Adalimumab | Side Effects, Dosage, Uses & More
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Generic Name:

adalimumab, Injectable solution

All Brands

  • Humira
SECTION 1 of 5

Highlights for adalimumab

Injectable solution
1

Adalimumab is used to reduce inflammation in a variety of conditions. These include some types of arthritis, Crohn’s disease, ulcerative colitis, and hidradenitis suppurativa.

2

This drug comes in the form of an injection you give yourself. It’s available as a pen injection and injectable prefilled syringe.

3

Adalimumab is available as the brand-name drug called Humira. It isn’t available as a generic drug.

4

This drug can lower your immune system. This may put you at risk for serious viral, fungal, or bacterial infections.

5

The most common side effects that occur with adalimumab include reactions at the site on your skin where you receive the injection, common cold, and headaches.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Serious infections. This drug can lower your immune system and put you at risk for serious infections. These include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria. These infections can be fatal.

Your doctor may test you for TB before starting adalimumab and again during treatment.

Cancer. This drug increases the risk of cancer. Children, teenagers, and young adults have sometimes gotten unusual cancers, such as hepatosplenic T-cell lymphoma, when using this type of drug. People with rheumatoid arthritis may have a higher chance of getting lymphoma.

This drug also increases risk of the skin cancers basal cell cancer and squamous cell cancer. These cancers are generally not life threatening if treated promptly. Tell your doctor if you have a bump or open sore that doesn’t heal.

This drug has led to a rare type of cancer called hepatosplenic T-cell lymphoma in some people. This mostly occurred in male teenagers or young men and people being treated for Crohn’s disease or ulcerative colitis. This type of cancer often results in death.

Hepatitis B virus warning

If you carry the hepatitis B virus, it can become active when you use this drug. Your doctor may do blood tests before, during, and after treatment to check for the virus.

Heart failure

Call your doctor right away if you get new or worsening symptoms of heart failure while taking this drug.  Symptoms may include shortness of breath, swelling of your ankles or feet, and sudden weight gain.

Nervous system problems

In rare cases, this drug can cause serious nervous system problems. Call your doctor right away if you experience:

  • numbness or tingling in parts of your body
  • problems with your vision
  • weakness in your arms or legs
  • dizziness

What is adalimumab?

Adalimumab is a prescription drug. It’s available as a pen injection and injectable prefilled syringe. You inject this medication yourself. 

This drug isn’t available as a generic drug. It only comes as the brand-name drug Humira.

This drug may be used as part of a combination therapy. That means you may need to take it with other drugs.

Why it's used

Adalimumab is used to reduce inflammation in many conditions. This keeps them from getting worse.

More Details

How it works

Adalimumab blocks a substance in your body that causes inflammation and makes your immune system react.

More Details

Why it's used

Adalimumab is used to reduce inflammation in many conditions. This keeps them from getting worse.

It’s approved to treat:

  • rheumatoid arthritis (inflammation in your joints)
  • moderate to severe juvenile rheumatoid arthritis. It’s used in children ages 2 years and older.
  • psoriatic arthritis (arthritis in people with the skin condition psoriasis)
  • ankylosing spondylitis (arthritis of your spine, hips, and/or shoulders)
  • Crohn’s disease (patches of inflammation throughout your digestive tract). It’s given to adults and children ages 6 years and older when other drugs don’t work.
  • moderate to severely active ulcerative colitis (inflammation in your large intestine). It’s given when other drugs don’t work.
  • moderate to severe plaque psoriasis. This condition happens when your body makes too many skin cells. This causes red, scaly patches of skin.
  • hidradenitis suppurativa. This drug is used to treat symptoms and stop it from getting worse. This condition causes small, painful lumps under your skin.

How it works

Adalimumab blocks a substance in your body that causes inflammation and makes your immune system react. 

It belongs to a class of drugs called tumor necrosis factor (TNF) blockers. TNF is normally found in your body and causes inflammation. If you have a disease that causes your body to make too much TNF, adalimumab can work to block it.

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SECTION 2 of 5

adalimumab Side Effects

Injectable solution

Most Common Side Effects

The more common side effects of adalimumab can include:

  • redness, rash, swelling, itching, or bruising at the site on your skin where you receive the injection

  • upper respiratory infections, such as the common cold

  • headaches

  • rash

  • nausea

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • Serious Infections, such as tuberculosis. Symptoms can include:

    • cough that doesn’t go away
    • coughing up blood
    • low-grade fever (between 99°F and 100.9°F or 37.2°C and 38.3°C)
    • unexplained weight loss
    • loss of body fat and muscle
  • Hepatitis B virus infection and liver problems. Symptoms can include:

    • muscle aches
    • clay-colored stools
    • feeling very tired
    • fever
    • dark-colored urine
    • chills
    • skin or whites of the eyes that look yellow
    • stomach pain
    • little or no appetite
    • skin rash
    • vomiting
  • Allergic reactions. Symptoms can include:

    • hives
    • swelling of your face, eyes, lips, or mouth
    • trouble breathing
    • fever that doesn’t go away
  • Nervous system problems. Symptoms can include:

    • numbness or tingling
    • problems with your vision
    • weakness in your arms or legs
    • dizziness
  • Blood problems. Symptoms can include:

    • bruising or bleeding very easily
    • looking very pale
  • Heart failure. Symptoms can include:

    • shortness of breath
    • swelling of your ankles or feet
    • sudden weight gain
  • Lupus-like reaction. Symptoms can include:

    • chest discomfort or pain
    • shortness of breath
    • joint pain
    • rash on your cheeks or arms that gets worse in the sun
  • Psoriasis. Symptoms can include:

    • red, scaly patches of skin
    • raised bumps on your skin that are filled with pus
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Adalimumab doesn’t cause drowsiness.

It’s common for this drug to cause reactions at the site on your skin where you receive the injection. You should call your doctor right away if you have a reaction that doesn’t go away within a few days or one that gets worse.

Other mild side effects may go away within a few days or a couple of weeks. Talk to your doctor or pharmacist if they’re more severe or don’t go away.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot 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.
SECTION 3 of 5

adalimumab May Interact with Other Medications

Injectable solution

Adalimumab 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.

Medications that might interact with this drug

Interactions that increase your risk of side effects

Side effects from adalimumab: Taking adalimumab with certain medications raises your risk of side effects. This is because these drugs have similar side effects. Examples of these drugs include:

  • Biologic drugs, such as anakinra, abatacept, rituximab, and rilonacept. Taking adalimumab with these drugs can increase your chance of getting a serious infection.

Drugs you should not use with adalimumab

Do not take these drugs with adalimumab. Doing so can cause dangerous effects in the body. Examples of these drugs include:

  • Live vaccines, such as varicella (chickenpox) and measles, mumps, rubella vaccine. Don’t receive a live vaccine while taking this drug. Your immune system may not be strong enough to receive a live vaccine.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot 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.
Adalimumab warnings
tuberculosis
People with tuberculosis

This drug affects your immune system and may make it easier for you to get an infection. Your doctor may check you for tuberculosis (TB). If your doctor feels that you’re at risk for TB, you may be treated with drugs for TB before and during treatment with adalimumab.

Even if your TB test is negative, your doctor may carefully monitor you for TB infections. You may still develop a TB infection while you’re taking this drug, even if you had a negative TB test.

hepatitis B virus
People with hepatitis B virus infection

If you carry the hepatitis B virus, it can become active while you take this drug. This could damage your liver. Your doctor may do blood tests to check for the virus before, during, and after you take this drug.

nervous system
People with nervous system problems

This drug can make nervous system problems worse. Ask your doctor whether this drug is safe for you if you have multiple sclerosis or Guillain-Barre syndrome.

heart failure
People with heart failure

This drug can make certain heart problems worse. Call your doctor right away if you get new or worsening symptoms of heart failure while taking it. Symptoms may include shortness of breath, swelling of your ankles or feet, or sudden weight gain.

psoriasis
People with psoriasis

In rare cases, this drug may make psoriasis worse. Tell your doctor if you develop red scaly patches or raised bumps that are filled with pus. Your doctor may decide to stop your treatment with adalimumab.

pregnant women
Pregnant women

Adalimumab is a pregnancy category B drug. That means two things: 

  1. Research in animals hasn’t shown a risk to the fetus when the mother takes the drug.
  2. There aren’t enough studies done in humans to show if the drug poses a risk to the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. Animal studies don’t always predict the way humans would respond. Therefore, this drug should only be used in pregnancy if clearly needed.

breastfeeding
Women who are breast-feeding

Adalimumab can pass through breast milk in small amounts. However, babies who were exposed to adalimumab through breast milk didn’t have any side effects.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

seniors
For seniors

If you’re over the age of 65 years, you may be at higher risk for a serious infection or certain types of cancers while taking this drug.

children
For children

The safety and effectiveness of this drug haven’t been established in children younger than 18 years for conditions other than juvenile arthritis and Crohn’s disease.

The safety and effectiveness of this drug haven’t been established in children younger than 2 years for the treatment of juvenile arthritis. 

The safety and effectiveness of this drug haven’t been established in children younger than 6 years for the treatment of Crohn’s disease. 

allergies
Allergies

Adalimumab can cause a severe allergic reaction. Symptoms can include:

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

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 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).

SECTION 4 of 5

How to Take adalimumab (Dosage)

Injectable solution

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

What are you taking this medication for?

Rheumatoid arthritis

Brand: Humira

Form: Self-injectable pen
Strengths: 40 mg/0.8 mL
Form: Self-injectable prefilled syringe/solution
Strengths: 40 mg/0.8 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL
Adult dosage (ages 18 years and older)

The dose is either 40 mg taken once every 2 weeks or 40 mg taken every week. The dose of 40 mg every week may be used in some people who aren’t taking methotrexate.

Child dosage (ages 0-17 years)

A safe and effective dose hasn’t been determined for this age group.

Juvenile rheumatoid arthritis

Brand: Humira

Form: Self-injectable pen
Strengths: 40 mg/0.8 mL
Form: Self-injectable prefilled syringe/solution
Strengths: 40 mg/0.8 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL
Adult dosage (ages 18 years and older)

This condition doesn’t occur in this age group. It only affects children younger than 18 years of age.

Child dosage (ages 2–17 years and who weigh 22 lbs. or more)
  • The dose is based on a child’s weight.
  • The dose may range from 10–40 mg taken once every 2 weeks.
Child dosage (ages 0-1 year)

A safe and effective dose hasn’t been determined for this age group.

Psoriatic arthritis

Brand: Humira

Form: Self-injectable pen
Strengths: 40 mg/0.8 mL
Form: Self-injectable prefilled syringe/solution
Strengths: 40 mg/0.8 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL
Adult dosage (ages 18 years and older)

The dose is 40 mg taken once every 2 weeks.

Child dosage (ages 0-17 years)

A safe and effective dose hasn’t been determined for this age group.

Ankylosing spondylitis

Brand: Humira

Form: Self-injectable pen
Strengths: 40 mg/0.8 mL
Form: Self-injectable prefilled syringe/solution
Strengths: 40 mg/0.8 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL
Adult dosage (ages 18 years and older)

The dose is 40 mg taken once every 2 weeks.

Child dosage (ages 0-17 years)

A safe and effective dose hasn’t been determined for this age group.

Crohn’s disease

Brand: Humira

Form: Self-injectable pen
Strengths: 40 mg/0.8 mL
Form: Self-injectable prefilled syringe/solution
Strengths: 40 mg/0.8 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL
Adult dosage (ages 18 years and older)
  • The first dose (day 1) is 160 mg. This can also be split up into 2 days with 80 mg on day 1 and 80 mg on day 2.
  • The second dose is taken 2 weeks later (day 15). The dose is 80 mg.
  • The third dose is taken 2 weeks after that, on day 29. It’s 40 mg.
  • From then on, you take 40 mg every other week.
Child dosage (ages 6–17 years)
  • The dose is based on child’s weight.
  • Your child’s doctor will determine their dose.
Child dosage (ages 0–5 years)

A safe and effective dose hasn’t been determined for this age group.

Ulcerative colitis

Brand: Humira

Form: Self-injectable pen
Strengths: 40 mg/0.8 mL
Form: Self-injectable prefilled syringe/solution
Strengths: 40 mg/0.8 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL
Adult dosage (ages 18 years and older)
  • The first dose (day 1) is 160 mg. This can also be split up into 2 days with 80 mg on day 1 and 80 mg on day 2.
  • The second dose is taken 2 weeks later (day 15). The dose is 80 mg.
  • The third dose is taken 2 weeks after that, on day 29. It’s 40 mg. From then on, you take 40 mg every other week.
Child dosage (ages 0-17 years)

A safe and effective dose hasn’t been determined for this age group.

Plaque psoriasis

Brand: Humira

Form: Self-injectable pen
Strengths: 40 mg/0.8 mL
Form: Self-injectable prefilled syringe/solution
Strengths: 40 mg/0.8 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL
Adult dosage (ages 18 years and older)
  • The first dose is 80 mg.
  • The second dose is taken 1 week later. Begin taking 40 mg every other week.
Child dosage (ages 0-17 years)

A safe and effective dose hasn’t been determined for this age group.

Hidradenitis Suppurativa

Brand: Humira

Form: Self-injectable pen
Strengths: 40 mg/0.8 mL
Form: Self-injectable prefilled syringe/solution
Strengths: 40 mg/0.8 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL
Adult dosage (ages 18 years and older)
  • The first dose is 160 mg. It’s given as four 40 mg injections on day 1. Or it’s given as two 40 mg injections per day on days 1 and 2.
  • The second dose is taken 2 weeks later, on day 15. The dose is 80 mg.
  • The third dose is taken 2 weeks after that, on day 29. It’s 40 mg.
  • From then on, you take 40 mg every other week.
Child dosage (ages 0-17 years)

A safe and effective dose hasn’t been determined for this age group.

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

Adalimumab comes with serious risks if you don’t take it as prescribed.

What to do if you miss a dose

If you miss a dose, take it as soon as possible. However, if it’s almost time for your next dose, take the next dose only. Don’t take double or extra doses.

How to tell if the drug is working

You may be able to tell if this drug is working if you have less inflammation from your condition.

For psoriatic arthritis, rheumatoid arthritis, and ankylosing spondylitis, you may be able to tell it’s working if you have less joint pain and can move better. 

For ulcerative colitis and Crohn’s disease, you may be able to tell it’s working if you have less diarrhea, bloody stools, and stomach pain. 

For plaque psoriasis, you may be able to tell it’s working if your skin looks better.

For hidradenitis suppurativa, you may be able to tell it’s working if you have less pain and lumps under your skin.

Adalimumab is used for long-term treatment.

Store this drug carefully

  • Store adalimumab in the refrigerator. Keep it between 36°F and 46°F (2.2°C and 7.7°C). If you can’t refrigerate it, you can store it at room temperature (up to 77°F or 25°C) for up to 14 days.
  • Don’t freeze this drug. Don’t use it after it’s been frozen, even if it’s thawed.
  • Keep it in its original carton until you use it. This will protect it from light. Keep it away from extreme heat or cold. Don’t use it after the expiration date printed on the label.

Throw this drug away carefully:

  • Don’t throw used needles or syringes in your household trashcan. Put them in an FDA-cleared needle disposal container right after using them. When the container is almost full, follow your community guidelines for the right way to throw out the container. 

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:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
  • This medication normally needs to be refrigerated. When traveling, you can store it in temperatures up to 77°F (25°C) for up to 14 days.
  • Needles and syringes need to be used to take this drug. Check for special rules about traveling with medication, needles, and syringes.
  • Be sure that you have enough medication when you travel. It may be difficult to buy this drug while you’re traveling since it’s not always stocked. 

Self-management

You or your caregiver should receive training on the right way to prepare and inject adalimumab. Don’t try to inject the drug until your doctor or nurse shows you the right way to give it. 

For the adalimumab injection, you’ll need: 

  • sterile alcohol wipes
  • a needle clipper
  • a container for throwing away used needles and adalimumab pens

Syringes and needles are used to inject this drug. Don’t throw out needles in trashcans or recycling bins, and never flush them down the toilet.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug.

Your doctor may do the following tests:

  • Tuberculosis test. Your doctor may test you for tuberculosis (TB) before and during your treatment. Symptoms of TB can include:
    • cough that doesn’t go away
    • low fever
    • unexplained weight loss
    • loss of body fat and muscle
  • Hepatitis B virus infection test. If you carry the hepatitis B virus, your doctor may do blood tests before, during, and after you take this drug.
  • Blood test. Your doctor may check your levels of white blood cells and platelets.

Hidden costs

In addition to the drug, you’ll need to buy:

  • sterile alcohol wipes
  • a needle clipper
  • a container for throwing away used needles and adalimumab pens

Insurance

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.

Are there any alternatives?

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.

SECTION 5 of 5

How Much Does adalimumab Cost?

Injectable solution

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Lowest price for adalimumab

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These prices represent the lowest priced national pharmacies for adalimumab on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on December 3, 2015

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 herein 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.
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