Adalimumab is used to treat various inflammatory diseases such as:
- moderate to severe Crohn’s disease (long-term inflammatory disease of the digestive tract)
- moderate to severe ulcerative colitis (inflammation of the large intestines and rectum)
- ankylosing spondylitis (inflammation of the joints of your spine)
- non-radiographic axial spondyloarthritis (a rare type of joint inflammation in the spine)
- moderate to severe long-term plaque psoriasis (a type of skin disease that allows the skin cells to rapidly build up causing itchy patches of thick, red skin and silvery scales)
- hidradenitis suppurativa (a long-term inflammatory skin condition characterised by painful bumps usually in armpits or groin)
This medicine may also be used on its own or together with other medicines to treat rheumatoid arthritis (inflammation in joints of fingers, wrist, feet, ankles), psoriatic arthritis (joint pain and inflammation that affects people with psoriasis), and certain forms of non-infectious uveitis (type of eye inflammation).
Adalimumab may be used to treat other conditions as decided by your doctor.
Adalimumab is to be injected subcutaneously (into the fatty layer under the skin, usually in the thighs or abdomen area).
Your doctor or nurse will administer the injection for you. If you or your caregiver had been given the proper training on the preparation and injection techniques of this medicine, you or your caregiver may do the administration.
Use Adalimumab exactly as directed by your doctor or according to the instructions on the label. Do not administer more or less than instructed by your doctor.
Remember to rotate the injection sites. Do not inject into the same area all the time. New injection sites should be at least 1.5 inches away from the previous injection site. Do not inject near the navel (belly button), and into areas where the skin is tender, bruised, red, hard, scarred, or affected by psoriasis.
Adalimumab is available as a single-dose vial, and as a pre-filled pen or syringe.
Make sure you know how to use the pre-filled pen or syringe. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
The single-dose vial is intended to be used only if you are in the hospital or the doctor’s clinic.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Adalimumab must be administered regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor.
Ensure that you keep all appointments with your doctor so that you do not miss any dose. Your doctor also needs to regularly monitor your response to Adalimumab.
If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.
If you or a caregiver had been trained to administer this medicine and missed a dose, inject the missed dose as soon as you remember and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
Inform your doctor or pharmacist immediately if you forgot to administer your dose.
Alert your doctor if you have the following conditions:
- active TB (infection known as tuberculosis) or other severe infections
- moderate to severe heart failure (weakness and inability of the heart to pump blood)
as Adalimumab may not be suitable for you.
Alert your doctor if you have been recently vaccinated. You must avoid any vaccinations without consulting with your doctor.
Inform your doctor if you have the following conditions:
- mild heart failure
- long-term or recurring infections
- current or history of cancer
- HIV infection
- long-term lung disease that causes airflow obstruction making it hard to breathe
- history of blood disorders
- demyelinating disorders (condition that leads to damage in the protective covering of nerve fibres in the brain or spinal cord)
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving this medicine to a child or the elderly. Children and elderly people may be more sensitive to the side effects.
Inform your doctor if you have resided in or travelled to areas with endemic cases of TB or fungal infections.
Notify your doctor if you are a heavy smoker.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are using Adalimumab.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Your doctor may conduct screening tests for TB or hepatitis B infection before treatment to know if this medicine is suited for you to use.
- Routine tests (e.g. complete blood count, blood sugar, electrolyte) may be done while you are being treated with Adalimumab. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring for signs and symptoms of infection and allergic reactions may also be needed.
Adalimumab may cause dizziness with sensations of spinning or some problems with your eyesight. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.
Other side effects include any of the following: headache, nausea, vomiting, stomach pain, indigestion, cough, runny nose, back or muscle pain, difficulty sleeping, hair loss, and swelling, pain, redness or itching at the injection site.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of allergic reactions e.g. rashes, breathlessness, swelling of the face, eyes, lips, or tongue
- signs and symptoms of heart problems e.g. shortness of breath, swelling of ankles or feet, sudden weight gain
- fever, joint pain, persistent unexplained rash that worsens when exposed to the sun
- changes in vision, dizziness, weakness in the arms or legs, numbness or tingling sensation in any part of the body
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, unusual tiredness
This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Avoid vaccinations with live vaccines during treatment with this medicine. Alert your doctor if you have been recently vaccinated or if you are planning to get vaccinated.
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- other medicines used to treat rheumatoid arthritis e.g. abatacept, anakinra
- theophylline (asthma medicine)
- ciclosporin (medicine used in organ transplant or certain immune disorders)
- warfarin (blood-thinning medicine)
This list does not include all medicines that may interact with Adalimumab.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Store in a refrigerator, between 2-8°C.
Do not freeze Adalimumab otherwise, it will no longer be effective and should not be used.
Keep the pre-filled pen or syringe in its original carton to protect from light.
If necessary such as when travelling, you may store the pre-filled pen or syringe at room temperature (up to 25°C) for up to 14 days. Protect from light. Once removed from the refrigerator for room temperature storage, the pen or syringe must be used within 14 days.
If you notice that the injection has changed colour or has become cloudy, do not use it. Throw it away and use a new injection.
Medicines must not be used past the expiry date.