Adalimumab

Humira

Humira is an FDA-approved medication prescribed by a medical professional to treat various medical conditions, including plaque psoriasis, Crohn’s disease, psoriatic arthritis, juvenile idiopathic, and more. Its active ingredient, Adalimumab, helps reduce pain, inflammation, and skin symptoms in patients with chronic autoimmune conditions. It is sold under various brand names, like Abrilada, Cyltezo, Hulio, Idacio, Yusimry, Amjevita, Hadlima, and Yuflyma. Besides, the medication is suitable for both adults and children, but patients need to be mindful of its dosage due to different body needs, conditions, and the severity of each condition. So, always follow your healthcare provider’s advice to avoid any major complications.   

Humira Overview

Humira is a leading medication used to treat various autoimmune diseases. As an FDA-approved prescription drug, Humira is known for its effectiveness in reducing the signs and symptoms of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. This medication is also beneficial in treating moderate to severe Crohn’s disease, ulcerative colitis, and chronic plaque psoriasis. Adalimumab, a monoclonal antibody, targets and inhibits TNF or tumor necrosis factor, a protein that plays a crucial role in inflammatory processes.

Available in the form of a prefilled syringe or pen, Humira is typically administered as a subcutaneous injection. Depending on the forms of Humira, their strengths may vary. With such availability of Humira strengths, it becomes crucial for patients to follow their medical provider’s instructions for accurate dosage and administration. Humira can be taken by adults and certain children diagnosed with specific conditions. It reduces inflammation, alters the immune system’s response, relieves symptoms, and improves quality of life.

However, there are certain common side effects of Humira, which include injection site reactions, headaches, and respiratory infections. Therefore, patients are advised to contact their medical professional if they experience severe side effects such as allergic reactions or signs of infection. Moreover, precautions should be taken by those with a history of infections or who are currently using other immunosuppressive drugs. In case someone misses their dose of Humira, they should cover it up by taking the missed dose as soon as possible but do not overdose as it can lead to adverse reactions, which can be life-threatening. Lastly, store your medication in the refrigerator and protect it from light to avoid complications.

Uses of Humira

There are various uses of Humira, which are as follows:

• Crohn’s Disease in adults and children of 6 years and above.
• Ulcerative colitis in adults & children ages 5 years and above.
• Rheumatoid arthritis in adults.
• Plaque psoriasis in adults.
• Juvenile idiopathic arthritis in children of 2 years and older.
• Psoriatic arthritis in adults.
• Ankylosing spondylitis in adults.
• Hidradenitis suppurativa in adults & children ages 12 years and above.
• Specific forms of uveitis in children and adults 2 years of age and above.

Humira Dosage

Strengths and Forms

Humira comes in three different forms and has the following strengths:

Single-Dose Pen 

• 40 mg/0.4 mL
• 40 mg/0.8 mL, and 
• 80 mg/0.8 mL

Single-Dose Prefilled Syringe

• 10 mg/0.1 mL
• 10 mg/0.2 mL
• 20 mg/0.2 mL
• 20 mg/0.4 mL
• 40 mg/0.4 mL
• 40 mg/0.8 mL, and
• 80 mg/0.8 mL

Single-Dose Vial of Liquid Solution

• 40 mg/0.8 mL

Recommended Humira Dosage for Different Patients

Dosage for Adults

Since Humira is used to treat various conditions, its dosage may vary depending on the patient’s medical condition or the condition the drug treats. 

Plaque Psoriasis

• The usual starting dose is 80 mg, followed by a 40 mg dose every alternate week. This schedule starts the week after you have the first injection.
• To seamlessly follow their dosing schedule, patients can use a Humira starter kit that comes with prefilled pens or syringes. This kit helps them use the correct pen dosage during the first month of treatment.

Hidradenitis Suppurativa (HS)

• In the beginning, you will have a loading dose of 160 mg. It may be given as a single dose in a single day or divided into two doses that are administered back-to-back.
• After two weeks, you will be given a dose of 80 mg.
• On the 29th day, you will be given a 40 mg injection each week or an 80 mg injection every other week.
• To seamlessly follow their dosing schedule, patients can use a Humira starter kit that comes with prefilled pens or syringes. This kit helps them use the correct pen dosage during the first month of treatment.

Rheumatoid Arthritis (RA)

• The usual starting dose is 40 mg every other week.
• For patients who are not taking methotrexate (Trexall) with their Humira medication, doctors may increase their dosage to 40 mg or 80 mg every other week.

Psoriatic Arthritis (PsA)

• The starting dose is 40 mg every alternate week.

Ulcerative Colitis (UC)

• In the beginning, you will have a loading dose of 160 mg. It may be given as a single dose in a single day or divided into two doses that are administered back-to-back.
• After two weeks or on day 15th, you will be given a dose of 80 mg.
• On the 29th day, you will be given a 40 mg injection every second week.
• To seamlessly follow their dosing schedule, patients can use a Humira starter kit that comes with prefilled pens or syringes. This kit helps them use the correct pen dosage during the first month of treatment.

Crohn’s Disease (CD)

• In the beginning, you will have a loading dose of 160 mg. It may be given as a single dose in a single day or divided into two doses that are administered back-to-back.
• After two weeks or on day 15th, you will be given a dose of 80 mg.
• On the 29th day, you will be given a 40 mg injection every second week.
• To seamlessly follow their dosing schedule, patients can use a Humira starter kit that comes with prefilled pens or syringes. This kit helps them use the correct pen dosage during the first month of treatment.

Uveitis

• Doctors usually prescribe 80 mg of Humira at the beginning of the treatment, followed by a 40 mg dosage biweekly. This will start the week after you have the first injection.
• To seamlessly follow your dosing schedule, patients can use a Humira starter kit that comes with prefilled pens or syringes, helping them use the correct pen dosage during the first month of the treatment.

Ankylosing Spondylitis (AS)

• The starting dose of Humira is 40 mg twice a month.  

Dosage for Children

Humira dosages for children are determined on the basis of the child’s weight in kg (1kg=2.2 pounds/lb)

Hidradenitis Suppurativa (12 Years and Older)

• Children weighing 10 kg to less than 60 kg will receive an 80 mg loading dose on the first day and a 40 mg dose on the 8th day, followed by a 40 mg every other week.
• Children weighing 60 kg or more will get a 160 mg loading dose on the first day. This dose can split into two doses on 2 back-to-back days. Later, they will get an 80 mg dose on the 15th day, followed by a 40 mg dose every week or an 80 mg dose every alternate week on the 29th day. 
• To seamlessly follow the above dosing schedule, parents can use a Humira starter kit for their children that comes with prefilled pens or syringes, helping them use the correct pen dosage during the first month of the treatment.

Ulcerative Colitis (5 Years and Older)

• Children weighing 20 kg to below 40 kg will receive an 80 mg loading dose on the first day and a 40 mg dose on the 8th day, followed by a 40 mg on the day 15th. On the 29th day, they will be given either a 40 mg dose every other week or 20 mg every week.
• Children weighing 40 kg or more will be administered a 160 mg loading dose on the first day. This dose can be split into two doses on 2 back-to-back days. Later, they will get an 80 mg dose on the 8th day, followed by another 80 mg dose on the 15th day. Then, on the 29th day, they will either receive an 80 mg dose biweekly or 40 mg each week.   
• To seamlessly follow the above dosing schedule, parents can give their children a Humira starter kit that comes with prefilled pens or syringes. This kit helps them use the correct pen dosage during the first month of treatment.

Crohn’s Disease (6 Years and Above)

• Children with a body weight of 17 kg to less than 40 kg will receive an 80 mg loading dose on the first day and a 40 mg dose on the 15th day. On the 29th day, they will be given 20 mg every alternate week.
• Children weighing 40 kg or more will be administered a 160 mg loading dose on the first day. This dose can be divided into 2 doses on 2 back-to-back days. Later, they will get an 80 mg dose on the 15th day, followed by a 40 mg dose on the 29th day. Then, they will receive a 40 mg dose each alternate week.   
• To seamlessly follow the above dosing schedule, parents can give their children a Humira starter kit that comes with prefilled pens or syringes. This kit helps them use the correct pen dosage during the first month of treatment.

Uveitis (2 Years & Above)

• Children weighing 10 kg to below 15 kg will receive 10 mg of Humira biweekly.
• Children with a body weight of 15 kg to less than 30 mg will be administered 20 mg twice a month.
• Children weighing 30 kg or more will be administered with a 40 mg every alternate week.

Juvenile Idiopathic Arthritis (2 Years and Older)

• Children weighing 10 kg to below 15 kg will receive 10 mg of Humira biweekly.
• Children weighing 15 kg to below 30 mg will be administered with a 20 mg twice a month.
• Children weighing 30 kg or more will be administered with a 40 mg every alternate week.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take Humira?

• Humira is available as an injection, which is administered under the skin.
• Follow your doctor’s instructions or ask them about the dosage and administration, as they will be based on your specific condition and needs.
• Do not exceed the doses of your Humira injection that your medical professional has prescribed.
• Read the usage instructions for detailed information that comes inside the carton. This will give an idea of how to prepare and use the injection the right way.
• Before self-administering the injection, ensure that you have been shown how to inject Humira. If not, you can discuss your doubts with your healthcare practitioner.
• These injections are given in the belly and front of the thigh.
• Administer the injections on different spots of your body, at least 1 inch away from the last area you used them. This step prevents your skin from getting irritated and minimizes the risk of injection site reactions.
• Make sure that the injection site should be cleaned and sterilized beforehand.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Humira Work?

Humira works by targeting and blocking a protein called tumor necrosis factor (TNF). TNF plays a major role in causing inflammation in the body. By restricting TNF, Humira reduces inflammation and helps manage symptoms of autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis. This action helps decrease pain, swelling, and damage to the affected tissues, improving the patient’s overall quality of life.

Humira Side Effects

Common side effects of Humira may include:

• Pain
• Itching
• Swelling near the injection site
• Headache
• Cold
• Sneezing
• Cough
• Sore throat
• Rash
• Allergic reactions
• Weight loss

Serious side effects of Humira may include:

• Heart failure. Its signs may include:
  • Breath shortness
  • Weight gain
  • Swelling in ankles or feet
• Lupus-like syndrome. Signs are:
  • Difficulty in breathing
  • Joint pain
  • Chest pain or discomfort
  • Rash on arms or cheeks that worsens with sun exposure
• Nerve disorders like seizures or multiple sclerosis. Its symptoms include:
  • Dizziness
  • Tingling 
  • Numbness
  • Weakness in arms or legs
  • Vision issues
• Blood disorders like anemia (low red blood cells). Symptoms are:
  • Bleeding
  • Bruising
  • Fever
  • Skin paleness
• Liver damage. Its symptoms may include:
  • Belly pain
  • Not feeling hungry
  • Jaundice
  • Vomiting
• Lymphoma (white blood cell cancer)
• Severe infections like tuberculosis or pneumonia
• Loss of body muscle and fat
• Dark urine
• Clay-colored bowel movements

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Humira Warnings

• Drug Interactions: Co-administering TNF blockers and anakinra or abatacept can increase the chances of developing severe infections in patients who have rheumatoid arthritis. Therefore, such a group of patients should avoid the combination of Humira with these biologic products.
• Active Infection: People with active infections, like localized infections, should avoid using Humira. Before starting your treatment, you should talk to your doctor and discuss every associated complication.
• Specific Populations: Certain groups of people have a high chance of developing serious infections. So, before initiating your treatment with Humira, you should discuss every risk and benefit with your healthcare provider. These groups include patients:
  • With prolonger or recurrent infection
  • Who has been exposed to TB.
  • With a medical history of opportunistic infection
  • Who has stayed in contact with or traveled in areas of endemic mycoses or tuberculosis, including histoplasmosis, blastomycosis, or coccidioidomycosis.
  • With chronic conditions that expose them to infections.
• Hypersensitivity: People taking this medication have experienced angioneurotic edema and anaphylaxis. So, if you are noticing any unusual or serious allergic reaction, discontinue the use of Humira right away.
• Neurologic Reactions: Using TNF-blocking medications, such as Humira, has been associated with a small number of new or worsening symptoms, as well as MRI findings of diseases that demyelinate the central nervous system, such as optic neuritis and multiple sclerosis (MS). There have also been reports of peripheral demyelinating illnesses, such as Guillain-Barré syndrome. When prescribing Humira to patients who have recent or prior demyelinating diseases, prescribers should remain cautious.
• Hematologic Reactions: Rare reports of blood problems have been associated with using Humira. Symptoms may include bruising, bleeding, looking pale, and constant fever. While the relationship between these reports and Humira remains unclear, patients are advised to get medical help if they experience these signs. 
• Heart Failure: Cases of worsening CHF (congestive heart failure) and new onset CHF have been reported with TNF blockers, including Humira. Although Humira has not been formally studied in CHF patients, similar drugs showed a higher rate of serious CHF-related adverse reactions in clinical trials. Physicians should exercise caution and closely monitor patients with heart failure when using Humira.
• Autoimmunity: This medication may cause the formation of antibodies and the development of lupus-like syndrome. If you are experiencing signs like joint pain, difficulty breathing, chest pain, etc., discontinue the treatment and seek medical assistance.  

Humira Boxed Warning

• Serious Infections: Patients taking Humira have a high risk of developing serious infections, causing life-threatening situations like death or even hospitalizations. These infections may include:
  • Sepsis (condition when the body responds improperly to an infection, leading to death)
  • Tuberculosis (lung infection)
  • Histoplasmosis (fungal infection)

If a patient develops such serious infections during their treatment, the medication should be discontinued after consulting with a medical professional.

• Cancer: Several studies have reported cases of lymphomas (cancer of the lymphatic system ) and other types of cancers in adults and teens using Humira as their medication. Besides, young adults and teenagers with conditions like ulcerative colitis or Crohn’s disease have reported cases of hepatosplenic T-cell lymphoma (a rare lymphoma type), leading to digestive issues.     
• Allergy to Latex: Certain Humira products use needle covers made of latex or rubber. If you are among the people who have latex or rubber allergy, talk to your doctor about this issue beforehand. They will suggest some alternate options.
• Pregnancy: There is no clear warning regarding the use of Humira during pregnancy, but doctors usually recommend this product only when needed.  Consult with a medical expert and discuss every risk and benefit with them before using Humira.
• Breastfeeding: Lactating mothers are recommended against using this medication as it can pass into the human breast milk and may harm the breastfed child. Talk to a medical professional before making any decision.

Humira Precautions

• Before using this medication, tell your medical practitioner about your medical history or if you have any signs of infections, including fever, chills, cough, skin soreness, diarrhea, aches, tiredness, or tingling sensation during urination.
• If you are starting your treatment with Humira, make sure to test yourself for tuberculosis and closely monitor for any signs of TB during the usage.
• Do not take injections in spots where your skin is injured, hard, red, bruised, or tendered.
• If you are undergoing surgery or any medical procedure, inform your doctor about the products you are using, including prescription drugs, nonprescription drugs, and herbal products.

Humira Contraindications

There are no specific contraindications to Humira; however, patients allergic to Adalimumab or any of the product’s ingredients should not start their treatment with Humira.

Humira Missed Dose

Take the missed dose as soon as possible or whenever you remember.

If it is time for your new dose, you may omit the missed dose and continue your regular dosing schedule. 

In case you receive your doses at a medical clinic, call your medical provider immediately and reschedule for your missed dose.

Use medical apps or reminders to avoid missing any doses.

Take your doses at the same time each day or as your doctor prescribes.

If you are still unsure about the missed dose, you can talk to a medical professional. 

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Humira Overdose 

Patients are usually advised against overdosing on Humira or any other medication, as such actions can cause life-threatening situations. However, if you have mistakenly exceeded your maximum daily dose and are experiencing signs of adverse reactions, visit your nearest clinic or call 911.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Humira Storage

• Store your medication at 2°C to 8°C in the original container.
• Keep them away from light or direct sunlight.
• Avoid freezing Humira.
• You can also keep the medication at room temperature of 25°C maximum for 14 days.
• Avoid flushing the medication down the toilet.
• Do not keep them in damp areas like the bathroom or near the sink.
• Keep them out of reach and out of sight of children and pets.
• Discard the product properly when not in use.
• Ask your pharmacist or practitioner how to dispose of the product without harming the environment.
• Do not keep them at extreme heat or cold temperatures.
• Read the product’s label for detailed storage instructions.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Humira Interactions

• Enbrel (etanercept)
• Imuran (azathioprine)
• Methotrexate LPF Sodium (methotrexate)
• Abatacept
• Abemaciclib
• Abrocitinib
• Acalabrutinib
• Belatacept
• Belimumab
• Belinostat
• Bendamustine
• Cisplatin
• Cladribine
• Dacarbazine
• Daclizumab
• Epcoritamab
• Epirubicin
• Fentanyl
• Fexinidazole
• Idelalisib
• Ifosfamide

[Note: This isn’t a complete list, and there could be other drugs that interact with Humira. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Humira Alternatives

• Secukinumab (Cosentyx)
• Apremilast (Otezla)
• Acetaminophen (Tylenol)
• Infliximab (Remicade)
• Prednisone 
• Methylprednisolone
• Golimumab (Simponi)
• Tazarotene (Tazorac)
• Tofacitinib (Xeljanz)
• Azathioprine (Imuran)
• Vedolizumab (Entyvio)
• Balsalazide (Colazal)
• Certolizumab pegol (Cimzia)
• Cyclosporine 
• Sulfasalazine (Azulfidine)
• Leflunomide (Arava)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

For how long can I use Humira?

The duration of Humira use depends on your specific medical condition and response to treatment. Your medical practitioner will determine the appropriate length of time for your therapy. Some patients may use Humira long-term, while others might use it for shorter periods. Try to follow your doctor’s recommendations and have regular check-ups to assess your progress.

Can I use Humira while traveling?

Yes, you can use Humira while traveling shorter distances. However, it is essential to plan ahead. Keep your medication refrigerated and protected from light. Use a cooler or insulated bag for transportation. Ensure you have adequate supplies for your trip, and do not forget to carry a copy of your prescription. Consult your doctor for specific travel-related advice.

What happens if I suddenly stop using Humira?

Abruptly stopping Humira can lead to a return of your symptoms. It’s necessary to talk to an expert medical provider before altering or discontinuing your medication regimen. They can guide you on how to safely discontinue or adjust your treatment to avoid potential flare-ups or complications.

Can I experience hair loss while taking Humira?

Hair loss is not a common side effect of Humira, but some patients may experience it. If you notice significant hair loss during your treatment with Humira, discuss it with your doctor. They can help determine if the medication or another underlying condition is the cause and provide appropriate guidance.

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