What is Adalimumab (Humira®)?
Adalimumab is a drug that reduces the signs and symptoms of moderate to severe rheumatoid arthritis (RA), such as joint swelling, pain, and fatigue. It is also approved for the treatment of psoriatic arthritis and ankylosing spondylitis, juvenile idiopathic arthritis, Crohn’s disease, uveitis, and hidradenitis suppurativa. Adalimumab is commonly known as Humira®. It is a type of drug called a biologic.
How do I take it?
Adalimumab is injected under the skin (similar to insulin injections) once every other week. The injections are 40 mg each and are available in either a prefilled syringe or an automatic “pen” injector. You will be instructed on how to give yourself injections.
What about side effects?
The medicine can cause itching or redness near the injection site. If this happens, the discomfort should be mild. If you have pain, swelling, warmth, or discoloration near the injection site, you should contact your healthcare provider.
Allergic reactions may happen. Call your healthcare provider or 911 if you have any signs of an allergic reaction, such as rashes or hives; swollen face, eyelids, lips, or tongue; and difficulty breathing.
The most common serious side effect is infection. Adalimumab can lower the body’s ability to fight infection. Be sure to contact your physician if you have any signs of infection, such as fever, fatigue, cough, or red or painful skin. You may have to stop adalimumab while being treated for an infection. You may also have to stop if you are planning a surgery.
You will need to have a negative tuberculosis (TB) test before beginning adalimumab therapy. Your doctor will also check your blood to make sure you do not have Hepatitis B or C.
Make sure your doctor knows if you have any symptoms of heart disease, like shortness of breath when you lie down or exert yourself, swelling or edema of your legs, ankles, and feet, or chest pain or heaviness. This class of drugs may cause your heart disease to get worse.
Tell your doctor if you live or have lived in an area where fungal infections are more common. You may be at higher risk of getting a fungal infection while taking adalimumab.
You should not take a live vaccine (Flu-Mist, chicken pox vaccine, shingles vaccine) while on adalimumab. The flu-shot is not a live virus and all patients should consider having this vaccination yearly.
What about other medications?
Many patients need to continue another oral medicaiton for RA, like methotrexate or plaquenil, while on adalimumab, and should continue to take this if advised to do so by their doctor.
Never take adalimumab with another TNF blocker such as etanercept (Enbrel®), or infliximab (Remicade®), or any other biologic medication used to treat RA.
When you are taking adalimumab, it is very important that your doctors know if you are taking any other medicine. This includes prescription and non-prescription medicines as well as birth control pills, vitamins, and herbal supplements.
What else should I know?
The adalimumab pen or pre-filled syringe must be refrigerated in its original container. Do not freeze this medicine. If you are traveling, you may store adalimumab at room temperature at a maximum of 77oF (25oC) for up to 14 days.
You must continue your regular visits to the rheumatologist. Your doctor will monitor you for any improvements in your disease and for any signs of infections. Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with TNF blockers, including adalimumab.
A Federal Drug Administration approved medication guide can be found at: