What is Hadlima: Uses, Warnings & Interactions

Medically reviewed by Karen BergerPharm.D.
Licensed Pharmacist
Updated May 14, 2025  •  Published Sep 29, 2023
Fact Checked

Hadlima is an injectable prescription medication containing the active ingredient adalimumab-bwwd. Made by the pharmaceutical company Organon, it is biosimilar to and interchangeable with Humira. This means that if a healthcare provider writes a prescription for Humira, the pharmacist may dispense Hadlima if allowed by state law. Hadlima is used to treat various autoimmune inflammatory conditions. Hadlima was FDA-approved in July 2019, and became available in the U.S. in July 2023.

Hadlima overview

BRAND NAMES:

  • Hadlima

Generic Names:

  • N/A

Uses:

  • Rheumatoid arthritis in adults

  • Juvenile idiopathic arthritis in pediatric patients 2 years and older

  • Psoriatic arthritis in adults

  • Ankylosing spondylitis in adults 

  • Crohn’s disease in adults and children 6 years and older

  • Ulcerative colitis in adults

  • Plaque psoriasis in adults

  • Hidradenitis suppurativa in adults

  • Uveitis in adults

Therapeutic Classes:

  • Tumor necrosis factor (TNF) blocker

Forms:

  • Injectable

How it’s taken:

  • Subcutaneous (under the skin) injection of the thigh or abdomen

What is Hadlima used for?

Hadlima is FDA approved to treat:

Expert tips for using Hadlima

  • Take Hadlima exactly as prescribed by your doctor. Be sure you understand how to use Hadlima before injecting it at home.

  • Your doctor will need to monitor your progress. Keep all appointments for your doctor as well as for bloodwork.

  • Rotate your injection site with each injection. Do not inject Hadlima into the same site two times in a row. Avoid injecting Hadlima into hard, red, swollen, or bruised skin—or skin with stretch marks or scars.

  • While taking Hadlima, avoid people who are sick or have an infection. 

  • Avoid live vaccines when taking Hadlima. Ask your healthcare provider or pharmacist before getting any vaccines.

What form(s) does Hadlima come in

  • Auto-injector

    • 40 milligrams (mg)/0.4 milliliters (mL)

    • 40 mg/0.8 mL

  • Pre-filled syringe

    • 40 mg/0.4 mL

    • 40 mg/0.8 mL

  • Injection (vial)

    • 40 mg/0.8 m

What are common Hadlima doses?

  • Adults with rheumatoid arthritis (RA), psoriatic arthritis, or ankylosing spondylitis: 40 mg every other week. Some individuals with RA may require a higher or more frequent dosage.

  • Pediatric patients with Crohn’s disease or juvenile idiopathic arthritis: dosage depends on weight

  • Adults with Crohn’s disease or ulcerative colitis: 160 mg on day 1 (given in one day or can be split over two consecutive days), 80 mg on day 15, and 40 mg every other week beginning on day 29.

  • Adults with plaque psoriasis or uveitis: 80 mg as an initial dose, then 40 mg every other week, beginning one week after the first dose

  • Hidradenitis suppurativa: 160 mg on day 1 (given in one day or can be split over two consecutive days), 80 mg on day 15, and 40 mg every week OR 80 mg every other week beginning on day 29.

Common Hadlima prescriptions

  • Hadlima
    0.8ml of 40mg/0.8ml syringe

  • Hadlima
    2ml of 40mg/0.4ml syringe

How to take Hadlima

  • Your healthcare provider will teach you and/or a caregiver or family member how to prepare and inject Hadlima. Do not try to inject Hadlima until you have been trained on how to use it.

  • Hadlima is given as a subcutaneous injection, under the skin of the thigh or abdomen.

  • Follow your healthcare provider’s instructions on how and when to inject Hadlima. Use Hadlima exactly as directed. 

  • Prepare the injection when you are ready to administer it. Do not use the medication if it appears cloudy, has particles in it, or has changed colors. Call your pharmacist.

  • Your doctor will order blood tests before and while taking Hadlima.

  • Store Hadlima in the original container in the refrigerator, away from light. Do not freeze Hadlima. 

  • Take the medicine out of the refrigerator about 30 minutes before using it, and let it come to room temperature. Do not try to warm it up yourself. 

  • Do not reuse a needle or syringe. Discard a prefilled syringe or auto-injector after one injection, even if there is medicine still inside. Use a sharps container to dispose of used syringes and needles. 

What to do if you miss a dose of Hadlima

  • If you miss a dose of Hadlima, inject it as soon as you remember. Then, resume your next dose on the regularly scheduled day. However, if it is almost time for the next dose, skip the missed dose and resume your regular schedule. Do not take extra doses to try to make up for a missed dose. If you are not sure what to do, consult your healthcare provider.

Hadlima contraindications

  • You should not take Hadlima if you are allergic to Humira, adalimumab, or any ingredient in the medication. 

  • You should not start taking Hadlima if you have an active infection.

Hadlima warnings

Before taking Hadlima, tell your healthcare provider about all of your medical conditions. Let your doctor know if you are pregnant, planning to become pregnant, or breastfeeding.

Hadlima can cause serious complications, including:

  • Serious infections, including invasive fungal infections 

  • Certain types of cancer

  • Serious allergic reactions

  • Reactivation of the hepatitis B virus (be alert to signs of liver problems, such as pain in the upper right side of the stomach, vomiting, appetite loss, fatigue, or yellowing of the skin or eyes)

  • Problems with the brain and spinal cord

  • Low blood cell counts

  • Heart failure

  • Lupus-like syndrome

Hadlima interactions

  • Before taking Hadlima, tell your doctor about all the medications you take, including prescription and OTC drugs, vitamins, and supplements. 

  • You should not take Hadlima in combination with Orencia (abatacept), Kineret (anakinra), or Rituxan (rituximab).

  • Hadlima should not be taken with other TNF blockers.

  • You should not get a live vaccine while taking Hadlima. Examples of live vaccines include measles, mumps, and rubella (MMR), varicella, rotavirus, and the nasal flu vaccine.

  • Other drugs that require close monitoring, such as Coumadin (warfarin), cyclosporine, or theophylline, may require additional monitoring and/or a dosage adjustment if taken with Hadlima.

Hadlima side effects

If you have symptoms of an allergic reaction, seek emergency medical help. Symptoms may include hives, difficulty breathing or swallowing, or swelling of the face, lips, tongue, or throat. 

Symptoms of a life-threatening skin reaction also require emergency medical help. Be alert to symptoms of fever, sore throat, burning eyes, skin pain, red or purple rash, or blistering or peeling skin.

Common side effects of Hadlima include:

  • Injection site reactions (redness, itching, swelling, bruising, or pain at the injection site)

  • Nausea 

  • Back pain

  • Headache 

  • Rash 

  • Upper respiratory infections

  • Sinusitis 

Serious side effects of Hadlima include:

  • Liver problems: upper stomach pain, appetite loss, fatigue, itching, dark urine, clay-colored stools, yellowing of the skin or whites of the eyes

  • Heart problems: swelling, shortness of breath, sudden weight gain

  • Lupus-like symptoms: muscle and/or joint pain, flulike symptoms, rash that gets worse in the sun

  • Nervous system problems such as numbness and tingling, dizziness, vision problems, weakness in the arms or legs

  • Tuberculosis: fever, cough, night sweats, appetite and weight loss, fatigue

This is not a full list of side effects and others may occur. Talk to your healthcare professional about potential side effects and what to do if you experience them.

Medically reviewed by Karen BergerPharm.D.
Licensed Pharmacist

After receiving her doctorate from the University of Pittsburgh School of Pharmacy, Karen Berger, Pharm.D., has worked in both chain and independent community pharmacies. She currently works at an independent pharmacy in New Jersey. Dr. Berger enjoys helping patients understand medical conditions and medications—both in person as a pharmacist, and online as a medical writer and reviewer.

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