If you have certain types of arthritis, or if you’re having a certain kind of transplant, your doctor may prescribe treatment with Orencia.

Orencia is a prescription drug that’s used for:

Orencia is also used to help prevent acute (sudden) graft-versus-host disease in adults and some children undergoing hematopoietic stem cell transplantation.

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

Orencia comes as a liquid solution and as a powder that’s mixed into a liquid solution. It’s given by either:

You may be able to give injections of Orencia to yourself if you’re taking it as injections under your skin. Your doctor will show you how to give the injections. But if you’re getting Orencia by IV infusion, you’ll get your doses from a healthcare professional.

Is Orencia a biologic?

Yes. Orencia contains the drug abatacept, which is a biologic medication. A biologic is made from parts of living cells.

Orencia is not available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.) Instead, abatacept comes only as the brand-name drug Orencia.

Read below for information about Orencia’s side effects, how it’s taken, and more.

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

In studies, children ages 2 years old and older taking Orencia had similar side effects as adults did.

Your doctor or pharmacist can tell you more about the potential side effects of Orencia. 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 Orencia can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Orencia’s patient information.

Mild side effects of Orencia can include:

  • headache
  • respiratory infection
  • common cold
  • nausea

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.

Serious side effects

Serious side effects from Orencia can occur, but they aren’t common. If you have serious side effects from Orencia, 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:

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

Side effect focus

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

Infections

You may develop infections when you’re taking Orencia. And sometimes, these infections can become serious.

If you’ve had repeated infections in the past, your doctor will consider the risks and benefits before having you start Orencia.

Also, if you have any conditions that raise your risk for infections, you may develop more infections with Orencia use. For example, if you have chronic obstructive pulmonary disease (COPD), you may have a higher risk for respiratory infections with Orencia.

The most common infections people can develop when taking Orencia include:

Also, your doctor will want to make sure that you don’t have certain infections before you start taking Orencia. These include hepatitis B and tuberculosis. Knowing whether you have these infections will help your doctors determine if Orencia is safe for you. See the “What should be considered before starting Orencia?” section below for details.

Note: Certain other infections are also possible in people receiving Orencia for graft-versus-host disease prevention. See the “Epstein-Barr virus and cytomegalovirus” section just below for details.

What might help

To help prevent infections, your doctor may suggest updating your vaccinations before you start taking Orencia. Talk with your doctor to see if you need any vaccines before starting this drug.

Handwashing is a simple, effective way to help prevent infection. You should do this regularly. For tips on how to properly wash your hands, check out this article.

If you feel sick while taking Orencia, call your doctor. They can check to see if you have an infection.

Sometimes, your doctor may recommend that you stop taking Orencia for a short time if you develop an infection, especially if it’s a serious infection. But don’t ever stop taking Orencia without first talking with your doctor.

Epstein-Barr virus and cytomegalovirus

If you’re receiving Orencia to help prevent acute (sudden) graft-versus-host disease, the drug may cause or reactivate infection with cytomegalovirus or Epstein-Barr virus.

Both are serious viral infections. If you’ve had either in the past, Orencia can cause the virus to reactivate (flare up and cause symptoms). Symptoms can include:

  • fever
  • fatigue (low energy)
  • swollen lymph nodes
  • reduced appetite

What might help

When used for graft-versus-host disease, Orencia is usually given with other drugs to help prevent cytomegalovirus and Epstein-Barr virus infections. You’ll be monitored for symptoms of these and other infections during your Orencia treatment.

Cancer

It’s not known if Orencia increases your risk for cancer.

In studies, lung and immune system cancers were seen more in people with rheumatoid arthritis who took Orencia than in people taking a placebo. (A placebo is a treatment with no active drug.)

Other cancers that were seen in people during studies include:

After Orencia was approved for use, some people developed skin cancer while taking it. It isn’t known what condition Orencia was being used to treat. And it’s important to know that when side effects are reported after a drug is approved, it’s often hard to tell whether the side effect was caused by the drug or something else.

It’s not yet known if or how Orencia causes cancer. If you have concerns about developing cancer with Orencia use, talk with your doctor.

What might help

Before starting Orencia, tell your doctor if you or any family members have had skin cancer in the past. Your doctor may not prescribe Orencia for you if you have a history of skin cancer.

If you have any risk factors for skin cancer, your doctor may check your skin from time to time while you’re taking this drug. But your doctor may check your skin even if you don’t have risk factors for skin cancer.

And if you notice any growths or changes in your skin during or after taking Orencia, tell your doctor.

Allergic reaction

Some people may have an allergic reaction to Orencia.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth, swelling, or redness in your skin)

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. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

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

Your doctor will recommend the dosage of Orencia that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Forms

Orencia comes as a liquid solution and as a powder that’s mixed into a liquid solution. It’s given by either:

Recommended dosages

The Orencia dose your doctor prescribes for you will depend on your body weight.

For rheumatoid arthritis and polyarticular juvenile idiopathic arthritis, you’ll get Orencia as either an injection under your skin or IV infusion. If you’re getting:

  • injections under your skin, you’ll take the drug once each week.
  • IV infusions, you’ll get the drug once, then 2 weeks later, and then 2 weeks after that. And after those three doses, you’ll get Orencia once every 4 weeks.

For psoriatic arthritis, you’ll get Orencia as an injection under your skin. And you’ll take the drug once each week.

For graft-versus-host disease prevention, you’ll get Orencia as an IV infusion. It’ll be given on the day before your transplant and on days 5, 14, and 28 afterward.

Depending on the condition you’re taking Orencia for, your doctor might prescribe other drugs for you to take with Orencia.

Questions about Orencia’s dosage

Below are some common questions about Orencia’s dosage.

  • What if I miss a dose of Orencia? If you miss a dose of Orencia, call your doctor. They’ll help you decide when it’s best to have your next dose. To help avoid missing a dose, set a medication reminder on your phone or write a note on your calendar.
  • Will I need to use Orencia long term? Orencia treats long-lasting diseases. So you may need to take it long term. For graft-versus-host disease prevention, you’ll only take Orencia for about 1 month. Talk with your doctor about how long you should use this drug.
  • How long does Orencia take to work? Everyone may have a different experience with Orencia treatment. A study in people with rheumatoid arthritis showed that some people had improvement in their condition after 6 months. And people who continued taking Orencia still showed that improvement at 12 months. Talk with your doctor about what you can expect with treatment.

Your doctor will explain how you should take Orencia. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Orencia

Orencia comes as a liquid solution and as a powder that’s mixed into a liquid solution. It’s given by either:

If you’re taking Orencia as injections under your skin, you may be able to give the injections to yourself. Your doctor will show you how to do so using an autoinjector device. You’ll inject Orencia into these areas:

  • your belly, but staying 2 inches away from your belly button
  • the front of your thighs
  • the outer part of your upper arms

If you’re getting Orencia by IV infusion, you’ll get your doses from a healthcare professional. These infusions typically last about 30 minutes, or 60 minutes if you’re receiving Orencia for acute (sudden) graft-versus-host disease prevention.

Taking Orencia with other drugs

Depending on your condition, your doctor may have you take other medications along with Orencia.

For polyarticular juvenile idiopathic arthritis and for rheumatoid arthritis, Orencia may be given by itself or with methotrexate.

For graft-versus-host disease prevention, you’ll receive Orencia along with methotrexate and a type of drug called a calcineurin inhibitor (such as cyclosporine or tacrolimus). Your doctor may also prescribe medications to help prevent certain viral infections, such as cytomegalovirus or Epstein-Barr virus. Examples of these drugs include acyclovir, valacyclovir, and ganciclovir.

Orencia and food

Orencia is taken by injection, so eating doesn’t affect how your body absorbs it. You can take the medication with or without food.

Find answers to some commonly asked questions about Orencia.

How does Orencia work?

Orencia works by targeting cells called T lymphocytes. These cells are part of your immune system, which works to help your body fight off infections.

Overactive T lymphocytes are seen in people with rheumatoid arthritis, psoriatic arthritis, and polyarticular juvenile idiopathic arthritis. These are the conditions Orencia is used to treat.

Overactivity of the immune system, including T lymphocytes, is also seen in people with acute (sudden) graft-versus-host disease. Orencia is used to help prevent this condition after a certain kind of transplant. By reducing this activity of the immune system, Orencia can lower your risk of developing this condition.

Orencia stops T lymphocytes from being activated. Experts think that blocking the activity of T lymphocytes slows the progression of certain diseases related to the immune system.

Does Orencia cause weight gain?

No, Orencia doesn’t cause weight gain or weight loss. If you have concerns about changes in your weight during Orencia treatment, talk with your doctor. They can help you create a plan to manage a healthy body weight.

What’s the difference between Orencia and Humira?

Both Orencia and Humira are biologic medications, which means they’re made from parts of living cells. And these two drugs are both taken as injections.

But each drug targets a different part of your immune system:

Humira and Orencia can cause similar side effects, including serious ones such as infections and cancer. But Humira has a boxed warning for these side effects.

Boxed warnings are the most serious warnings given about a drug’s side effects. They alert people to side effects that may be very dangerous.

Orencia doesn’t have a boxed warning for cancer or infections, even though it can also cause these side effects.

The difference in side effect severity between Orencia and Humira may be due to differences in how the two drugs work.

If you have more questions about how Orencia and Humira are different, talk with your doctor.

Orencia is used for the following long-lasting conditions:

  • Rheumatoid arthritis (RA). For RA, Orencia is given to adults. With RA, you have joint pain, swelling, and stiffness. This condition isn’t caused by overusing your joints. Instead, it’s caused by your immune system attacking your joints.
  • Psoriatic arthritis (PsA). For PsA, Orencia can be given to adults. With PsA, you have painful and swollen joints. But you also have psoriasis plaques on your skin. (Plaques are areas of red or pink, scaley patches.) This condition is caused by your immune system attacking certain tissues in your body.
  • Polyarticular juvenile idiopathic arthritis (pJIA). For JIA, Orencia can be given to people ages 2 years and older. pJIA is the most common type of arthritis in children. And it’s also thought to be caused by the immune system attacking the joints.

Orencia is also used to help prevent acute (sudden) graft-versus-host disease caused by hematopoietic stem cell transplantation. For this purpose, it can be given to adults and children ages 2 years and older. And for this use, Orencia is given along with methotrexate and a type of drug called a calcineurin inhibitor.

With each of the above conditions, your immune system is attacking cells in your own body.

Orencia works on these conditions by lowering the activity of a certain immune system cell. For more information about how Orencia works, see the “What are some frequently asked questions about Orencia?” section above.

Orencia shouldn’t be used with certain other drugs that work on your immune system. Talk with your doctor to learn about other drugs that may or may not be used with Orencia.

Before starting Orencia, you’ll need to tell your doctor about any other drugs you’re taking. Other things to discuss with your doctor include:

  • any medical conditions you have
  • whether you’re pregnant or breastfeeding

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 Orencia, be sure to tell your doctor about all medications you take (including prescription and over-the-counter 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 Orencia.

Interactions with drugs or supplements

Orencia can interact with several types of drugs, including:

Combining Orencia with any of these types of drugs can increase your risk for serious infections.

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

Other interactions

Orencia may interact with vaccines and alter the results of certain tests. Read on to learn more.

Orencia and vaccines

It isn’t known whether Orencia will cause vaccines to not work as well as they should. More studies are needed to fully understand what effects, if any, the drug has on vaccine effectiveness.

But that said, if you’re taking Orencia, you shouldn’t get any live vaccines. (Live vaccines contain live forms of germs they’re meant to protect you from.) Examples of live vaccines include measles, mumps, rubella (MMR) and chickenpox.

This is because Orencia lowers the activity of your immune system. And live vaccines contain a live form of the virus that the vaccine is meant to protect you from. Getting a live vaccine could make you sick if you have a weakened immune system.

You should talk with your doctor to make sure your vaccinations are up to date before you start treatment with Orencia. After stopping Orencia, you’ll need to wait at least 3 months before getting any live vaccines.

Talk with your doctor for more information about getting vaccines while using Orencia.

Orencia and results of blood sugar tests

If you get Orencia by intravenous (IV) infusion and you check your blood sugar levels, you may see higher readings than usual. (With an IV infusion, the drug is injected into your vein over a period of time.)

The form of Orencia that’s given by IV infusion contains maltose. And this substance reacts with certain types of blood sugar test strips. The reaction may cause an incorrect blood sugar reading to show on your monitor.

So be sure to talk with your doctor and pharmacist if you check your blood sugar levels and you’re using Orencia. This is especially important to do if you have diabetes, because changes in blood sugar levels can be concerning if you have this condition.

Your pharmacist can recommend blood sugar testing strips that don’t react with maltose.

Warnings

Orencia 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 Orencia. Factors to consider include those described below.

Tuberculosis (TB). It’s not known if Orencia is safe for people with either latent TB or active TB. (With latent TB, you have TB in your body. But you don’t have symptoms, and you can’t pass it to others. With active TB, you have a TB and it’s causing symptoms.)

Before starting Orencia, your doctor will order a test to check and see if you have TB. If your test is positive for TB, your doctor may recommend TB treatment before prescribing Orencia.

Hepatitis B. It’s not known if Orencia is safe for people with hepatitis B. Certaindrugs such as Orencia, may reactivate hepatitis B. (With reactivation, the virus is already inside your body, and it flares up.) Your doctor may order a test to check and see if you have hepatitis B before you start taking Orencia. If you test positive for hepatitis B, your doctor may not prescribe Orencia for you.

Allergic reaction. If you’ve had an allergic reaction to Orencia or any of its ingredients, you shouldn’t take Orencia. Ask your doctor what other medications are better options for you.

Chronic obstructive pulmonary disease (COPD). In studies of Orencia, adults with COPD had higher rates of side effects with this drug. If you have COPD, talk with your doctor before starting Orencia. They may monitor you more closely than usual for worsened breathing during Orencia treatment.

Reduced immune system activity. If you have a weakened immune system, you might have a higher risk of infections with Orencia. Talk with your doctor about whether the drug is safe for you.

Risk factors for skin cancer. Orencia may increase your cancer risk, particularly your risk of skin cancer. If you already have an increased risk of skin cancer, you’ll likely have regular skin exams during Orencia treatment. See “Cancer” in the “What are Orencia’s side effects?” section above for details.

Cytomegalovirus or Epstein-Barr virus. If you’re receiving Orencia to help prevent acute (sudden) graft-versus-host disease, the drug can cause or reactivate either viral infection. For graft-versus-host disease prevention, Orencia is usually given with certain drugs to help prevent these infections. Your doctor may test you for both infections before you start the Orencia treatment. And they’ll monitor you for signs of any infection while you’re receiving Orencia.

Use with alcohol

Alcohol may affect how some drugs work. But it doesn’t interact with Orencia.

Talk with your doctor about the safety of drinking alcohol while you’re using Orencia.

Pregnancy and breastfeeding

It’s not known for sure whether Orencia is harmful if used by pregnant people. Be sure to talk with your doctor before taking this drug while pregnant.

It’s also not known if Orencia passes into human breast milk. Talk with your doctor about the safety of breastfeeding while using 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.

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

Don’t take more Orencia than your doctor prescribes. Using more than this can lead to serious side effects. If you do take too much Orencia, your doctor will closely monitor you for possible overdose symptoms.

What to do in case you take too much Orencia

Call your doctor if you think you’ve taken too much Orencia. 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 using Orencia, talk with your doctor or pharmacist before starting this drug.

Also, talk with your doctor about other treatment options for your condition. Here’s a list of articles that you might find helpful:

Some questions to ask your doctor about Orencia treatment include:

  • Will I be able to receive any vaccines while I’m using Orencia?
  • Can Orencia be taken at home?
  • If I have diabetes, can I use Orencia?
  • Where should I inject Orencia?

You can read advice and stories from others with your condition in the Bezzy PsA and Bezzy RA communities. You can also learn more about rheumatoid arthritis (RA) and its treatment options by subscribing to the Healthline RA newsletter.

Q:

How should I store Orencia while traveling?

Anonymous

A:

If you need to take your Orencia prefilled syringes or autoinjector with you while traveling, it’s important to properly store them during your trip.

Orencia prefilled syringes and autoinjectors should be stored in the refrigerator. They should be kept at temperatures between 36°F and 46°F (2°C and 8°C) until you’re ready to take a dose of the drug.

To properly store Orencia while traveling, the drug’s manufacturer recommends storing your prefilled syringes or autoinjectors in their original carton inside a cool carrier bag. This could include a bag with insulation that’s able to keep Orencia at the proper temperature.

The manufacturer also recommends keeping the medication with you rather than storing it in your checked luggage.

If you believe your Orencia may have been in temperatures outside of the acceptable range, call the drug’s manufacturer at 800-ORENCIA (800-673-6242).

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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 another 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.