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Adalimumab, Injectable Solution

Highlights for adalimumab

  1. Adalimumab is available as a brand-name drug. It’s not available as a generic drug. Brand name: Humira.
  2. This drug comes as an injection you give yourself. It’s available as a pen injection and an injectable prefilled syringe.
  3. Adalimumab is used to reduce inflammation in a variety of conditions. These include some types of arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, plaque psoriasis, hidradenitis suppurativa, and some types of uveitis.
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Important warnings

Important warnings

FDA warnings
  • This drug has black box warnings. A black box warning is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
  • Serious infections. This drug can weaken 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. If treated promptly, these cancers are generally not life threatening. 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.

Other warnings

  • 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

About

What is adalimumab?

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

Adalimumab is available as a pen injection and an injectable prefilled syringe. You inject this medication yourself.

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. It’s approved to treat:

How it works

Adalimumab belongs to a class of drugs called tumor necrosis factor (TNF) blockers. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

TNF is a substance in your body that causes inflammation and makes your immune system react. If you have a disease that causes your body to make too much TNF, adalimumab can help block it.

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Side effects

Adalimumab side effects

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

More 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

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.

Call your doctor right away if you have a reaction at the injection site that doesn’t go away within a few days or that gets worse.

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:

  • 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

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.

Interactions

Adalimumab may interact with other medications

Adalimumab 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 adalimumab are listed below.

Drugs you should not use with adalimumab

Do not take these drugs with adalimumab. Doing so can cause dangerous effects in your 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 handle a live vaccine.

Interactions that increase your risk of side effects

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 raises your chance of getting a serious infection.

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.

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Other warnings

Adalimumab warnings

This drug comes with several warnings.

Allergy warning

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 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 tuberculosis: This drug affects your immune system and may make it easier for you to get an infection. Your doctor may check you for 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 infection. This is because you may still develop a TB infection while you’re taking this drug, even if you had a negative TB test.

For 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 your treatment with this drug.

For 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.

For 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.

For 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.

Warnings for other groups

For pregnant women: It’s not known if adalimumab will harm your pregnancy. However, we do know that the amount of drug crosses into the placenta in increasing amounts as pregnancy progresses. As a result, the largest amount of drug is transferred into the placenta during the third trimester.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used in pregnancy if clearly needed.

For women who are breastfeeding: Adalimumab can pass through breast milk in small amounts. However, studies of babies who were exposed to adalimumab through breast milk showed that they didn’t have any side effects.

Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

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.

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.
  • children younger than 2 years for the treatment of juvenile arthritis.
  • children younger than 6 years for the treatment of Crohn’s disease.
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Dosage

How to take adalimumab

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

Dosage for rheumatoid arthritis

Forms and strengths

Brand: Humira

  • Form: self-injectable pen
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL

  • Form: self-injectable prefilled syringe/solution
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4mL, 20 mg/0.4 mL, and 10 mg/0.2 mL

Adult dosage (ages 18 years and older)

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

Child dosage (ages 0–17 years)

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

Dosage for juvenile rheumatoid arthritis

Forms and strengths

Brand: Humira

  • Form: self-injectable pen
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL

  • Form: self-injectable prefilled syringe/solution
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 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. [10 kg] or more)

  • The dosage is based on a child’s weight.
  • The dosage may range from 10 mg to 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.

Dosage for psoriatic arthritis

Forms and strengths

Brand: Humira

  • Form: self-injectable pen
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL

  • Form: self-injectable prefilled syringe/solution
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL

Adult dosage (ages 18 years and older)

The typical dosage 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.

Dosage for ankylosing spondylitis

Forms and strengths

Brand: Humira

  • Form: self-injectable pen
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL

  • Form: self-injectable prefilled syringe/solution
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL

Adult dosage (ages 18 years and older)

The typical dosage is 40 mg taken once every 2 weeks.

Child dosage (ages 0–17 years)

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

Dosage for Crohn’s disease

Forms and strengths

Brand: Humira

  • Form: self-injectable pen
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL

  • Form: self-injectable prefilled syringe/solution
  • Strengths: 80 mg/0.8 mL, 40 mg/0.8 mL, 40 mg/0.4 mL, 20 mg/0.4 mL, and 10 mg/0.2 mL

Adult dosage (ages 18 years and older)

  • The typical 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.
  • The initial dose may range from 80 mg to 160 mg taken one day 1.
  • The second dose is taken 2 weeks later (day 15), and may range from 40 mg to 80 mg.
  • The third dose is taken 2 weeks after that, on day 29. This dose may range from 20 mg to 40 mg.
  • From then on, the child may receive a dose of 20 mg to 40 mg every other week.

Child dosage (ages 0–5 years)

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

Dosage for ulcerative colitis

Forms and strengths

Brand: Humira

  • Form: self-injectable pen
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL

  • Form: self-injectable prefilled syringe/solution
  • Strengths: 80 mg/0.8 mL, 40 mg/0.8 mL, 40 mg/0.4 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.

Dosage for plaque psoriasis

Forms and strengths

Brand: Humira

  • Form: self-injectable pen
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL

  • Form: self-injectable prefilled syringe/solution
  • Strengths: 80 mg/0.8 mL, 40 mg/0.8 mL, 40 mg/0.4 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.

Dosage for hidradenitis suppurativa

Forms and strengths

Brand: Humira

  • Form: self-injectable pen
  • Strengths: 40 mg/0.8 mL, 40 mg/0.4 mL

  • Form: self-injectable prefilled syringe/solution
  • Strengths: 80 mg/0.8 mL, 40 mg/0.8 mL, 40 mg/0.4 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 week.

Child dosage (ages 0–17 years)

A safe and effective dosage 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 speak with your doctor or pharmacist about dosages that are right for you.

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Take as directed

Take as directed

Adalimumab is used for long-term treatment. It 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 have less joint pain and be able to move better.
  • For ulcerative colitis and Crohn’s disease, you may have less diarrhea, bloody stools, and stomach pain.
  • For plaque psoriasis, your skin may look better.
  • For hidradenitis suppurativa, you may have less pain and fewer lumps under your skin.

Important considerations

Important considerations for taking adalimumab

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

Storage

  • Store adalimumab in the refrigerator. Keep it at a temperature between 36°F and 46°F (2°C and 8°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 this drug in its original carton until you use it. This will protect it from light.
  • Don’t use this drug after the expiration date printed on the label.

Throw this drug away carefully:

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

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:

  • 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.
  • 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. Pharmacies don’t always stock this drug, so it may be difficult to buy this drug while you’re traveling.

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
  • an FDA-cleared needle disposal container for throwing away used needles and adalimumab pens

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 TB before and during your treatment.
  • 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.

Availability

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

Hidden costs

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

  • sterile alcohol wipes
  • a needle clipper
  • an FDA-cleared needle disposal container for throwing away used needles and adalimumab pens

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.

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Alternatives

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.

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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