Adalimumab (injection), sold under the brand name Humira, comes in the form of a solution (liquid). It belongs to a class of drugs known as TNF blockers. It is typically used to reduce pain and swelling due to certain types of arthritis and skin disorders. In this article, we’ll answer some of the most common questions about adalimumab, including its uses, side effects, and interactions.

What is adalimumab?

Adalimumab is an immunosuppressive medication that belongs to a class of drugs known as TNF (Tumor Necrosis Factor) blockers. It is usually prescribed to people who experience some types of autoimmune disorders (conditions in which the immune system attacks healthy parts of the body and causes pain, swelling, and damage). Some examples of the disorders are arthritis diseases (such as rheumatoid, psoriatic, juvenile idiopathic, and ankylosing spondylitis) and certain skin diseases (such as plaque-type psoriasis and hidradenitis suppurativa).

How does adalimumab work?

Adalimumab works by blocking a protein (TNF) found in the body’s immune system that causes joint swelling and damage in arthritis or red scaly patches in psoriasis. The drug reduces the swelling, lessens the damage it causes, and preserves the joints’ function.

How is adalimumab administered?

Adalimumab is administered by injecting the drug into the subcutaneous tissue of the body, for example, the upper outer area of the arm, the front and outer sides of the thighs, and the upper hip. If you have to self-administer the injection or to your child at home, your doctor, pharmacist, or a homecare support nurse will show you how to do it correctly. Use this medication exactly as prescribed and instructed.

This video provides helpful step-by-step instructions and demonstration on how to self-inject adalimumab (Humira).

Remember to clean the injection site with rubbing alcohol before injecting. Change the injection site each time to lessen the injury under the skin. Give each injection at least 1 inch (2.5 centimeters) away from the previous spot. Don’t inject into a sore, bruise, or red area of the skin.

How do I use the adalimumab syringe kit?

First and foremost, read the guide that comes with the drug package before using this medication and follow the instructions from your health care professional.

If you are using a prefilled syringe or a dosing pen that has been refrigerated, don’t warm the medication by placing it in hot water, heating it in a microwave, or through any other method. Simply allow it to warm up to room temperature naturally.

Before injecting adalimumab, always check the injection solution. The liquid should be clear and colorless. Additionally, learn how to store the drug and discard the syringe kit responsibly.

What are the available dosage forms of adalimumab?

Under the brand name Humira, adalimumab is available in three single-use dosage forms (prefilled glass syringe, prefilled syringe/pen, and vial) and four different strengths (10, 20, 40, and 80 mg).

Your doctor will decide what dosage and how often you should take the medication based on your medical condition and response to treatment. We recommend not to discontinue using adalimumab injection without talking to your doctor even if you feel well.

What should I tell my doctor before starting adalimumab?

Some people may not be suitable for using adalimumab. To make sure this medicine is safe for you, tell your doctor about your past and current health conditions, including if you:

• Have or have had cancer
• Have or had heart failure
• Have diabetes
• Have or have had hepatitis B
• Have an infection, are being treated for infection, or have symptoms of an infection
• Have tuberculosis (TB) or have been in close contact with someone with TB, or travelled where there is more risk for getting TB
• Have numbness or tingling or a nervous system disease such as multiple sclerosis
• Have recently received or are scheduled to receive a vaccine
• Are allergic to rubber or latex
• Are scheduled for major surgery
• Are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed

This isn’t a complete list of all the conditions that may interact with adalimumab. To avoid any unwanted effects, we recommend having a thorough discussion with your doctor.

What are the side effects of adalimumab?

The common side effects of adalimumab are pain at the injection site, (e.g., redness, itching, pain, or swelling), nausea, and headache. Tell your doctor if these symptoms don’t go away within a few days or get worse.

Since adalimumab affects the immune system, you might develop some signs of infection, including sore throat, cough, and fever, while using this medication. Avoid contact with people who have infections that may spread (such as chickenpox, measles, and flu). Wash your hands well and keep your house clean and hygienic to minimize the chance of getting infected. Discuss with your doctor before getting vaccinated and avoid contact with people who have recently received live vaccines, such as FluMist (nasal flu vaccine), mumps, and rubella.

In some cases, the side effects can be serious. If you are experiencing any of the following symptoms, seek emergency medical attention right away:

• Symptoms of heart failure – such as shortness of breath, swelling ankles/feet, unusual tiredness, and unusual/sudden weight gain
• Allergic reactions – with symptoms such as hives, trouble breathing, and swelling of your face
• Liver problems – with symptoms such as frequent nausea/vomiting, poor appetite, skin/eyes look yellow, and pain on the right side of your stomach

Not all possible side effects of adalimumab are listed above. We suggest contacting your doctor if you notice other effects that aren’t on the list.

What other medicines can interact with adalimumab?

You shouldn’t take adalimumab with medicines that can increase the risk of serious infections. Some medications that may interact with this drug are:

• Live vaccines – live vaccines are contraindicated (should not be used) in patients taking adalimumab such as FluMist (nasal flu vaccine), MMR (measles, mumps, rubella), Varicella and Herpes Zoster
• Other TNF blockers – such as etanercept and infliximab
• Other drugs that weaken the immune system – such as abatacept and anakinra

This is not a complete list of medicines that can interact with adalimumab. Tell your doctor or pharmacist if you're taking any other medications, including herbal medicines, vitamins, or supplements.

What should I do if I missed a dose?

If you miss a dose, you should take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Don’t double the dose to catch up.

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