WARNING

Adalimumab, commonly known by its brand name Humira, is a medication used to treat a variety of autoimmune conditions, such as rheumatoid arthritis, Crohn’s disease, and psoriasis. It works by inhibiting tumor necrosis factor-alpha (TNF-alpha), a substance in the body that contributes to inflammation. While adalimumab can be very effective, it does carry some risks and potential side effects. Here’s a detailed look at them:

• Infections: Adalimumab can suppress the immune system, making you more susceptible to infections. Common infections include upper respiratory tract infections, sinusitis, and urinary tract infections. More serious infections like tuberculosis (TB), bacterial, fungal, or viral infections can also occur.
• Allergic Reactions: Some people may experience allergic reactions to adalimumab. These can range from mild symptoms like rash or itching to severe reactions such as anaphylaxis, which is a medical emergency.
• Injection Site Reactions: Local reactions at the site of the injection are common. These can include redness, swelling, pain, or itching. These are usually mild and resolve on their own.
• Autoimmune Reactions: Rarely, adalimumab can trigger or worsen autoimmune conditions. This could include conditions like lupus-like syndrome or worsening of pre-existing autoimmune diseases.
• Liver Issues: Adalimumab can affect liver function, causing liver enzyme levels to rise. It is important to monitor liver function through regular blood tests.
• Blood Disorders: There is a risk of developing blood disorders, such as anemia, leukopenia (low white blood cell count), or thrombocytopenia (low platelet count). Regular blood monitoring may be required.
• Heart Failure: In patients with heart failure, adalimumab can potentially worsen the condition. It should be used with caution in individuals with a history of heart failure.
• Cancer Risk: Long-term use of TNF inhibitors like adalimumab has been associated with an increased risk of certain cancers, such as lymphomas and other malignancies. The overall risk is still considered to be low, but it is something to be aware of.
• Neurological Effects: Some individuals may experience neurological issues, such as seizures or demyelinating diseases (e.g., multiple sclerosis).
• Gastrointestinal Issues: There can be gastrointestinal side effects such as nausea, vomiting, and abdominal pain. In rare cases, there may be an increased risk of developing or worsening gastrointestinal conditions.
• Screen for TB: Before starting adalimumab, patients should be screened for tuberculosis (TB). Treatment for latent TB should be completed before beginning adalimumab.
• Regular Monitoring: Regular follow-up with your healthcare provider is necessary to monitor for side effects and assess the medication’s effectiveness.

While adalimumab can be very effective in managing autoimmune conditions, it’s important to weigh these risks against the potential benefits. Always discuss any concerns and possible side effects with your healthcare provider, who can provide personalized advice based on your health history and condition.

Why is this medication prescribed?

Adalimumab, commonly known by the brand name Humira, is prescribed for various conditions, mainly because it is a type of biologic medication that targets specific components of the immune system. It works by blocking tumor necrosis factor-alpha (TNF-alpha), a protein involved in inflammation. Here are some conditions for which it might be prescribed:

• Rheumatoid Arthritis: To reduce inflammation and slow disease progression.
• Psoriasis: To manage symptoms and improve skin appearance.
• Crohn’s Disease: To reduce inflammation and manage symptoms in the digestive tract.
• Ulcerative Colitis: For managing inflammation in the colon.
• Ankylosing Spondylitis: To relieve pain and stiffness in the spine.
• Juvenile Idiopathic Arthritis: For children with certain forms of arthritis.

It’s used when other treatments haven’t been effective or are not suitable.

How should this medicine be used?

Adalimumab is usually administered via subcutaneous injection. Here’s a general guide on how it’s used:

• Preparation: Wash your hands thoroughly before handling the medication. If you have multiple doses, ensure each injection is given at a different site to avoid irritation.
• Injection Site: Common sites include the abdomen (except the area around the navel) and the thighs. Avoid injecting into areas where the skin is bruised, tender, or scarred.
• Procedure:
  • Let the medication warm to room temperature for about 30 minutes before injecting (but do not warm it in any other way, like in a microwave).
  • Clean the injection site with an alcohol swab and let it dry.
  • Use the prefilled syringe or pen according to the instructions provided with your medication.
  • Insert the needle into the skin at a 45-degree angle (or as instructed) and push the plunger to inject the medication.
  • After the injection, remove the needle and dispose of it properly (usually in a sharps container).
• Frequency: The frequency of injections depends on the condition being treated. It might be once every two weeks or every four weeks, but follow your healthcare provider’s specific instructions.
• Storage: Store the medication in the refrigerator and not in the freezer. It should be kept in its original packaging until ready for use.

Always follow the instructions provided by your healthcare provider and the medication’s prescribing information. If you have any doubts or experience side effects, contact your healthcare provider for guidance.

Other uses for this medicine

Adalimumab has several uses beyond those I mentioned earlier, including:

• Hidradenitis Suppurativa: A chronic skin condition causing painful bumps under the skin.
• Uveitis: Inflammation of the uvea (middle layer of the eye).
• Sarcoidosis: An inflammatory disease that can affect multiple organs.
• Polyarticular Juvenile Idiopathic Arthritis: For children with this form of arthritis.

What special precautions should I follow?

When using Adalimumab, consider these precautions:

• Infections: Adalimumab can increase the risk of infections. Inform your healthcare provider if you have any current or past infections. Screen for tuberculosis (TB) before starting treatment.
• Allergic Reactions: Watch for signs of severe allergic reactions, such as rash, itching, swelling, or difficulty breathing. Seek medical attention immediately if these occur.
• Vaccinations: Avoid live vaccines while on Adalimumab, as it may weaken the immune response. Consult your healthcare provider about any vaccinations.
• Chronic Conditions: Inform your healthcare provider if you have chronic conditions such as heart disease, liver problems, or cancer, as these may affect how you respond to the medication.
• Pregnancy and Breastfeeding: Discuss with your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. Adalimumab may affect pregnancy and breastfeeding.
• Injection Site Reactions: Rotate injection sites to prevent irritation. Watch for reactions like redness or swelling at the injection site.
• Monitoring: Regular monitoring by your healthcare provider is important to assess the effectiveness and detect any potential side effects.

Always follow your healthcare provider’s instructions and report any unusual symptoms or concerns promptly.

What special dietary instructions should I follow?

Adalimumab does not generally require specific dietary restrictions. However, maintaining a balanced diet and staying hydrated can support overall health and potentially improve your response to treatment. If you have any specific dietary concerns or restrictions, it’s a good idea to discuss them with your healthcare provider or a dietitian.

What should I do if I forget a dose?

• Timing: If you miss a dose, administer it as soon as you remember.
• If Close to Next Dose: If the time is near for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double up to make up for a missed dose.
• Notify Your Healthcare Provider: Inform your healthcare provider about the missed dose. They can provide specific guidance on how to proceed.

What side effects can this medication cause?

Adalimumab can cause various side effects, though not everyone will experience them. Here are some potential side effects:

Common Side Effects:

• Injection Site Reactions: Redness, swelling, pain, or itching at the injection site.
• Headache: A common issue reported by some users.
• Upper Respiratory Infections: Symptoms like sore throat, sinusitis, or cough.

Less Common but Serious Side Effects:

• Infections: Risk of serious infections like tuberculosis, bacterial, fungal, or viral infections.
• Allergic Reactions: Severe reactions including rash, itching, swelling, or difficulty breathing.
• Liver Problems: Symptoms like jaundice (yellowing of the skin or eyes), dark urine, or severe abdominal pain.
• Heart Problems: Symptoms such as chest pain or shortness of breath.
• Blood Disorders: Issues like low blood cell counts, which can cause symptoms like easy bruising or bleeding.
• Cancer: Rarely, it may be associated with an increased risk of certain cancers, such as lymphomas.
• Neurological Symptoms: Such as numbness, tingling, or vision problems.
• Autoimmune Disorders: In rare cases, new or worsening autoimmune conditions.

If you experience mild side effects, like minor injection site reactions or headaches, they may resolve on their own. However, consult your healthcare provider if they persist or worsen. Seek immediate medical attention if you experience severe side effects, such as symptoms of an allergic reaction, signs of infection, or any new or unusual symptoms.

Always report any side effects to your healthcare provider, who can provide guidance on managing them and determine if any adjustments to your treatment are needed.

What should I know about storage and disposal of this medication?

Storage of Adalimumab Injection:

• Refrigeration: Store Adalimumab in the refrigerator at 36°F to 46°F (2°C to 8°C). Do not freeze.
• Room Temperature: If needed, it can be stored at room temperature (up to 77°F or 25°C) for up to 14 days before use. Once it has been out of the refrigerator, do not return it.
• Protect from Light: Keep the medication in its original packaging to protect it from light.

Disposal of Adalimumab Injection:

• Sharps Container: Use a proper sharps container for disposing of used needles, syringes, or pens. Do not throw them in the household trash.
• Medication Disposal: Follow local regulations for disposing of unused or expired medications. Some areas have take-back programs or specific disposal instructions.

In case of emergency/overdose

• Contact Emergency Services: If you experience severe symptoms or an allergic reaction (such as difficulty breathing, swelling, or severe rash), seek immediate medical attention.
• Inform Health Providers: If you are in an emergency situation, inform medical personnel that you are taking Adalimumab
• Symptoms: While an overdose is unlikely, if you suspect an overdose or experience unusual symptoms, contact your healthcare provider or poison control center right away.
• Medical Guidance: Follow the instructions of your healthcare provider or emergency services for managing an overdose.

What other information should I know?

• Regular Follow-ups: Regular check-ups with your healthcare provider are essential to monitor your response to the medication and any potential side effects.
• Adherence: Take Adalimumab exactly as prescribed. Do not adjust your dose or frequency without consulting your healthcare provider.
• Other Medications: Inform your healthcare provider of all other medications, including over-the-counter drugs and supplements, as they may interact with Adalimumab:
• Disclose Information: Provide a complete medical history to your healthcare provider, including any history of infections, liver problems, or other significant conditions.
• Patient Information Leaflet: Read the leaflet provided with your medication for detailed information on usage, side effects, and storage.
• Support Services: Some manufacturers offer patient support services that can provide additional resources and assistance.

Always consult your healthcare provider for personalized advice and instructions related to your specific treatment plan.