Humira Injection

How does it work?

• The active ingredient, adalimumab, is a human monoclonal antibody produced by cultured cells. Monoclonal antibodies are proteins that recognise and bind to other unique proteins.
• Adalimumab binds to a specific protein (tumour necrosis factor or TNFα), which is present at increased levels in infl ammatory diseases such as rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease and psoriasis.

When and how do I take it?

• Always take Humira exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
• Humira is injected under the skin (subcutaneous use).

What’s the dose?

The usual dose for adults with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis is 40 mg adalimumab given every other week as a single dose.

In rheumatoid arthritis, methotrexate is continued while using Humira. If your doctor determines that methotrexate is inappropriate, Humira can be given alone.
If you have rheumatoid arthritis and you do not receive methotrexate with your Humira therapy, your doctor may decide to give 40 mg adalimumab every week.
The recommended dose of Humira for patients with polyarticular juvenile idiopathic arthritis, aged 13 years and above, is 40 mg adalimumab administered every other week as a single dose via subcutaneous injection.

The usual dose regimen for Crohn’s disease is 80 mg at Week 0 and followed by 40 mg every other week starting at Week 2. In cases where a more rapid response is required your doctor may prescribe a dose of 160 mg at Week 0 (as 4 injections in one day or 2 injections per
day for two consecutive days), 80 mg (2 injections) at Week 2, and thereafter as 40 mg (1 injection) every other week. Depending on your response, your doctor may increase the dose to 40 mg every week. The usual dose for adults with psoriasis is an initial dose of 80 mg, followed by 40 mg given every other week starting one week after the initial dose. You should continue to inject Humira for as long as your doctor has told you.

Could it interact with other tablets?

• Humira can be taken together with methotrexate or certain disease-modifying anti-rheumatic agents (sulfasalazine, hydroxychloroquine, lefl unomide and injectable gold preparations), steroids or pain medications including non-steroidal anti-infl ammatory drugs (NSAIDs).
• Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
• You should not take Humira with medicines containing the active substance, anakinra or abatacept. If you have questions, please ask your doctor.
• Herbal products should also only be taken after talking with your doctor.

What are the possible risks or side-effects?

Like all medicines, Humira can have side effects, although not everybody gets them. Most side effects are mild to moderate. However, some may be serious and require treatment. Side effects may occur at least up to 5 months after the last Humira injection.

Tell your doctor immediately if you notice any of the following:

• Severe rash, hives or other signs of allergic reaction;
• Swollen face, hands, feet;
• Trouble breathing, swallowing;
• Shortness of breath with exertion or upon lying down or swelling of the feet;
• Signs and symptoms suggestive of blood disorders such as persistent fever, bruising, bleeding, paleness;

Tell your doctor as soon as possible if you notice any of the following:

• Signs of infection such as fever, feeling sick, wounds, dental problems, burning on urination;
• Feeling weak or tired;
• Coughing;
• Tingling;
• Numbness;
• Double vision;
• Arm or leg weakness;
• A bump or open sore that doesn’t heal.

The symptoms described above can be signs of the below listed side effects, which have been observed with Humira:

Very common (in more than 1 in 10 patients):

• injection site reactions (including pain, swelling, redness or itching);
• respiratory tract infections (including cold, runny nose, sinus infection, pneumonia);
• headache;
• abdominal pain;
• nausea and vomiting;
• rash;
• musculoskeletal pain.

Common (in more than 1 in 100 patients but less than 1 in 10 patients):

• serious infections (including blood poisoning and influenza);
• skin infections (including cellulitis and shingles);
• ear infections;
• oral infections (including tooth infections and cold sores);
• reproductive tract infections;
• urinary tract infection;
• fungal infections;
• benign tumours;
• skin cancer;
• allergic reactions (including seasonal allergy);
• mood swings (including depression);
• anxiety;
• feeling sleepy and difficulty sleeping;
• sensation disorders such as tingling, prickling or numbness;
• migraine;
• sciatica (including low back pain and leg pain);
• vision disturbances;
• eye inflammation;
• vertigo;
• sensation of heart beating rapidly;
• high blood pressure;
• flushing;
• haematoma;
• cough;
• asthma;
• shortness of breath;
• gastrointestinal bleeding;
• dyspepsia (indigestion, bloating, heartburn);

Can I drink alcohol while taking it?

• There are no known interactions between alcohol and Humira

Always ask you doctor or pharmacist however as other medications you are taking may have a bearing on this.

What if I’m pregnant/breastfeeding?

• The effects of Humira in pregnant women are not known and so the use of Humira in pregnant women is not recommended. You are advised to avoid becoming pregnant and must use adequate contraception while using Humira and for at least 5 months after the last Humira
• treatment.
• It is not known whether adalimumab passes into breast milk. If you are a breast-feeding mother, you should stop breast-feeding during Humira treatment
• and for at least 5 months after the last Humira treatment.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

http://www.medicinenet.com/adalimumab/article.htm

https://www.humira.com/

http://www.drugs.com/humira.html

http://www.rxlist.com/humira-drug.htm

https://en.wikipedia.org/wiki/Adalimumab

http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088611.pdf