Drug Name

Brand Name(s)
Humira®, Hadlima®, Hulio®, Hyrimoz®, Idacio®, Amgevita®

Drug Class

Adalimumab is used to treat inflammatory types of arthritis, such as rheumatoid arthritis (RA), psoriatic arthritis and ankylosing spondylitis.

  • What types of arthritis is adalimumab used for?

    Adalimumab is used to treat inflammatory types of arthritis, such as rheumatoid arthritis (RA), psoriatic arthritis and ankylosing spondylitis.

    For RA and psoriatic arthritis, adalimumab may be used as monotherapy or in combination with DMARD therapy, such as methotrexate (MTX).

    For people recently diagnosed with RA, who have not been previously treated with MTX, adalimumab should be given in combination with MTX (unless MTX cannot be taken).

    Adalimumab may be used as monotherapy for treatment of ankylosing spondylitis that has not responded to DMARD therapy.

  • How is adalimumab administered?

    Adalimumab is delivered by subcutaneous (s.c.) injection (meaning in the fatty layer of tissue just under the skin).

  • What is the typical dose and when do I take it?

    The usual dose of adalimumab is 40 mg given once every two weeks. In some cases, it may be given once a week.

    The medication comes in single use pre-filled syringes for administration.

  • How long will it take to work?

    As with all of the biologics, you may not feel the effects of the adalimumab right away. Some people begin to feel the effects of the medication fairly quickly; however, it may take three to six months to feel its full effect. It is important to be patient and keep taking your medication.

    To provide symptom relief while you are waiting for adalimumab to take effect, your health-care provider may recommend taking a steroid, such as prednisone, or a non-steroidal anti-inflammatory drug (NSAID).

  • When should I not take adalimumab and call my doctor?

    Taking adalimumab can make it more difficult for your body to fight infections. Therefore, people with active infections should not take this medication. If you have a fever, think you may have an infection or have been prescribed an antibiotic, contact your health-care provider. People who have had frequent infections in the past or a history of tuberculosis should discuss the use of adalimumab with their health-care provider.

    Also contact your health-care provider if you are having surgery as you may need to stop adalimumab until you are healed and there is no sign of infection.

    Adalimumab has not been studied in pregnant women or nursing mothers so its effect(s) on pregnant women or nursing babies are unknown. You should tell your doctor if you are pregnant, or are planning to become pregnant. Because of the potential for adverse reactions in nursing infants, a decision should be made with your health-care provider on whether or not to discontinue nursing or the medication, taking into account the importance of the drug to the mother. Breastfeeding is not recommended for at least five months after the last adalimumab treatment.

    Those who have had a previous allergic reaction to adalimumab should avoid the medication.

    Anyone with a history of cancer or nervous system problems, such as multiple sclerosis, should discuss the use of adalimumab with their health-care provider.

    Adalimumab may make a condition called congestive heart failure worse. Tell your doctor if you have congestive heart failure.

    Ideally, your vaccinations should be up to date prior to starting adalimumab. If you have already started therapy with adalimumab, your health-care provider will likely recommend most inactive vaccines (e.g., influenza, pneumococcal). Live vaccines are not recommended due to risk of causing infection. Before receiving any vaccinations while taking adalimumab, you should speak with your health-care provider.

  • What are the side effects of adalimumab?

    Like all medications, taking adalimumab carries some risk of side effects, which must be balanced with its potential benefits. In general, the risk of joint damage and permanent disability (resulting from arthritis) is much greater than the risks of side effects from adalimumab. When monitored properly, the vast majority of side effects are rare, most improve over time and are reversible.

    Firstly, adalimumab can increase your risk of infections.

    In rare cases, adalimumab can cause a reaction (redness, pain, and itching) at the injection site. Talk to your health-care provider if these symptoms become severe.

    Another rare side effect people may experience while taking adalimumab is headaches. If this becomes severe please speak with your health-care provider.

    Some people have developed lupus-like symptoms that disappeared after the medication was stopped. If you have chest pains that do not go away, shortness of breath or a rash on your cheeks or arms that gets worse in the sun, call your doctor right away.

    There have been unusual cases of disorders that affect the nervous system resulting from people taking adalimumab or other TNF-blockers. Signs that you could be experiencing a problem affecting your nervous system include: numbness or tingling, problems with your vision, weakness in your legs and dizziness.

    Adalimumab very rarely can cause a drop in blood counts.

  • What helps to reduce side effects?

    Take adalimumab as prescribed and contact your health-care provider if you have any concerns while taking the medication.

    To avoid injection reactions, injection sites should be rotated and avoid areas where the skin is tender, bruised, red and/or hard.

  • Do I need any monitoring while taking adalimumab?

    Blood tests are not routinely required while you are taking adalimumab. However, your health-care provider may order periodic blood tests to check your blood count and follow the activity of your arthritis.

This information was last updated November 2017, with expert advice from:

Jason Kielly, B.Sc. (pharm.), Pharm.D.
Assistant Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health

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