If you have certain health conditions, your doctor may prescribe Cimzia. It’s a prescription drug that’s used in adults to manage:

To learn more about these conditions and how Cimzia is used for them, see the “What is Cimzia used for?” section below.

Cimzia comes as a solution inside prefilled syringes and as powder that’s mixed into a solution. You’ll take Cimzia as an injection under your skin.

Cimzia contains the active drug certolizumab, which is a tumor necrosis factor (TNF) inhibitor.

Cimzia is a biologic medication, and isn’t available in a biosimilar form. Biosimilar medications are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs. Instead, certolizumab only comes as the brand-name drug Cimzia.

In this article, we describe Cimzia’s side effects, how it’s taken, its uses, and more.

Like most drugs, Cimzia may cause mild or serious side effects. The lists below describe some of the more common side effects that Cimzia may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Cimzia. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Cimzia can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Cimzia’s medication guide.

Mild side effects of Cimzia can include:

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information on this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Cimzia can occur, but they aren’t common. If you have serious side effects from Cimzia, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects can include:

  • reactivation of hepatitis B, if it’s already in your body*
  • new or worsening heart failure*
  • new or worsening nerve problems*
  • blood disorders
  • boxed warnings: serious infection and cancer (see the “Side effect focus” section directly below)
  • hair loss (see the “Side effect focus” section directly below)
  • allergic reaction (see the “Side effect focus” section directly below)

* For more information on this side effect, see the “What to consider before taking Cimzia” section below.

Side effect focus

Learn more about some of the side effects Cimzia may cause.

Boxed warnings

Cimzia has boxed warnings for serious infection and cancer. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Serious infection. When you’re taking Cimzia, you have a risk of getting serious infections. These infections can include:

You may have a higher risk of infection while you’re using Cimzia if you:

Common symptoms of infections to watch for include:

  • fever or chills
  • sweating
  • cough
  • burning when you urinate
  • muscle aches
  • diarrhea

Cancer. Lymphoma (cancer of the lymph nodes) and other cancers have occurred in children and adolescents taking tumor necrosis factor (TNF) inhibitors. And Cimzia is a TNF inhibitor.

In addition, skin cancers have been seen in people using TNF inhibitors including Cimzia. Examples of these skin cancers include melanoma and Merkel cell carcinoma.

What might help

If you get a serious infection while you’re taking Cimzia, tell your doctor right away. Your doctor may have you stop taking Cimzia. But don’t stop taking Cimzia without first talking with your doctor.

Your doctor will not prescribe Cimzia for you if you have an active infection. If you have frequent or long-lasting infections, your doctor will weigh the benefits and risks of Cimzia before prescribing it for you.

While you’re taking Cimzia, your doctor will check you regularly for infection. If you travel to or live in areas with a high risk of fungal infections, you may need to take antifungal treatment to avoid a fungal infection.

Because TNF inhibitors increase the risk of cancer in children, Cimzia isn’t approved for use in people younger than 18 years of age.

During Cimzia treatment, it’s recommended that you check your skin regularly for any changes that may indicate skin cancer. If you have risk factors for skin cancer, having routine skin checks is especially important.

Be sure to talk with your doctor if you notice any changes in your skin’s appearance during or after treatment with Cimzia. These changes could include new growths or sores.

Tiredness

If you feel more tired than usual, it may be a side effect of Cimzia.

But tiredness may also be a symptom of infection. And Cimzia has a warning about the risk of infection while using the drug. For more information about this warning, see the “Boxed warnings” section above. If you think you had an infection before taking Cimzia, or think you have an infection during or after taking Cimzia, tell your doctor right away.

What might help

If you’re feeling more tired than usual while taking Cimzia, talk with your doctor. They may check to see if you have an infection. If you do have an infection, your doctor will treat the illness.

Your doctor may also tell you to stop taking Cimzia for a short time. But don’t stop taking Cimzia without first talking with your doctor.

If you don’t have an infection, your doctor may suggest ways to help boost your energy levels.

Hair loss

It’s possible to have hair loss while you’re taking Cimzia. This side effect was seen in some people who had an immune system flare-up during studies of Cimzia. The type of hair loss seen is called alopecia totalis, which is a complete loss of all the hair on your head.

Studies showed that hair loss is a rare side effect of tumor necrosis factor (TNF) inhibitors. And Cimzia is a TNF inhibitor.

What might help

If you’re concerned about hair loss while you’re taking Cimzia, talk with your doctor. And check out these tips on how to help prevent hair loss.

Allergic reaction

Some people may have an allergic reaction to Cimzia.

Symptoms of a mild allergic reaction can include:

  • rash
  • itchiness
  • flushing (warmth, swelling, redness, or discoloration in your skin)
  • injection site reactions, such as bruising, pain, redness or discoloration, or swelling

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat, which can cause trouble breathing
  • low blood pressure
  • dizziness or fainting
  • hot flashes
  • fever

Also, Cimzia prefilled syringes contain materials that are similar to latex. So, if you’re allergic to latex, you may have an allergic reaction when handling these syringes. It’s recommended that if you’re sensitive to latex, you should handle Cimzia syringes with care.

Call your doctor right away if you have an allergic reaction to Cimzia. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Your doctor will explain how you should take Cimzia. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions. Below are commonly used dosages, but always take the dose your doctor prescribes.

Taking Cimzia

Cimzia comes in two forms:

  • a powder inside single-dose vials that’s mixed into a solution
  • a solution inside single-dose prefilled syringes

You or your doctor will inject Cimzia under your skin. If you’re giving the injections to yourself, you’ll use the prefilled syringes. But if you’re getting the injection from your doctor, they may use Cimzia powder after they mix it into a solution.

If you’re injecting Cimzia yourself, your healthcare provider will show you how to administer the drug. You’ll inject Cimzia into one of these areas on your body:

  • your belly, staying 2 inches (5 centimeters [cm]) away from your belly button
  • the front of your thighs

Each time you inject Cimzia, you should change injection sites. And each new injection should be at least 1 inch (2.5 cm) away from the injection site you last used.

Dosage

Depending on the reason you’re using Cimzia, your doctor will prescribe a specific dosage for you. For instance, if you’re taking Cimzia for:

  • plaque psoriasis, you’ll get a Cimzia injection once every 2 weeks. But if you weigh less than 90 kilograms (about 198 pounds), your doctor may prescribe a first dose, followed by another 2 doses that are each taken 2 weeks apart. Then after those 3 doses, you’ll receive a dose of Cimzia once every 2 weeks.
  • Crohn’s disease, you’ll get your first injection, and then another injection 2 weeks later. Then, you’ll take the drug again 2 weeks after that. After those 3 doses, if your condition is responding to the drug, you’ll take Cimzia once every 4 weeks.
  • rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, or axial spondyloarthritis, you’ll get your first dose and a second dose 2 weeks later. Then, you’ll take another dose 2 weeks after that. After those 3 doses, your doctor may recommend a Cimzia injection once every 4 weeks or once every 2 weeks.

Taking Cimzia with other drugs

In some cases, your doctor may recommend that you take other medications with Cimzia. For example, if you have:

  • plaque psoriasis, your doctor may prescribe Cimzia together with methotrexate.
  • Crohn’s disease, your doctor may prescribe Cimzia together with certain other drugs. These include:
  • RA, your doctor may prescribe Cimzia together with methotrexate, if needed.
  • psoriatic arthritis, Cimzia is usually prescribed alone. Using it together with methotrexate is typically avoided. But if you have severe psoriatic arthritis, your doctor may consider prescribing Cimzia together with methotrexate.
  • stable ankylosing spondylitis or non-radiographic axial spondyloarthritis, Cimzia is usually prescribed without methotrexate. Your doctor may have you take nonsteroidal anti-inflammatory drugs (NSAIDs) with Cimzia. But you’d likely only take them together for a short time.

Also, for flare-ups of arthritis or Crohn’s disease, your doctor may have you take prednisone with Cimzia.

Questions about taking Cimzia

Below, we answer some questions related to Cimzia dosage.

  • What if I miss a dose of Cimzia? If you miss an appointment to get a Cimzia injection from your doctor, call your doctor’s office to reschedule. If you forget to inject Cimzia yourself, take the dose as soon as you remember, or call your doctor. They can tell you whether you should take the missed dose now, or skip it and wait for your next dose. If you’re unsure when to inject your next dose after a missed dose, call your doctor to set up a new schedule for your injections.
  • Will I need to use Cimzia long term? The conditions that Cimzia treats are long lasting. So, you’ll likely take Cimzia long term. Talk with your doctor to find out how long you’ll need to take Cimzia.
  • Should I take Cimzia with food? You can inject Cimzia on an empty or a full stomach. Eating food doesn’t affect how much of the medication is absorbed by your body.
  • How long does Cimzia take to work? Everyone may have a different experience with Cimzia treatment. Depending on the reason you’re using Cimzia, you may notice the drug working at different times. For example, in studies of people with Crohn’s disease, improvements were seen after 6 weeks of Cimzia treatment. In studies of people with RA, improvements were seen after 24 weeks of Cimzia treatment. But it’s possible to have improvements within a few weeks of starting treatment. Ask your doctor how long it should take for Cimzia to work for your condition.
Questions for your doctor

You may have questions about Cimzia and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions like:
    • How will Cimzia affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare providers are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

If you have certain conditions, your doctor may recommend that you take Cimzia. It’s used for people ages 18 years and older, to treat the following long-lasting conditions:

  • Plaque psoriasis (PsO). With PsO, you have inflammation in your skin. You may have pink or dark-colored patches with scales. These may appear on your scalp, elbows, knees, and lower back. Any part of your body can be affected by PsO.
  • Crohn’s disease (CD). CD is an inflammatory bowel disease that can affect your entire digestive system. Most people with CD have inflammation in their intestine.
  • Rheumatoid arthritis (RA). With RA, you have swollen, painful joints. Usually, you’ll have swelling in the small joints of your hands and the wrist. Other joints that may be affected by RA include the knees, ankles, elbows, shoulders, and hips.
  • Psoriatic arthritis (PsA). With PsA, you have swelling in your joints and your skin. This disease shares many features of both RA and PSO.
  • Ankylosing spondylitis (AS). AS is an inflammatory disease that affects the spine. People with AS usually have long-lasting lower back pain and stiffness in their spine.
  • Non-radiographic axial spondyloarthritis. With non-radiographic axial spondyloarthritis, you have symptoms consistent with AS. But unlike AS, you don’t have inflammation on your lower spine that can be seen on radiographs (X-rays).

Cimzia works for these conditions by blocking a protein called tumor necrosis factor (TNF). By blocking the action of TNF, Cimzia helps to reduce inflammation that leads to certain immune-related diseases.

Cimzia and Humira are both used to treat some of the same conditions. They have some of the same side effects and risks. But these drugs also have some differences.

To see a breakdown of how Cimzia and Humira are alike and different, view our “Cimzia vs. Humira” article.

Find answers to some commonly asked questions about Cimzia.

Does Cimzia cause weight gain or weight loss?

No, Cimzia doesn’t affect your weight.

But if you get an infection while you’re taking Cimzia, you may lose weight.

Cimzia has a warning about the risk of infection while using the drug. For more information about this warning, see the “Boxed warnings” in the “What are Cimzia’s side effects?” section above. If you think you had an infection before taking Cimzia, or you have an infection during or after taking Cimzia, tell your doctor right away.

On the other hand, if you have unexpected weight gain with Cimzia, it could indicate fluid retention in your body. And this can be a sign of heart failure. In rare cases, Cimzia has caused new or worsening heart failure.

If you’re concerned about your body weight while you’re taking Cimzia, talk with your doctor. They can recommend ways to help you manage a weight that’s healthy for you.

How does Cimzia work?

Cimzia works by affecting your immune system. If you have certain types of arthritis, plaque psoriasis, or Crohn’s disease, you have an overactive immune system. Cimzia is used to treat these conditions.

Cimzia is called a tumor necrosis factor (TNF) inhibitor. The drug blocks TNF, which is a protein that plays an important role in your immune system. But when TNF is overactive, it can cause disease.

By blocking TNF, Cimzia helps to control inflammation that occurs in diseases caused by your immune system.

Is Cimzia similar to Enbrel?

Cimzia and Enbrel are both biologic drugs. These drugs work by blocking the action of an immune system protein called tumor necrosis factor (TNF).

You’ll take either Cimzia or Enbrel as an injection under your skin.

Both Cimzia and Enbrel may be prescribed in certain people for:

In addition, Cimzia can be used for Crohn’s disease and non-radiographic spondyloarthritis. And Enbrel can be used in certain children for juvenile idiopathic arthritis.

It’s important to note that Cimzia has a warning regarding the risk of cancer, which has been seen in children using the drug. (For more information about this, see “Boxed warnings” in the “What are Cimzia’s side effects?” section above.) Unlike Enbrel, Cimzia isn’t used in people younger than 18 years of age.

If you’d like to know more about these drugs, talk with your doctor or pharmacist.

Some important things to discuss with your doctor when considering Cimzia treatment include your overall health and any medical conditions you may have.

Also, tell your doctor if you’re taking any prescription or over-the-counter (OTC) drugs. This is important to mention because some medications can interfere with how well Cimzia works.

These and other considerations to discuss with your doctor are described below.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking Cimzia, be sure to tell your doctor about all medications you take (including prescription and OTC types). Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Cimzia.

Interactions with drugs or supplements

Cimzia can interact with several types of drugs. This includes other biologic drugs such as:

This list doesn’t contain all types of drugs that may interact with Cimzia. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Cimzia.

Other interactions

Cimzia may also interact with vaccines and affect the results of certain lab tests. Read on to learn more.

Cimzia and live vaccines

Cimzia may make some vaccines less effective than usual. This happens because Cimzia lowers the activity of your immune system. When you get a vaccine, you need your immune system to respond to the vaccine. But while you’re taking Cimzia, your immune system can’t respond like it normally would.

Also, while you’re taking Cimzia, you shouldn’t get any live vaccines. Live vaccines are made from living germs. So, with your immune system being less active than usual, if you receive a live vaccine, you may get the infection the vaccine was meant to protect you from.

Examples of live vaccines include:

Before getting any vaccines, talk with your doctor. They can make sure it’s safe for you to have the vaccine with Cimzia.

Cimzia and lab tests

Cimzia may interfere with the results of lab tests called coagulation tests. These blood tests check to see how well your body forms blood clots.

If you have these tests while you’re taking Cimzia, they may show abnormalities. This can happen even if you don’t have a problem with your blood’s clotting ability.

Before having any blood tests, be sure to tell your doctor that you’re taking Cimzia.

Boxed warnings

Cimzia has boxed warnings about serious infection and cancer. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Serious infections. Some people may develop serious infections while taking Cimzia. Serious infections may include tuberculosis (TB), sepsis (bacterial infection in your blood), fungal, viral, and parasitic infections, and other rare infections.

Cancer. Cimzia may raise your risk for blood cancers and skin cancer. In addition, children and adolescents may develop lymphoma (cancer of the lymph nodes) and other cancers while taking tumor necrosis factor (TNF) inhibitors. And Cimzia is a TNF inhibitor.

For more information about these warnings, see the “What are Cimzia’s side effects?” section above.

Other warnings

Cimzia may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Cimzia. Factors to consider include those in the list below.

  • Reactivation of hepatitis B. Before taking Cimzia, your doctor will check to see if you have hepatitis B. It’s possible to have hepatitis B in your body, but not have any symptoms from it. If your test is positive for hepatitis B, your doctor may prescribe medication to treat the infection before you start taking Cimzia. Your doctor will monitor you for hepatitis B while you’re taking Cimzia, and for several months after you’ve stopped taking the drug. If your hepatitis B infection comes back, your doctor will have you stop taking Cimzia. And they’ll prescribe medication to treat the infection. But don’t stop taking Cimzia without first talking with your doctor.
  • Allergic reaction. If you’ve had an allergic reaction to Cimzia or any of its ingredients, you shouldn’t take Cimzia. Ask your doctor what other medications are better options for you.
  • Heart failure. Cimzia may cause new or worsening heart failure. If you already have heart failure, your doctor will weigh the benefits and risks of prescribing Cimzia for you. If you have any problems with your heart while you’re taking Cimzia, call your doctor right away.
  • Nerve reactions. Cimzia may cause new or worsening of certain nerve diseases. These include multiple sclerosis, Guillain-Barré syndrome, seizures, optic neuritis, and peripheral neuropathy. If you have problems with your nerves, ask your doctor if Cimzia is right for you. And if you have any seizures or other symptoms related to your brain, spinal cord, or nerves, tell your doctor right away.

Use with alcohol

Some medications interact with alcohol. Although Cimzia isn’t one of them, medicines you may take with Cimzia could interact with alcohol.

For example, methotrexate is sometimes used with Cimzia. And it can injure your liver, as does drinking a lot of alcohol. Because of this, you should avoid drinking alcohol while taking methotrexate with Cimzia.

To be safe, before starting Cimzia, ask your doctor or pharmacist if it’s okay for you to drink alcohol based on your treatment plan.

Pregnancy and breastfeeding

It’s not known whether Cimzia is safe to use during pregnancy. It’s thought rheumatoid arthritis (RA) that’s not well managed may be harmful to the pregnancy. And Cimzia is used for RA.

Before taking this drug, let your doctor know if you’re pregnant or considering pregnancy. Your doctor can recommend appropriate treatments for your condition.

If you do use Cimzia during pregnancy, consider enrolling in the drug’s pregnancy registry. This registry collects information on the effects of Cimzia used during pregnancy. Reporting effects of Cimzia during pregnancy helps researchers to better understand the drug’s risks if used during pregnancy. To enroll in the registry and report effects of Cimzia, call 866-626-6847 or visit the registry’s website.

Small amounts of Cimzia may pass into breast milk. But in studies, children breastfed by people taking Cimzia didn’t have side effects of the drug.

Talk with your doctor about the safety of breastfeeding while taking Cimzia. Your doctor may recommend safe ways to breastfeed while taking this drug.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for Cimzia tablets (or other forms) in your area, visit GoodRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Cimzia manufacturer’s website to see if they have support options.

Don’t take more Cimzia than your doctor prescribes. Using more than this can lead to serious side effects. If you take too much Cimzia, you doctor may closely monitor you for signs and symptoms of overdose.

What to do in case you take too much Cimzia

Call your doctor if you think you’ve taken too much Cimzia. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use their online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

If you have questions about taking Cimzia, talk with your doctor or pharmacist. Your doctor can tell you about other treatments available for your condition.

Here’s a list of articles that you might find helpful:

Also, some questions to ask your doctor about using Cimzia may include:

  • Which creams can I use with Cimzia for my plaque psoriasis?
  • How can I boost my immune system to prevent getting a cold or flu while taking Cimzia?
  • How should I store Cimzia if I am traveling on a plane?
  • What should I do if the solution in the Cimzia prefilled syringe is cloudy?

You can learn more about the uses of Cimzia by subscribing to Healthline’s newsletters for psoriasis, inflammatory bowel disease (IBD), and rheumatoid arthritis.

Q:

How should I store Cimzia prefilled syringe at home?

Anonymous patient

A:

If you inject Cimzia yourself, you’ll receive the drug in prefilled syringes that are packed in ice. Once you open and remove the outer packaging, the medication should be stored in the refrigerator at 36°F to 46°F (2°C to 8°C). But remember, Cimzia should never be frozen.

If you need to, you can also keep Cimzia syringes at room temperature (up to 77°F/25°C). But they can only be kept at room temperature for up to 7 days. Be sure to write down the date you took the syringe out of the refrigerator so you can remember when the 7 days are up.

Once you take Cimzia out of the refrigerator and bring it to room temperature, you shouldn’t put the medicine back into the fridge.

Also, it’s important to protect Cimzia from light. So, leave the syringes in their original carton while storing.

Purva Singla, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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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.