What Is Humira (Adalimumab)?
Humira is also used to treat juvenile idiopathic arthritis (JIA) in children over age 4.
When other treatments have failed, doctors sometimes prescribe Humira to adults for:
- Psoriatic arthritis
- Ankylosing spondylitis (a type of spinal arthritis)
- Crohn’s disease
- Ulcerative colitis
- Psoriasis
TNF blockers help reduce inflammation and slow the progression of inflammatory conditions by targeting TNF, a substance produced by the immune system that causes inflammation in the body.
Abbott Laboratories developed Humira, and the Food and Drug Administration (FDA) first approved the drug in 2002 to treat rheumatoid arthritis.
In 2013, Abbott Labs separated from its research-based pharmaceuticals business, now known as AbbVie, an independent biopharmaceutical company with a portfolio of medications including Humira.
AbbVie began clinical trials in 2014 to investigate use of Humira to treat fingernail psoriasis, which causes pitting, discoloration, irregular shape, and loosening of the fingernails.
Although the patent on Humira in the United States is not set to expire until the end of 2016, clinical trials are under way for a generic form of the drug.
Humira Warnings
Humira carries a black-box warning because it can affect your immune system and reduce your ability to fight infections.
Some people who have taken the drug have developed serious or life-threatening infections, including tuberculosis (TB).Your doctor should test you for TB before you start taking Humira and monitor you closely for any signs of infection during treatment.
Taking Humira or other TNF blockers may also increase your risk for certain types of cancer, including basal cell and squamous cell skin cancer.
Children, teenagers, and young adults taking these drugs have also developed unusual cancers.
If you have rheumatoid arthritis, you may be more likely to develop lymphoma, a cancer of a part of the immune system known as the lymph system.
Before you start taking Humira, be sure to tell your doctor if you think you have an infection, or if you have an infection that keeps coming back, such as a cold sore.
Tell your doctor if you have any signs of infection, including:
- Fever or chills
- Warm, red, or painful skin or sores on your body
- Muscle aches
- Diarrhea or stomach pain
- Cough
- Burning when you urinate or increased frequency of urination
- Shortness of breath
- Extreme fatigue
- Weight loss
These infections can develop or become more severe if you use Humira.
Let your doctor know if you have a condition that weakens your immune system. Before starting treatment with Humira, tell your doctor if you've ever been affected by any of the following:
- Heart failure
- Diabetes
- Cancer
- Hepatitis B
- Tuberculosis (or if you've been in contact with someone who has TB)
- Numbness, tingling, or a disease that affects your nervous system, such as multiple sclerosis or Guillain-Barré syndrome
Although Humira can ease the symptoms of juvenile idiopathic arthritis in children 4 to 17 years old, researchers have not studied the effects of the drug in children younger than 4 years, or those weighing less than 33 pounds.
Humira Cost
Pharmaceutical industry observers have noted that the cost of Humira, like that of many other anti-rheumatic drugs, has risen sharply.The Humira cost increase comes shortly before the drug's patent is set to expire (in 2016 in the United States and in 2018 in Europe).
According to a 2015 report in the journal Arthritis and Rheumatology, the annual cost for some anti-rheumatic drugs such as Humira can exceed $20,000.
Humira and Pregnancy
There is not sufficient evidence to know whether Humira is safe to take during pregnancy.If you're a woman, tell your doctor if you're pregnant, may become pregnant, or are breastfeeding.
You should take Humira only if the potential benefits of the drug outweigh possible risks to your fetus. Breastfeeding women should not take Humira.
Humira Side Effects
- Numbness or tingling
- Vision problems
- Weakness in your legs
- Chest pain
- Shortness of breath
- New joint pain
- Hives
- Itching
- Swelling of the face, feet, ankles, or lower legs
- Rash on your cheeks or arms that gets worse in the sun
- Trouble breathing or swallowing
- Fever, sore throat, chills, and other signs of infection
- Unusual bruising or bleeding
- Pale skin
- Dizziness
- Red, scaly patches or raised, pus-filled bumps
Symptoms of these reactions, which typically clear up within a few days, may include:
- Redness
- Swelling
- Itching
- Bruising
- Upper respiratory infections (including sinus infections)
- Headaches
- Rash
- Nausea
- Back pain
Humira Interactions
Humira and Drug Interactions
Some drugs may affect the way Humira works, and Humira injections may affect other drugs you are taking.It's very important to let your doctor know about all drugs you are taking, including illegal or recreational drugs, over-the-counter medications, herbs and herbal preparations, and dietary and nutritional supplements.
Humira interacts with methotrexate (Trexall), a drug prescribed for rheumatoid arthritis, psoriasis and certain cancers.
It's important to note that doctors often prescribe Humira in combination with methotrexate.
Most people who developed serious infections while taking Humira were also taking drugs such as methotrexate or corticosteroids that suppress the immune system.
Other drugs that interact with Humira include:
- Disease-modifying antirheumatic drugs (DMARDs), including anakinra (Kineret), Abatacept (Orencia), and rituximab (Rituxan and MabThera)
- Live vaccines, such as Flu-Mist, shingles vaccine, chicken pox vaccine, yellow fever vaccine, or MMR (measles-mumps-rubella) vaccine.
Other Humira Interactions
As noted above, you should not receive any live vaccines if you are taking Humira.Among the live vaccines you should avoid:
- Yellow fever
- Measles-mumps-rubella (MMR)
- Varicella vaccines
- Flu-Mist
- Shingles vaccine
Humira Dosage
For people with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, a typical dose is 40 milligrams (mg) injected under the skin every other week.
Sometimes people with rheumatoid arthritis who are not also taking methotrexate get an injection every week.
For those with Crohn's disease and ulcerative colitis, the usual initial dose of Humira is 160 mg on the first one or two days of treatment, followed two weeks later by 80 mg.
Two weeks after that, you would probably start a maintenance dose of 40 mg every other week.
People with plaque psoriasis normally take an initial weekly dose of 80 mg, followed by 40 mg every other week.
The typical dosage for children with juvenile idiopathic arthritis who weigh less than 66 pounds is 20 mg every other week.
Humira comes in pre-filled syringes and dosing pens. Use each syringe or pen only once and inject all of the medicine inside.
Don't reuse an injection, even if there is still some liquid left in the syringe or pen. The syringe is glass, so if you accidentally drop or crush a prefilled Humira syringe, don't use it.
Refrigerate Humira in its original container until it's time to use it. Don't freeze this medication, and store it out of direct sunlight.
Make sure your doctor thoroughly explains how to inject Humira before you try to do it on your own.
It's a good idea to watch a trained health professional administer the injection so you know exactly what to do, and to practice while a health professional watches you.
You can inject Humira anywhere on the front of your thighs or stomach, except your bellybutton and the area 2 inches around it.
Using different sites for each injection helps reduce the likelihood that you will develop soreness or redness.
Humira Overdose
It's important to not use more Humira than your doctor prescribed. If you accidentally take more Humira than your prescribed dose, call your doctor.In clinical trials, high doses of Humira did not show toxic effects. To date, the exact effects of a Humira overdose are unclear.
If you think that you or someone else may have overdosed on Humira, call your doctor or a poison control center (1-800-222-1222).
A medical professional should monitor you or the other person carefully to watch for any warning signs or symptoms of a negative reaction.
If someone collapses or isn't breathing after taking Humira, call 911.
Missed Dose of Humira
Humira may help control your rheumatoid arthritis or other condition, but it's not a cure.Keep taking this medication, even if you feel well. Don't stop taking Humira without talking to your doctor first.
If you forget one of your injections, take a dose as soon as you remember.
To get back on schedule, inject your next dose of Humira at your regularly scheduled time.
If you're unsure of when to inject the medication, call your doctor right away for advice.
