Adalimumab: Uses, Dosage, Side Effects, and Cost Explained

Summary of Key Points

Adalimumab, commonly known by its brand name Humira, is a prescription medication used to treat several autoimmune diseases, including rheumatoid arthritis, Crohn’s disease, and psoriasis. It works by targeting a specific protein in the immune system to reduce inflammation. Adalimumab is available in various forms and strengths, typically administered as an injection. Always consult your healthcare provider before starting or adjusting your dose. You can also speak with one of our providers through telemedicine for personalized advice.

Names of Medication

US Brand Name: Humira

Generic Name: Adalimumab

The generic name, Adalimumab, is the active ingredient in the medication. It is listed in parentheses after the brand name.

Pharmacologic Category

Adalimumab belongs to the pharmacologic category of Tumor Necrosis Factor (TNF) Blockers, which are used to treat autoimmune conditions by reducing inflammation.

Adalimumab Dosage

Adalimumab is prescribed for various conditions, and the dosage may vary depending on the specific disease being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers for guidance.

Adalimumab for Rheumatoid Arthritis (Adults)

Dosage: 40 mg every other week. Some patients not taking methotrexate may require 40 mg every week.

Adalimumab for Psoriatic Arthritis (Adults)

Dosage: 40 mg every other week.

Adalimumab for Ankylosing Spondylitis (Adults)

Dosage: 40 mg every other week.

Adalimumab for Crohn’s Disease (Adults)

Initial Dosage: 160 mg on Day 1 (can be split into two doses over two days), followed by 80 mg at Week 2.

Maintenance Dosage: 40 mg every other week starting at Week 4.

Adalimumab for Ulcerative Colitis (Adults)

Initial Dosage: 160 mg on Day 1 (can be split into two doses over two days), followed by 80 mg at Week 2.

Maintenance Dosage: 40 mg every other week starting at Week 4.

Adalimumab for Plaque Psoriasis (Adults)

Initial Dosage: 80 mg on Day 1, followed by 40 mg every other week starting one week later.

Adalimumab for Hidradenitis Suppurativa (Adults)

Initial Dosage: 160 mg on Day 1 (can be split into two doses over two days), followed by 80 mg at Week 2.

Maintenance Dosage: 40 mg every week starting at Week 4.

Adalimumab for Juvenile Idiopathic Arthritis (Adults)

Dosage: 40 mg every other week for patients weighing 30 kg (66 lbs) or more. For patients weighing less than 30 kg, the dosage is 20 mg every other week.

Adalimumab for Uveitis (Adults)

Dosage: 40 mg every other week.

Adalimumab for Atopic Dermatitis (Adults)

Initial Dosage: 160 mg on Day 1 (can be split into two doses over two days), followed by 80 mg at Week 2.

Maintenance Dosage: 40 mg every other week starting at Week 4.

Dosage Forms and Strengths of Adalimumab

Adalimumab is available in the following dosage forms and strengths:

1. Injection, subcutaneous: 40 mg/0.8 mL in a prefilled syringe or pen
2. Injection, subcutaneous: 20 mg/0.4 mL in a prefilled syringe (for pediatric use)
3. Injection, subcutaneous: 10 mg/0.2 mL in a prefilled syringe (for pediatric use)

Adalimumab Injection Instructions

Adalimumab is administered as a subcutaneous injection, meaning it is injected under the skin. It is typically given in the abdomen or thigh. You or a caregiver can be trained to administer the injection at home. Always follow your healthcare provider’s instructions for proper use. If you miss a dose, take it as soon as you remember, but do not double up on doses. Contact your healthcare provider or schedule a telemedicine appointment with us for further guidance.

Contraindications for Adalimumab

A contraindication is a specific situation or condition where a particular medication should not be used because it may be harmful to the patient. If you have any of the following conditions, you should not take Adalimumab, or you should discuss your situation with a healthcare provider to weigh the risks and benefits.

1. Active infections: Adalimumab can weaken your immune system, making it harder for your body to fight infections. If you have an active infection, such as tuberculosis (TB) or a fungal infection, taking Adalimumab could make the infection worse.
2. History of tuberculosis: If you have had TB in the past, Adalimumab may cause the infection to reactivate. Your doctor may screen you for TB before starting treatment.
3. Moderate to severe heart failure: Adalimumab may worsen heart failure in some patients. If you have a history of heart failure, your doctor will likely recommend an alternative treatment.
4. Allergic reactions to Adalimumab or its components: If you have had a severe allergic reaction to Adalimumab or any of its ingredients, you should not take this medication.
5. Multiple sclerosis or other demyelinating diseases: Adalimumab may worsen conditions like multiple sclerosis, where the protective covering of nerves is damaged.

Adalimumab Drug Interactions

Adalimumab can interact with other medications, which may increase your risk of side effects or reduce the effectiveness of your treatment. Always inform your healthcare provider about all the medications you are taking, including over-the-counter drugs, vitamins, and supplements. Some medications that may interact with Adalimumab include:

1. Abatacept (Orencia): Taking Abatacept with Adalimumab may increase the risk of serious infections.
2. Anakinra (Kineret): Combining Anakinra with Adalimumab can also increase the risk of infections.
3. Live vaccines: You should avoid live vaccines (like the MMR or varicella vaccines) while taking Adalimumab, as the medication can weaken your immune system and make these vaccines less effective or increase the risk of infection.
4. Rituximab (Rituxan): Using Rituximab with Adalimumab may increase the risk of infections and other side effects.
5. Tofacitinib (Xeljanz): Combining Tofacitinib with Adalimumab can increase the risk of serious infections and other immune-related side effects.

Adalimumab in Pregnancy

Is it Safe to Take Adalimumab When Pregnant?

Adalimumab, commonly known as Humira, is classified as a pregnancy category B medication. This means that while animal studies have not shown harm to the fetus, there are limited well-controlled studies in pregnant women. If you are pregnant or planning to become pregnant, it is crucial to discuss the potential risks and benefits of continuing Adalimumab with your healthcare provider. In some cases, managing your condition may be more important than the potential risks to your baby. Our telemedicine providers are available to help you make an informed decision based on your unique situation.

Adalimumab While Breastfeeding

Is it Safe to Take Adalimumab While Breastfeeding?

Adalimumab can pass into breast milk in small amounts, but the effects on a nursing infant are not fully understood. If you are breastfeeding or planning to breastfeed, it is important to consult your healthcare provider to determine whether continuing Adalimumab is the best option for you. In some cases, the benefits of treatment may outweigh the potential risks. You can also speak with one of our telemedicine providers to explore your options.

Estimated Cost of Adalimumab

The cost of Adalimumab can vary depending on your location, pharmacy, and insurance coverage. Without insurance, a 30-day supply using a GoodRX coupon is estimated to cost between $5,000 and $6,000. For accurate pricing, check with your pharmacy, and consider discussing financial assistance programs with your healthcare provider.

Possible Alternatives to Adalimumab

If Adalimumab is not the right treatment for you, there are alternative medications and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are here to assist you in exploring these alternatives.

Rheumatoid Arthritis Alternatives

For rheumatoid arthritis, alternatives include medications like methotrexate, sulfasalazine, or biologics such as etanercept (Enbrel). Lifestyle changes, including regular exercise, a balanced diet, and physical therapy, can also help manage symptoms.

Psoriatic Arthritis Alternatives

For psoriatic arthritis, biologics such as secukinumab (Cosentyx) or oral medications like apremilast (Otezla) may be considered. Maintaining a healthy weight and avoiding smoking can also improve symptoms.

Ankylosing Spondylitis Alternatives

For ankylosing spondylitis, alternatives include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or biologics such as infliximab (Remicade). Regular exercise, particularly stretching, can help maintain flexibility and reduce discomfort.

Crohn’s Disease Alternatives

For Crohn’s disease, alternatives include biologics like infliximab (Remicade) or vedolizumab (Entyvio). Dietary adjustments, such as following a low-fiber diet, may also help manage symptoms.

Ulcerative Colitis Alternatives

For ulcerative colitis, alternatives include mesalamine (Asacol) or biologics like ustekinumab (Stelara). A low-residue diet may help reduce symptoms and improve quality of life.

Plaque Psoriasis Alternatives

For plaque psoriasis, topical treatments such as corticosteroids or biologics like secukinumab (Cosentyx) may be effective. Avoiding triggers like stress and smoking can also help manage flare-ups.

Hidradenitis Suppurativa Alternatives

For hidradenitis suppurativa, antibiotics or biologics like infliximab (Remicade) may be considered. Weight loss and avoiding tight clothing can help reduce symptoms and prevent flare-ups.

Juvenile Idiopathic Arthritis Alternatives

For juvenile idiopathic arthritis, alternatives include methotrexate or biologics like etanercept (Enbrel). Physical therapy and regular exercise can help maintain joint function and mobility.

Uveitis Alternatives

For uveitis, corticosteroids or biologics like infliximab (Remicade) may be considered. Wearing sunglasses and managing any underlying conditions can help prevent flare-ups and protect your vision.

Atopic Dermatitis Alternatives

For atopic dermatitis, topical corticosteroids or biologics like dupilumab (Dupixent) may be effective alternatives. Regular moisturizing and avoiding known irritants can help manage symptoms and prevent flare-ups.

Recent Updates on Adalimumab Research

Recent studies continue to investigate the long-term safety and effectiveness of Adalimumab, particularly for autoimmune conditions such as rheumatoid arthritis and Crohn’s disease. Research has shown that Adalimumab can effectively maintain remission in Crohn’s disease and reduce joint damage in rheumatoid arthritis. Ongoing studies are also exploring the use of Adalimumab in combination with other therapies to improve outcomes and minimize side effects.

Additionally, biosimilar versions of Adalimumab, such as Amjevita, have been approved, offering more affordable treatment options. These biosimilars have been shown to be as effective as the original medication, providing patients with more accessible options for managing autoimmune conditions.

As research progresses, staying informed about new developments is important. Our telemedicine providers can help you understand how these updates may impact your treatment plan and guide you through any necessary adjustments.

James Kingsley

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