Abatacept, Injectable Solution

Abatacept is a prescription medication. It comes as an injectable solution that can be given in two ways:

• As a subcutaneous (under the skin) injection that comes in a prefilled syringe. Your doctor may allow you or a caregiver to give your injections of abatacept at home. Don’t try to inject it until you’ve been trained by your healthcare provider.
• As a powder that comes in a single-use vial for mixing into a solution for intravenous infusion. This form can not be given at home.

Abatacept is only available as the brand-name drug Orencia. There’s no generic form available.

Why it’s used

Abatacept is used to treat adult rheumatoid arthritis, juvenile idiopathic arthritis, and adult psoriatic arthritis.

How it works

Rheumatoid arthritis, juvenile idiopathic arthritis, and adult psoriatic arthritis cause your immune system to attack normal cells in your body. This can lead to joint damage, swelling, and pain. Abatacept can help keep your immune system working well. It can also help reduce swelling and pain, and it may prevent further damage to your bones and joints.

Abatacept injectable solution doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that can occur with abatacept include:

• headache
• upper respiratory tract infection
• sore throat
• nausea

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• New or worsened infections. These include respiratory infections and urinary tract infections. Symptoms of infection may include:
• fever
• tiredness
• cough
• flu-like symptoms
• warm, red, or painful skin
• Allergic reactions. Symptoms may include:
• hives
• swollen face, eyelids, lips, or tongue
• trouble breathing
• Cancer. Certain kinds of cancer have been reported in people using abatacept. It isn’t known if abatacept increases your risk of getting certain kinds of cancer.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Abatacept injectable solution can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with abatacept are listed below.

Biologics

You may have a higher chance of getting a serious infection if you take abatacept with other biologic drugs for your arthritis. Examples of these drugs include:

• infliximab
• etanercept
• adalimumab

Live vaccines

Don’t receive a live vaccine while taking abatacept and for at least 3 months after stopping the medication. The vaccine will not fully protect you from disease while taking abatacept. Examples of these vaccines include:

• nasal flu vaccine
• measles/mumps/rubella vaccine
• chickenpox (varicella) vaccine

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we can not guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue
• hives

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with infections: You have an increased chance of getting a serious infection when taking this drug. Tell your doctor if you have any kind of infection, even if it’s small (such as an open cut or sore), or an infection that’s in your whole body (such as the flu).

For people with tuberculosis: Tell your doctor if you’ve had the lung infection tuberculosis (TB) or a positive skin test result for TB, or if you’ve recently been in close contact with someone who’s had TB. Before you use this drug, your doctor may examine you for TB or do a skin test. Taking this drug if you have TB could worsen the TB and make it uncontrollable. This could result in death. Symptoms of TB can include:

• cough that doesn’t go away
• weight loss
• fever
• night sweats

For people with COPD: If you have chronic obstructive pulmonary disease (COPD), you may be at greater risk of worsening symptoms. These may include a flare-up of your disease, making it harder for you to breathe. Other side effects may include worsening cough or shortness of breath.

For people with hepatitis B virus infection: If you’re a carrier of the hepatitis B virus, the virus can become active while you use this drug. Your doctor may do blood tests before and during your drug treatment.

Warnings for other groups

For pregnant women: There are no good studies of abatacept use in pregnant women, so the risk to pregnant women isn’t known. If you’re pregnant or plan to become pregnant, talk to your doctor about whether you should use abatacept. This drug should only be used during pregnancy if the potential benefit justifies the potential risk.

There is a pregnancy exposure registry that monitors outcomes in women given abatacept during pregnancy. You can enroll in this registry by calling 1-877-311-8972. Your doctor can tell you more.

For women who are breastfeeding: It isn’t known if this drug passes through breast milk. If it does, it can cause serious negative effects to a child who is breastfed. Tell your doctor if you’re breastfeeding. You may need to decide whether to breastfeed or take this drug.

The following dosages are ranges for typical dosages only for the form of abatacept that you give to yourself under your skin (subcutaneously). Your treatment may also include abatacept that is given to you through a vein (intravenously) by your healthcare provider.

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Drug forms and strengths

Brand: Orencia

• Form: subcutaneous injection in an autoinjector
• Strength: 125 mg/mL solution

• Form: subcutaneous injection in a single-dose prefilled syringe
• Strengths: 50 mg/0.4 mL, 87.5 mg/0.7 mL, 125 mg/mL solution

Dosage for adult rheumatoid arthritis

Adult dosage (ages 18–64 years)

The typical dosage is 125 mg, injected once per week under your skin.

Child dosage (ages 0–17 years)

This drug is not used for this condition in children younger than 18 years.

Dosage for adult psoriatic arthritis

Adult dosage (ages 18–64 years)

The typical dosage is 125 mg, injected once per week under your skin.

Child dosage (ages 0–17 years)

This drug is not used for this condition in children younger than 18 years.

Dosage for juvenile idiopathic arthritis

Adult dosage (ages 18–64 years)

This drug is not used for this condition in adults.

Child dosage (ages 2–17 years)

Dosage is based on weight. It’s typically given once per week.

• For children who weigh 22 pounds (10 kg) to less than 55 pounds (25 kg): The typical dosage is 50 mg.
• For children who weigh 55 pounds (25 kg) to less than 110 pounds (50 kg): The typical dosage is 87.5 mg.
• For children who weigh more than or equal to 110 pounds (50 kg): The typical dosage is 125 mg.

Child dosage (ages 0–1 year)

Subcutaneous dosing has not been studied in children younger than 2 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Abatacept injectable solution is used for long-term treatment. It comes with risks if you don’t take it as prescribed.

If you don’t take it at all: If you don’t take this medication your symptoms won’t be controlled. You could have worse symptoms, such as bone or joint damage.

If you don’t take it on schedule: It’s important to keep on schedule to ensure that the medication has the same effect on your symptoms and condition. Not taking the medication on schedule could cause your condition and symptoms to get worse.

If you stop taking it: If you stop taking this medication, your condition and symptoms could get worse.

What to do if you miss a dose: This drug is given once per week. If you miss a dose, take it as soon as possible. If it’s almost time for your next dose, take only that dose. Don’t take double or extra doses.

How to tell if the drug is working: You should have less pain and inflammation, and you should be able to do your daily activities more easily.

Keep these considerations in mind if your doctor prescribes abatacept for you.

Storage

• Store this drug in the refrigerator.
• Keep it in temperatures ranging between 36°F (2°C) and 46°F (8°C). Don’t freeze this medication.
• Keep this drug in the original package. Store it away from light.
• Safely throw away any medication that’s out of date or no longer needed.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Carry prefilled syringes with you in your travel cooler at a temperature of 36°F (2°C) to 46°F (8°C) until you’re ready to use them.
• Don’t freeze this drug.
• Generally, you’re allowed to carry abatacept prefilled syringes with you on an airplane. Be sure to keep the prefilled syringes with you on the plane. Don’t put them in your checked luggage.
• Don’t worry about airport x-ray machines. They can’t harm your medication.
• Keep this drug in the original carton with its original preprinted labels.
• Your healthcare provider may know about special carrying cases for injectable medications.

Self-management

Your healthcare provider may allow you or a caregiver to give your injections of this drug at home. If so, you or your caregiver should receive training on the right way to prepare and inject it. Don’t try to inject this drug until you’ve been trained.

If you inject this medication on your own, you should rotate your injection sites. Typical injection sites include your thigh or abdomen. Don’t inject this drug into areas where your skin is tender, bruised, red, or hard.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained here in is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.