What is Humira: Uses, Warnings & Interactions
Humira (adalimumab) is a member of the drug class known as Tumor Necrosis Factor (TNF) inhibitors. TNF is a naturally occurring cytokine and plays an important role in many inflammatory medical conditions. Excess TNF release is associated with inflammation and tissue damage. This medication is administered by a subcutaneous injection and can be self-administered in one’s own home. TNF inhibitor therapy can be immunosuppressive and lead to serious infections and lymphoproliferative disorders, including lymphoma. Patients will need to be tested for latent tuberculosis and hepatitis B virus before initiation of therapy and during therapy.
Humira overview
BRAND NAMES:
Humira, Humira Pen, Humira Pediatric Crohn’s Start, Humira Pen-CD/UC/HS Starter, Humira Pen-Pediatric UC Start, Humira Pen-Psoriasis/Uveitis/Adolescent HS Start, Humira Pen-Psoriasis/Uveitis Starter
Generic Names:
Humira
Uses:
Treats arthritis, plaque psoriasis, ankylosing spondylitis, Crohn disease, ulcerative colitis, hidradenitis suppurativa, and uveitis
Therapeutic Classes:
Antirheumatic, TNF inhibitor
Forms:
Injectable
How it’s taken:
By subcutaneous injection at rotating sites in the thigh or lower abdomen
What is Humira used for?
Medications that inhibit TNF are effective anti-inflammatory drugs in conditions like rheumatoid arthritis (RA), ulcerative colitis (UC), Crohn's Disease (CD), ankylosing spondylitis, hidradenitis suppurativa, plaque psoriasis, polyarticular juvenile idiopathic arthritis, psoriatic arthritis, and uveitis. While TNF inhibitors hold many Food and Drug Administration (FDA) approved indications, they may be used off-label in some medical conditions, including graft versus host disease, sarcoidosis, and pyoderma gangrenosum.
Key takeaways
Humira therapy can cause serious side effects, including an increased the risk of infections. Infections include those caused by viruses, fungi, or bacteria. Candidates for Humira should be evaluated for active and latent tuberculosis prior to its initiation.
Humira can cause serious allergic reactions so the first injection should be given under the supervision of a healthcare professional.
Humira should be stored in a refrigerator in its original container and protected from light. If absolutely necessary, Humira may be stored at room temperature up to a maximum of 77 degrees Fahrenheit up to a maximum of 14 days.
The injection sites should be rotated between the thigh and lower abdomen.
Inform your doctor about all the medications you take, as some medications should not be combined with Humira.
What form(s) does Humira come in
Injectable
Humira Prefilled Syringe 10mg/0.1mL
Humira Prefilled Syringe 20mg/0.2mL
Humira Prefilled Syringe 40mg/0.4mL
Humira Pen 40mg/0.4mL
Humira Pen 80mg/0.8mL
What are common Humira doses?
Ankylosing Spondylitis
40 mg/0.4 mL every other week
Crohn’s Disease (adult)
160 mg (2 x 80mg/0.8mL) on Day 1, 80 mg/0.8 mL on Day 15, then 40 mg/0.4 mL every 2 weeks starting on Day 29
Crohn’s Disease (pediatric)
17 kg to < 40 kg: 80 mg/0.8 mL on Day 1, 40 mg/0.4 mL on Day 15, then 20 mg/0.2 mL every 2 weeks starting on Day 29
Greater than or equal to 40 kg: 160 mg (2 x 80 mg/0.8 mL) on Day 1, 80 mg/0.8 mL on Day 15, then 40 mg/0.4 mL every 2 weeks starting on Day 29
Hidradenitis Suppurativa (adult)
160 mg (2 x 80 mg/0.8 mL) on Day 1, 80 mg/0. 8mL on Day 15, then 80 mg/0.8 mL every 2 weeks starting on Day 29, OR
160 mg (2 x 80 mg/0.8 mL) on Day 1, 80 mg/0.8 mL on Day 15, then 40 mg/0.4 mL every week starting on Day 29
Hidradenitis Suppurativa (pediatric)
80 mg/0.8 mL on Day 1, 40 mg/0.4 mL on Day 8, 40 mg/0.4 mL on Day 22, then 40 mg/0.4 mL every 2 weeks starting on Day 36
Juvenile Idiopathic Arthritis
10 kg to less than 15 kg: 10 mg/0.1 mL every 2 weeks
15 kg to less than 30 kg: 20 mg/0.2 mL every 2 weeks
Greater than or equal to 30 kg: 40 mg/0.4 mL every 2 weeks
Plaque Psoriasis
80 mg/0.8 mL on Day 1, 40 mg/0.4 mL on Day 8, 40 mg/0.4 mL on Day 22, then 40 mg every 2 weeks
Psoriatic Arthritis
40 mg/0.4 mL every 2 weeks
Rheumatoid Arthritis
40 mg/0.4 mL every 2 weeks
Ulcerative Colitis (adult)
160 mg (2 x 80 mg/0.8 mL) on Day 1, 80 mg/0.8 mL on Day 15, then 40 mg/0.4 mL every 2 weeks starting on Day 29
Ulcerative Colitis (pediatric)
20 kg to < 40 kg: 80 mg (2 x 40 mg/0.4 mL) on Day 1, 40 mg/0.4 mL on Day 8, 40 mg/0.4 mL on Day 15, then 40 mg/0.4 mL every 2 weeks OR 20 mg/0.2 mL every week
Greater than or equal to 40 kg: 160 mg (2 x 80 mg/0.8 mL) on Day 1, 80 mg/0.8 mL on Day 8, 80 mg/0.8 mL on Day 15, then 80 mg/0.8 mL every 2 weeks OR 40 mg/0.4 mL every week
Uveitis (adult)
80 mg/0.8 mL on Day 1, 40 mg/0.4 mL on Day 8, 40 mg/0.4 mL on Day 22, then 40 mg/0.4 mL every 2 weeks
Uveitis (pediatric)
10 kg to less than 15 kg: 10 mg/0.1 mL every 2 weeks
15 kg to less than 30 kg: 20 mg/0.2 mL every 2 weeks
Greater than or equal to 30 kg: 40 mg/0.4 mL every 2 weeks
Common Humira prescriptions
Humira
1 auto-injector kit boxHumira
1 prefilled syringe kit boxHumira
10mg/0.2ml prefilled syringe kit
How to take Humira
This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
A nurse or other health provider will give you this medicine.
You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. Do not inject into skin areas that are red, bruised, tender, or hard. If you have psoriasis, do not inject into a raised, thick, red, or scaly skin patch or into skin lesions.
If you store this medicine at home, keep it in the refrigerator. Do not freeze. Protect the medicine from light. Keep your medicine and supplies in the original packages until you are ready to use them.
Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
What to do if you miss a dose of Humira
Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. Contact your prescriber for any additional questions.
Humira contraindications
This medicine is not right for everyone. Do not use it if you have had an allergic reaction to adalimumab. Humira should not be combined with certain medications, so be sure to go over your active medication list with your doctor or pharmacist prior to initiating Humira.
Humira warnings
Tell your doctor if you are pregnant or breastfeeding, or if you have liver disease, COPD, heart failure, diabetes, psoriasis, multiple sclerosis, optic neuritis, problems with your immune system, or a history of cancer or Guillain-Barré syndrome. Tell your doctor if you have any type of infection (including hepatitis B or tuberculosis) or an infection that keeps coming back.
This medicine may cause the following problems:
Increased risk for infection
Increased risk of certain cancers, including lymphoma or leukemia
New or worsening heart failure
Tell your doctor if you have a latex allergy. The needle cover of some syringes and pens contain latex and may cause allergic reactions.
You will need to have a skin test for tuberculosis (TB) before you start this medicine. Tell your doctor if you or anyone in your home has ever had a positive TB skin test or been exposed to TB.
This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
Keep all medicine out of the reach of children. Never share your medicine with anyone.
Humira interactions
Some foods and medicines can affect how adalimumab works. Tell your doctor if you are using any of the following:
Abatacept, anakinra, azathioprine, cyclosporine, mercaptopurine, rituximab, theophylline
Blood thinner (including warfarin)
Medicine that weakens the immune system (including a steroid or cancer medicine)
This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.
Tell your doctor if you have a latex allergy. The needle cover of the syringe contains latex and may cause allergic reactions.
Humira side effects
Signs or symptoms of an allergic or anaphylactic reaction, including swelling of the face or hands and shortness of breath, warrant an immediate evaluation or an emergency room or similar entity. Any other new or concerning side effects should be discussed with your healthcare provider as soon as possible.
Serious side effects
Cough, fever, chills, runny or stuffy nose, sore throat, body aches
Changes in vision
Sores or white patches on your lips, mouth, or throat
Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Chest pain, uneven heartbeat, trouble breathing
Numbness, tingling, or burning pain in your hands, arms, legs, or feet, joint pain
Swollen glands in your neck, underarms, or groin
Blistering, peeling, red skin rash, or red, scaly patches on the skin
Rapid weight gain, swelling in your hands, ankles, lower legs, or feet
Unusual bleeding, bruising, tiredness, weakness, or weight loss
Change in how much or how often you urinate, painful urination
Less serious side effects
Back pain
Headache
Redness, itching, bruising, bleeding, pain, or swelling where the shot was given
Sources:
Tumor necrosis factor (TNF) inhibitors, American College of Rheumatology (2023)
Lymphoproliferative disorders, StatPearls (2023)
Tuberculosis associated with blocking agents against tumor necrosis factor-alpha—California, 2002-2003, Morbidity and Mortality Weekly (2004)
Medication Guide, Humira (adalimumab), AbbVie Inc. (2021)
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