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Overview: Adalimumab is a medicine you inject under the skin. It is used for inflammatory or immune problems, such as certain types of arthritis, gut conditions, skin conditions, and an eye condition called uveitis. Common side effects include infections, rashes, headaches, or pain, redness, itching, or swelling where the needle went in. Contact your health care provider right away if you notice any signs of an infection or increased bleeding or bruising.

Uses

What is adalimumab used for?

Adalimumab is commonly used for the following inflammatory or immune conditions.

Adalimumab may also be used for other conditions as determined by your health care provider.

How does adalimumab work (mechanism of action)?

Tissue necrosis factor (TNF) is a natural chemical in your body that is involved in normal inflammatory and immune activity. In many types of arthritis, gut conditions, skin conditions, and uveitis, you may have higher than normal TNF levels. Adalimumab works by blocking some forms of TNF. By blocking TNF, adalimumab may reduce inflammation and immune activity, to help relieve these conditions.

How is adalimumab supplied (dosage forms)?

Brands and other names

  • Abrilada
  • Amjevita
  • Cyltezo
  • Hadlima
  • Hulio
  • Humira
  • Hyrimoz
  • Idacio
  • Simlandi
  • Yuflyma
  • Yusimry

Dosage forms and strengths

  • 10mg/0.1mL, 10mg/0.2mL, 20mg/0.2mL, 20mg/0.4mL, 40mg/0.4mL, 40mg/0.8mL, 80mg/0.8mL prefilled syringe
  •  40mg/0.4mL, 40mg/0.8mL, 80mg/0.8mL prefilled autoinjector

How should I store adalimumab?

Adalimumab should be stored in its original package, to protect it from light, in the refrigerator, between 36 F and 46 F (2 C and 8 C). Do not freeze it, and do not use it if it has been frozen. If needed, such as when traveling, adalimumab (protected from light) can be stored up to a temperature of 77 F (25 C) for short periods of time. When kept out of the refrigerator, adalimumab must be used within a certain number of days or thrown away. Consider writing the date on the package to keep track of the days outside the refrigerator. Ask your pharmacist or other health care provider for specifics about storing adalimumab outside of the refrigerator. Don’t expose it to extreme heat or cold. 

Side Effects

What are the most common side effects of adalimumab?

The most common side effects of adalimumab are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Infections (see below)
  • Redness, itching, pain, or swelling where the needle went in
  • Headache
  • Rash

There may be other side effects of adalimumab that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of adalimumab?

While less common, the most serious side effects of adalimumab are described below, along with what to do if they happen.

Severe Allergic Reactions. Adalimumab may cause allergic reactions, which can be serious. Stop using adalimumab and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Infections. Adalimumab can increase your risk of infections, including serious infections. Some of these infections may lead to death. Call your health care provider right away if you have an infection or any of the following symptoms.

  • Burning or stinging when you pee 
  • Coughing, or coughing up blood
  • Fever, sweats, chills, or muscle aches
  • Shortness of breath
  • Diarrhea or stomach pain
  • Weight loss

Cancer. Adalimumab can cause a new cancer to develop or cause a previously treated cancer to recur. Children, teenagers, and young adults or anyone with severe arthritis may be at higher risk, especially for lymphomas. Some of these cancers may lead to death. Tell your health care provider about any new symptoms that you may get. 

Reactivated Infections. Some types of microbes that cause infections (such as bacteria or viruses) can remain in the body after you recover from that infection. When a microbe stays in the body but does not cause an infection, it is called a “latent” microbe. Adalimumab may increase your risk of a latent microbe becoming active again, causing an infection. Keep all appointments, including lab appointments, before starting and while taking adalimumab. Before you start treatment with adalimumab, tell your health care provider if you have ever had tuberculosis (TB), hepatitis B, or any other serious infections.

Nerve Damage. In rare cases, adalimumab may damage the protective covering that surrounds the nerves (demyelinating disease). Before you start adalimumab, tell your health care provider if you already have a demyelinating disease, such as multiple sclerosis or optic neuritis, or if you have seizures. Once you have started using adalimumab, tell your health care provider right away if you have any of the following symptoms.

  • Changes in mental function
  • Muscle weakness
  • Numbness or tingling
  • Poor coordination or dizziness
  • Trouble walking
  • Vision changes or vision loss

Blood Disorders. Adalimumab can cause blood disorders, such as agranulocytosis, aplastic anemia, low platelet levels (thrombocytopenia), and low white blood cell levels (leukopenia). Stop using adalimumab and get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Heart Failure. Adalimumab may lead to or worsen heart failure. Tell your health care provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness

Immune System Reactions. Adalimumab can cause inflammation of your liver, blood vessels, or lymph vessels and cause symptoms that look like a condition called lupus. Stop using adalimumab and call your health care provider right away if you get any of the following symptoms.

  • Rash
  • Joint pain
  • Fever
  • Weakness or unusual tiredness

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using adalimumab. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Skin Problems. Adalimumab may cause or worsen a skin condition known as psoriasis. Tell your health care provider if you have any of the following symptoms of psoriasis.

  • Red patches that may be scaly
  • Pus-filled bumps on your skin

Warnings & Precautions

Who should not use adalimumab?

Allergies to Ingredients. People who are allergic to any of the following should not use adalimumab.

  • Adalimumab
  • Abrilada
  • Amjevita
  • Cyltezo
  • Hadlima
  • Hulio
  • Humira
  • Hyrimoz
  • Idacio
  • Simlandi
  • Yuflyma
  • Yusimry
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific adalimumab products they stock.

What should I know about adalimumab before using it?

Do not use adalimumab unless it has been prescribed to you by a health care provider. Use it as prescribed. This medicine is injected under the skin. Make sure that you or a caregiver understands how to properly prepare and use adalimumab. Read and follow the “Instructions for Use” that come with your adalimumab. If you have any questions, talk to your pharmacist or other health care provider.

Do not share adalimumab with other people, even if they have the same condition as you. It may harm them.

Keep adalimumab out of the reach of children. Since this medicine should be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

People who are 65 or older can be at greater risk of some side effects from adalimumab. Talk to your health care provider about your risks if you are in this age group.

Do not inject adalimumab in the exact same spot every time. You should rotate where you give adalimumab shots. Do not inject it in areas that are bruised or appear red or hardened.

What should I tell my health care provider before using adalimumab?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if adalimumab is right for you.

In particular, make sure that you discuss any of the following.

Vaccines. Talk with your health care provider about any vaccines that you may need. You should not receive certain vaccines right before or while using adalimumab. Tell your health care provider about any vaccines you have recently received or have scheduled.

Latex Allergy. Some adalimumab products may contain dry natural rubber, which is related to latex. Tell your health care provider if you have a latex allergy. 

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Think you have an infection, are being treated for an infection, or get infections often
  • Have or had cancer
  • Have or had heart failure
  • Nerve problems, including numbness, tingling, multiple sclerosis, Guillain-Barre syndrome, optic neuritis, and other conditions
  • Diabetes
  • Psoriasis
  • Immune system problems
  • Tuberculosis, or close contact with someone who has it
  • Traveled to or lived in areas where the risk of tuberculosis is high
  • Live or lived in areas (such as the Ohio or Mississippi River valleys) where there is an increased risk of certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis)
  • Have or had hepatitis B
  • Upcoming major surgery

Other Medicines and Supplements. Adalimumab may interact with other medicines and supplements. Before using adalimumab, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how adalimumab could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use adalimumab while you are pregnant or trying to get pregnant. If you were using adalimumab while you were pregnant, tell your baby’s health care provider before your baby gets any vaccines. 

Breastfeeding. Adalimumab passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use adalimumab while breastfeeding.

Interactions

Does adalimumab interact with foods or drinks?

There are no known interactions between adalimumab and foods or drinks.

It is unknown if drinking alcohol will affect adalimumab.

Does adalimumab interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using or have recently used any of the following before using adalimumab.

  • Azathioprine (Azasan, Imuran), which is a medicine used for rheumatoid arthritis
  • Mercaptopurine (Purinethol, Purixan), which is a medicine used for certain types of cancer
  • Rituximab (Rituxan, others), which is a medicine used for certain types of cancer or rheumatoid arthritis
  • A tumor necrosis factor (TNF) blocker, such as certolizumab (Cimzia), etanercept (Enbrel, others), golimumab (Simponi), or infliximab (Remicade, others), which is a medicine that is commonly used for rheumatoid arthritis and certain skin conditions
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system
  • Abatacept (Orencia), which is a medicine used for certain types of arthritis
  • Anakinra (Kineret), which is a medicine used for rheumatoid arthritis and other conditions
  • Warfarin, which is a blood thinner
  • Theophylline (Elixophyllin, Theo-24), which is a medicine for asthma or certain other breathing problems

Adalimumab may alter the blood levels of some other medicines. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with adalimumab. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much adalimumab?

If you or someone else has used too much adalimumab, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of adalimumab?

It is important not to miss doses of adalimumab. If you miss a dose, use it as soon as you remember it. Use your next dose when you normally would. Do not use double or extra doses.