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Crohn's disease
Adult: For moderately to severely active cases in patients who had an inadequate response to conventional therapy, or lost response to or are intolerant to infliximab: Induction: 80 mg, followed by 40 mg after 2 weeks. Alternatively, 160 mg on Day 1 (given as four 40 mg inj in 1 day, or as two 40 mg inj daily for 2 consecutive days), followed by 80 mg 2 weeks later on Day 15 (given as two 40 mg inj in 1 day). Maintenance: 40 mg every other week starting Day 29. If necessary, may increase dose to 40 mg weekly or 80 mg every other week according to individual response. Review therapy if there is no response within 12 weeks.
Child: For moderately to severely active cases in patients who had an inadequate response to conventional therapy including primary nutrition treatment, a corticosteroid and/or an immunomodulator, or are intolerant to or have contraindications for such treatments: ≥6 years weighing <40 kg: Induction: 40 mg on Day 1, then 20 mg 2 weeks later on Day 15. If a more rapid response is needed (with higher risk of adverse effects), may administer 80 mg on Day 1, then 40 mg 2 weeks later on Day 15. Maintenance: 20 mg every other week starting Day 29. In patients with insufficient response, dose may be increased to 20 mg weekly; ≥40 kg: Induction: 80 mg on Day 1, then 40 mg 2 weeks later on Day 15. If a more rapid response is needed (with higher risk of adverse effects), may administer 160 mg on Day 1 (given as 160 mg in 1 day, or as 80 mg daily for 2 consecutive days), then 80 mg 2 weeks later on Day 15. Maintenance: 40 mg every other week starting Day 29. In patients with insufficient response, dose may be increased to 40 mg weekly, or 80 mg every other week. Review therapy if there is no response within 12 weeks. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines).
Child: For moderately to severely active cases in patients who had an inadequate response to conventional therapy including primary nutrition treatment, a corticosteroid and/or an immunomodulator, or are intolerant to or have contraindications for such treatments: ≥6 years weighing <40 kg: Induction: 40 mg on Day 1, then 20 mg 2 weeks later on Day 15. If a more rapid response is needed (with higher risk of adverse effects), may administer 80 mg on Day 1, then 40 mg 2 weeks later on Day 15. Maintenance: 20 mg every other week starting Day 29. In patients with insufficient response, dose may be increased to 20 mg weekly; ≥40 kg: Induction: 80 mg on Day 1, then 40 mg 2 weeks later on Day 15. If a more rapid response is needed (with higher risk of adverse effects), may administer 160 mg on Day 1 (given as 160 mg in 1 day, or as 80 mg daily for 2 consecutive days), then 80 mg 2 weeks later on Day 15. Maintenance: 40 mg every other week starting Day 29. In patients with insufficient response, dose may be increased to 40 mg weekly, or 80 mg every other week. Review therapy if there is no response within 12 weeks. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines).
Subcutaneous
Ulcerative colitis
Adult: For moderately to severely active cases in patients who had an inadequate response to conventional treatment including corticosteroids and 6-mercaptopurine or azathioprine, or are intolerant to or have contraindications for such therapies: Induction: 160 mg on Day 1 (given as four 40 mg inj in 1 day, or as two 40 mg inj daily for 2 consecutive days), then 80 mg 2 weeks later on Day 15 (given as two 40 mg inj in 1 day). Maintenance: 40 mg every other week starting Day 29. If necessary, may increase dose to 40 mg weekly or 80 mg every other week according to individual response. Review therapy if there is no response within 8 weeks.
Child: For moderately to severely active cases in patients who had an inadequate response to conventional treatment including corticosteroids and 6-mercaptopurine or azathioprine, or are intolerant to or have contraindications for such therapies: ≥6 years weighing <40 kg: Induction: 80 mg on Day 1 (given as two 40 mg inj in 1 day), then 40 mg 2 weeks later on Day 15. Maintenance: 40 mg every other week or 20 mg weekly starting Day 29; ≥40 kg: 160 mg on Day 1 (given as four 40 mg inj in 1 day, or two 40 mg inj daily for 2 consecutive days), then 80 mg 2 weeks later on Day 15 (given as two 40 mg inj in 1 day). Maintenance: 80 mg every other week or 40 mg weekly starting Day 29. Review therapy if there is no response within 8 weeks. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines).
Child: For moderately to severely active cases in patients who had an inadequate response to conventional treatment including corticosteroids and 6-mercaptopurine or azathioprine, or are intolerant to or have contraindications for such therapies: ≥6 years weighing <40 kg: Induction: 80 mg on Day 1 (given as two 40 mg inj in 1 day), then 40 mg 2 weeks later on Day 15. Maintenance: 40 mg every other week or 20 mg weekly starting Day 29; ≥40 kg: 160 mg on Day 1 (given as four 40 mg inj in 1 day, or two 40 mg inj daily for 2 consecutive days), then 80 mg 2 weeks later on Day 15 (given as two 40 mg inj in 1 day). Maintenance: 80 mg every other week or 40 mg weekly starting Day 29. Review therapy if there is no response within 8 weeks. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines).
Subcutaneous
Non-radiographic axial spondyloarthritis
Adult: For severe cases but with objective signs of inflammation by elevated CRP and/or MRI in patients who had an inadequate response to or are intolerant to NSAIDs: 40 mg every other week as a single dose. Review therapy if there is no response within 12 weeks.
Subcutaneous
Ankylosing spondylitis
Adult: For active cases in patients who had an inadequate response to conventional therapy: 40 mg every other week as a single dose. Review therapy if there is no response within 12 weeks. Treatment guidelines may vary among individual products or between countries (refer to specific product recommendations).
Subcutaneous
Rheumatoid arthritis
Adult: For moderately to severely active cases in patients who had an inadequate response to disease-modifying antirheumatic drugs (DMARDs): As monotherapy or in combination with methotrexate or other DMARDs: 40 mg every other week as a single dose. When used as monotherapy, may increase dose to 40 mg weekly, or 80 mg every other week. Review therapy if there is no response within 12 weeks. Treatment guidelines may vary among individual products or between countries (refer to specific product recommendations).
Subcutaneous
Psoriatic arthritis
Adult: As monotherapy or in combination with DMARDs in patients with an inadequate response to previous DMARD treatment: 40 mg every other week as a single dose. Review therapy if there is no response within 12 weeks.
Subcutaneous
Enthesitis-related arthritis
Child: For active cases in patients who had an inadequate response to or are intolerant to conventional therapy: ≥6 years weighing 15 to <30 kg: 20 mg every other week; ≥30 kg: 40 mg every other week. Doses are given via SC inj.
Subcutaneous
Polyarticular juvenile idiopathic arthritis
Child: As monotherapy or in combination with methotrexate in patients who had an inadequate response to 1 or more DMARDs: ≥2 years weighing 10 to <30 kg: 20 mg every other week; ≥30 kg: 40 mg every other week. Doses are given via SC inj. Review therapy if there is no response within 12 weeks. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines).
Subcutaneous
Chronic non-infectious anterior uveitis
Child: In combination with methotrexate in patients who had an inadequate response to or are intolerant to conventional treatment, or in whom conventional therapy is inappropriate: ≥2 years weighing <30 kg: Initially, 40 mg loading dose given 1 week before maintenance therapy starts. Maintenance: 20 mg every other week; ≥30 kg: Initially, 80 mg loading dose given 1 week before maintenance therapy starts. Maintenance: 40 mg every other week. Doses are given via SC inj.
Subcutaneous
Plaque psoriasis
Adult: For moderate to severe chronic cases in patients who are candidates for systemic therapy or phototherapy, or when other systemic therapies are less appropriate: Initially, 80 mg as a single dose, followed by 40 mg every other week starting 1 week after the initial dose. Review therapy if there is no response within 16 weeks. If response is inadequate beyond 16 weeks, may increase dose to 40 mg weekly or 80 mg every other week. Once adequate response is achieved, subsequently reduce dose to 40 mg every other week.
Child: For severe chronic cases in patients who had an inadequate response to or are inappropriate candidates for topical therapy and phototherapy: ≥4 years weighing 15 to <30 kg: Initially, 20 mg, followed by 20 mg every other week beginning 1 week after the initial dose; ≥30 kg: Initially, 40 mg, followed by 40 mg every other week starting 1 week after the initial dose. Review therapy if there is no response within 16 weeks.
Child: For severe chronic cases in patients who had an inadequate response to or are inappropriate candidates for topical therapy and phototherapy: ≥4 years weighing 15 to <30 kg: Initially, 20 mg, followed by 20 mg every other week beginning 1 week after the initial dose; ≥30 kg: Initially, 40 mg, followed by 40 mg every other week starting 1 week after the initial dose. Review therapy if there is no response within 16 weeks.
Subcutaneous
Hidradenitis suppurativa
Adult: For moderate to severe active cases in patients with an inadequate response to conventional systemic hidradenitis suppurativa (HS) therapy: Initially, 160 mg at Day 1 (given as four 40 mg inj in 1 day, or as two 40 mg inj daily for 2 consecutive days), followed by 80 mg 2 weeks later at Day 15 (given as two 40-mg inj in 1 day). Maintenance: 40 mg weekly, or 80 mg every other week (given as two 40-mg inj in 1 day) starting Day 29. Review therapy if there is no response within 12 weeks.
Child: For moderate to severe active cases in patients with an inadequate response to conventional systemic HS therapy: ≥12 years weighing ≥30 kg: Initially, 80 mg at Day 1. Maintenance: 40 mg every other week starting Day 8. In patients with inadequate response, may increase the maintenance dose to 40 mg weekly, or 80 mg every other week. Review therapy if there is no response within 12 weeks.
Child: For moderate to severe active cases in patients with an inadequate response to conventional systemic HS therapy: ≥12 years weighing ≥30 kg: Initially, 80 mg at Day 1. Maintenance: 40 mg every other week starting Day 8. In patients with inadequate response, may increase the maintenance dose to 40 mg weekly, or 80 mg every other week. Review therapy if there is no response within 12 weeks.
Subcutaneous
Non-infectious intermediate uveitis, Noninfectious panuveitis, Non-infectious posterior uveitis
Adult: In patients who had an inadequate response to corticosteroids, those in need of corticosteroid-sparing, or in whom corticosteroid therapy is inappropriate: Initially, 80 mg as a single dose, followed by 40 mg every other week starting 1 week after the initial dose. Some guidelines recommend initiating treatment in combination with corticosteroids and/or other non-biologic immunomodulatory agents. Evaluate patients yearly to determine if continued long-term treatment is necessary.
