If you have certain types of arthritis, your doctor might suggest Orencia (abatacept) as a treatment option for you.

Orencia is a prescription medication that’s used to treat the following conditions in certain cases:

Orencia comes as a liquid solution that’s given as a subcutaneous injection (an injection under your skin). It also comes as a powder that’s mixed with water to form a solution. This solution is then given as an intravenous infusion (an injection into a vein that’s given over a period of time).

This article describes the dosages of Orencia, as well as its forms, strengths, and how to use the drug. To learn more about Orencia, see this in-depth article.

Note: This article covers Orencia’s typical dosages, which are provided by the drug’s manufacturer. But when using Orencia, always use the dosage that your doctor prescribes.

This section covers common dosage information about Orencia.

What are the forms of Orencia?

Orencia is available in the following forms:

  • a liquid solution that’s given as a subcutaneous injection (an injection under your skin)
  • a powder that’s mixed with water to form a solution, which is given as an intravenous (IV) infusion (an injection into a vein that’s given over a period of time)

What strengths does Orencia come in?

For the IV infusion, Orencia comes in a vial that contains 250 milligrams (mg) of powder. You may need more than one vial of Orencia for your full dose. Sterile (germ-free) water is added to the drug powder to make a solution for IV infusion.

When given by subcutaneous injection, Orencia comes as a solution in prefilled syringes and ClickJect autoinjectors. The prefilled syringes are available in three strengths: 50 mg/0.4 milliliters (mL), 87.5 mg/0.7 mL, and 125 mg/mL. The ClickJect autoinjector is available in a strength of 125 mg/mL.

What are the typical dosages of Orencia?

Your Orencia dosing frequency will depend on whether you receive the drug by IV infusion or subcutaneous injection.

If you receive the drug by IV infusion, your dosage will also depend on your weight in kilograms (kg). Your doctor will prescribe a dosage that’s right for you after taking your weight at your first appointment. They may adjust your dosage if your weight changes over time.

The table below shows the dosage recommendations for adults who receive Orencia by IV infusion:

Body weightDoseNumber of vials†
Less than 60 kg*500 mg2
60 to 100 kg750 mg3
More than 100 kg1,000 mg4

* One kg equals about 2.2 pounds.
† Each vial of Orencia contains 250 mg of the drug.

The information below describes dosages that are commonly used or recommended. But be sure to use the dosage that your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for rheumatoid arthritis

If you use Orencia to treat rheumatoid arthritis, you can receive the drug by subcutaneous injection or IV infusion.

If you receive Orencia by IV infusion, you’ll get your doses at your doctor’s office or an infusion center. Your dosage will depend on your weight. (See the table above for details.)

You’ll receive your first infusion, then another 2 weeks later, and another one 2 weeks after that. After these first three doses, you’ll have an infusion every 4 weeks.

If you use Orencia by subcutaneous injection, the dosage will be 125 mg given once per week. You may be able to give yourself the injections at home. Your doctor will help you decide if this option is right for you.

If you do use Orencia at home, your doctor will show you how to give yourself the injections. For information about where to inject Orencia, see the “How is Orencia used?” section below.

Before your first subcutaneous injection, you may receive one dose of Orencia given by IV infusion. This dose will be based on your weight. You should give yourself your first subcutaneous injection the day after you receive the dose by IV infusion.

Dosage for psoriatic arthritis

For psoriatic arthritis, Orencia can be given by IV infusion or subcutaneous injection.

If you receive Orencia by IV infusion, you’ll get the doses at your doctor’s office or an infusion center. Your dosage will depend on your weight. (See the table above for details.)

You’ll receive your first infusion, then another 2 weeks later, and another one 2 weeks after that. After these first three doses, you’ll have an infusion every 4 weeks.

If you receive Orencia by subcutaneous injection, you’ll use 125 mg once per week. You may be able to give yourself these injections at home. Your doctor will help you decide if this is right for you.

If you do use Orencia at home, your doctor will show you how to give yourself the injections. For information about where to inject Orencia, see the “How is Orencia used?” section below.

Dosage for polyarticular juvenile idiopathic arthritis

Orencia is used to treat polyarticular juvenile idiopathic arthritis in certain children. For details, see the “What’s the dosage of Orencia for children?” section just below.

What’s the dosage of Orencia for children?

Orencia is used to treat polyarticular juvenile idiopathic arthritis in children ages 2 years and older. Children ages 2 to 5 years will receive Orencia by subcutaneous injection. Children ages 6 years and older can receive Orencia either by IV infusion or subcutaneous injection.

When Orencia is given by IV infusion, the dosage depends on the child’s weight in kg.* The table below shows the dosage recommendations for children who receive Orencia by IV infusion:

Body weightDose
Less than 75 kg10 mg per kg of body weight
75 to 100 kg750 mg
More than 100 kg1,000 mg

The maximum dose of Orencia when given as an IV infusion is 1,000 mg.

When Orencia is given by subcutaneous injection, the dosage also depends on your child’s weight. Doses are given once per week, as shown in the table below.

Body weightDose (once weekly)
10 kg to less than 25 kg50 mg
25 kg to less than 50 kg87.5 mg
50 kg or more125 mg

To find out if your child can receive Orencia injections at home, talk with their doctor.

*One kg equals about 2.2 pounds.

Is Orencia used long term?

Yes, Orencia is typically used as a long-term treatment. If you and your doctor determine that Orencia is safe and effective for you, it’s likely that you’ll use it long term.

This section covers some frequently asked questions about Orencia.

How does dosing differ for an IV infusion and a subcutaneous injection of Orencia?

An intravenous (IV) infusion is an injection into a vein that’s given over time. If you receive Orencia by IV infusion, you’ll have each dose at your doctor’s office or an infusion center. Each infusion typically lasts 30 minutes.

Your dosage of the infusion will depend on your body weight. You’ll start with three infusions, spaced 2 weeks apart, and after that you’ll have an infusion every 4 weeks.

A subcutaneous injection is an injection under your skin. You might be able to give yourself Orencia injections at home using a prefilled syringe or the ClickJect autoinjector. The dosage for this form of the drug is 125 milligrams (mg) once per week.

For more details, see the “What is Orencia’s dosage?” section above.

What is a loading dose, and will I need one with Orencia?

A loading dose is a higher dose of a drug given at the beginning of treatment, before switching to a lower dosage. Loading doses are used to make sure that the level of the drug in your body is high enough that it can start treating your condition right away.

A loading dose of Orencia is only used in people with rheumatoid arthritis who want to receive the medication by subcutaneous injection. The loading dose will be based on your weight, and it’s given as a one-time IV infusion.

After this single loading dose, you can start a dosage of 125 mg by subcutaneous injection, once per week. You should give yourself your first subcutaneous injection the day after receiving the loading dose.

The dosage of Orencia you’re prescribed may depend on several factors. These include:

  • the type of condition you’re using Orencia to treat
  • your age
  • your body weight
  • the form of Orencia you’re using

Orencia can be given in two ways:

You and your doctor will discuss which option is best for you.

If you’re given Orencia by IV infusion, you’ll receive the infusions at your doctor’s office or an infusion center. Each infusion typically takes 30 minutes.

If you receive Orencia by subcutaneous injection, talk with your doctor about whether self-injections are an option for you. Your doctor will explain how to give yourself the injections using either the prefilled syringe or the ClickJect autoinjector.

If you give yourself subcutaneous injections at home, you should rotate the injection sites. You can inject Orencia into the following areas:

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

It’s important that you inject the full amount of Orencia each time. Avoid giving injections into areas where your skin is discolored, tender, hard, or bruised.

If you miss your appointment for the IV infusion, call your doctor’s office or the infusion center as soon as possible to reschedule.

If you use Orencia at home, and you’re unsure if you should give yourself a dose that you’ve missed, call your doctor or pharmacist for advice.

If you need help remembering to give yourself injections of Orencia on time, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

You shouldn’t use more Orencia than your doctor prescribes. Doing so can lead to serious side effects.

What to do in case you use too much Orencia

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

The sections above describe the typical dosages provided by the drug’s manufacturer. If your doctor recommends Orencia for you, they will prescribe the dosage that’s right for you.

Remember, you shouldn’t change your dosage of Orencia without your doctor’s recommendation. Only use Orencia exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Can I switch from receiving Orencia through intravenous infusions to having subcutaneous injections?
  • Will my dosage of Orencia change if my weight changes?
  • How do I give myself subcutaneous injections with either the prefilled syringe or the ClickJect autoinjector?

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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 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.