativa

-Initial dose: 160 mg subcutaneously on Day 1 (given in one day or split over 2 consecutive days) followed by 80 mg subcutaneously 2 weeks later (Day 15)

-Maintenance dose (starting Day 29 and subsequent doses): 40 mg subcutaneously every week

What is the dose of Adalimumab for a child?

Usual Pediatric Dose for Juvenile Idiopathic Arthritis

2 years and older:

10 kg to less than 15 kg: 10 mg subcutaneously every other week

15 kg to less than 30 kg: 20 mg subcutaneously every other week

30 kg or greater: 40 mg subcutaneously every other week

Safety and efficacy has not been established patients with polyarticular JIA less than 2 years or with a weight less than 10 kg.

Usual Pediatric Dose for Crohn’s Disease – Acute

6 years and older:

17 kg to less than 40 kg: 80 mg subcutaneously on Day 1, followed by 40 mg subcutaneously 2 weeks later (Day 15), then 20 mg subcutaneously every other week

40 kg or greater: 160 mg subcutaneously on Day 1, followed by 80 mg subcutaneously 2 weeks later (Day 15), then 40 mg subcutaneously every other week

Safety and efficacy has not been established pediatric patients with CD less than 6 years or less than 17 kg.

Usual Pediatric Dose for Crohn’s Disease – Maintenance

6 years and older:

17 kg to less than 40 kg: 80 mg subcutaneously on Day 1, followed by 40 mg subcutaneously 2 weeks later (Day 15), then 20 mg subcutaneously every other week

40 kg or greater: 160 mg subcutaneously on Day 1, followed by 80 mg subcutaneously 2 weeks later (Day 15), then 40 mg subcutaneously every other week

Safety and efficacy has not been established pediatric patients with CD less than 6 years or less than 17 kg.

How is Adalimumab available?

Adalimumab is available in the following dosage forms and strengths:

  • Subcutaneous kit.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Adalimumab, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 13, 2018 | Last Modified: November 13, 2018

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