Certolizumab Pegol: Uses, Dosage, and Side Effects Guide

Summary of Key Points

Certolizumab, sold under the brand name Cimzia, is a prescription medication used to manage inflammatory conditions such as rheumatoid arthritis, Crohn’s disease, and psoriatic arthritis. It works by targeting specific proteins in the immune system to help reduce inflammation. Administered as a subcutaneous injection, it’s essential to consult your healthcare provider before starting or adjusting your dose. You can schedule a telemedicine appointment with us to discuss Certolizumab treatment options tailored to your needs.

Names of Medication

US Brand Name: Cimzia

Generic Name: Certolizumab pegol

Certolizumab pegol is the active ingredient, while Cimzia is the brand name given by the manufacturer.

Pharmacologic Category

Category: Tumor Necrosis Factor (TNF) Inhibitor

Other medications in the TNF inhibitor category include:

1. Adalimumab (Humira)
2. Etanercept (Enbrel)
3. Infliximab (Remicade)

Certolizumab Dosage

Certolizumab is used to treat various inflammatory conditions, with dosing schedules that vary depending on the specific condition being treated. Always follow your healthcare provider’s instructions and never adjust your dose without consulting them first. You can schedule a telemedicine consultation with one of our providers to discuss your Certolizumab dosage and treatment plan.

Certolizumab for Rheumatoid Arthritis

The recommended starting dose is 400 mg (two 200 mg injections) at weeks 0, 2, and 4. The maintenance dose is 200 mg every two weeks or 400 mg every four weeks.

Certolizumab for Crohn’s Disease

The starting dose is 400 mg at weeks 0, 2, and 4. The maintenance dose is 400 mg every four weeks.

Certolizumab for Psoriatic Arthritis

The initial dose is 400 mg at weeks 0, 2, and 4. The maintenance dose is 200 mg every two weeks or 400 mg every four weeks.

Certolizumab for Ankylosing Spondylitis

The recommended dose is 400 mg at weeks 0, 2, and 4, followed by 200 mg every two weeks or 400 mg every four weeks.

Certolizumab for Ulcerative Colitis

Certolizumab is not currently approved for treating ulcerative colitis.

Certolizumab for Plaque Psoriasis

The starting dose is 400 mg at weeks 0, 2, and 4. The maintenance dose is 200 mg every two weeks or 400 mg every four weeks.

Certolizumab for Juvenile Idiopathic Arthritis

Certolizumab is not approved for use in children with juvenile idiopathic arthritis.

Certolizumab for Systemic Lupus Erythematosus

Certolizumab is not currently approved for treating systemic lupus erythematosus.

Certolizumab for Behçet’s Disease

The starting dose is 400 mg at weeks 0, 2, and 4, followed by 200 mg every two weeks or 400 mg every four weeks.

Certolizumab for Sarcoidosis

Certolizumab is not currently approved for treating sarcoidosis.

Dosage Forms and Strengths

Certolizumab is available in the following forms:

1. Pre-filled syringe: 200 mg/mL
2. Lyophilized powder for reconstitution: 200 mg

Administration Instructions for Certolizumab Injection

Certolizumab is administered as a subcutaneous injection, typically in the thigh or abdomen. You or a caregiver can be trained to administer the injections at home. It’s important to rotate injection sites to avoid irritation. If you miss a dose, contact your healthcare provider for guidance on when to take the next dose. Always follow your healthcare provider’s instructions to ensure the best results from your Certolizumab treatment.

Certolizumab Side Effects and Adverse Reactions

Like all medications, Certolizumab may cause side effects. Some are more common than others. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers to discuss any concerns regarding Certolizumab side effects.

Common Side Effects (Occurring in more than 10% of patients)

1. Upper respiratory infections: Symptoms may include cough, sore throat, or nasal congestion.
2. Headache: Mild to moderate headaches may occur.

Less Common Side Effects (Occurring in 1% to 10% of patients)

1. Rash: Skin irritation or redness at the injection site.
2. Nausea: Some patients may experience an upset stomach.

Serious Side Effects (Occurring in less than 1% of patients)

1. Serious infections: These may include tuberculosis, fungal infections, or bacterial infections, which could require hospitalization.
2. Heart failure: Worsening of heart failure symptoms, such as shortness of breath or swelling in the legs.
3. Allergic reactions: Symptoms may include hives, difficulty breathing, or swelling of the face and throat.

Contraindications for Certolizumab

A contraindication is a specific condition where a medication should not be used due to potential harm. For Certolizumab, there are several contraindications to be aware of before starting treatment.

1. Active infections: Certolizumab can weaken the immune system, making it harder to fight infections. If you have an active infection, such as tuberculosis (TB) or a fungal infection, Certolizumab can worsen the condition.
2. History of tuberculosis: Certolizumab may reactivate TB. Your healthcare provider will likely screen for TB before starting treatment.
3. Moderate to severe heart failure: Certolizumab can worsen heart failure symptoms. If you have heart failure, your healthcare provider may recommend an alternative treatment.
4. Allergic reactions to Certolizumab: If you’ve had an allergic reaction to Certolizumab or any of its components, you should not take this medication.

Drug to Drug Interactions

Certain medications can interact with Certolizumab, potentially increasing the risk of side effects or reducing its effectiveness. It is important to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs and supplements.

Abatacept (Orencia): Using Abatacept alongside Certolizumab may increase the risk of serious infections.

Anakinra (Kineret): Combining Anakinra with Certolizumab can also elevate the risk of infections.

Live vaccines: Certolizumab may reduce the effectiveness of live vaccines and increase the likelihood of contracting the infection the vaccine is designed to prevent. Examples of live vaccines include the measles, mumps, and rubella (MMR) vaccine and the varicella (chickenpox) vaccine.

Certolizumab in Pregnancy

Is it safe to take Certolizumab during pregnancy?

Certolizumab is classified as a pregnancy category B medication, meaning that animal studies have not shown harm to the fetus, but there are no well-controlled studies in pregnant women. Since Certolizumab does not cross the placenta in significant amounts, it may be considered safer than other biologics during pregnancy. If you are pregnant or planning to become pregnant, it is essential to discuss the risks and benefits of continuing Certolizumab with your healthcare provider. Our telemedicine providers are available to help you make an informed decision based on your individual circumstances.

Certolizumab while Breastfeeding

Is it safe to take Certolizumab while breastfeeding?

Certolizumab is generally considered safe to use while breastfeeding because it is a large molecule that is unlikely to pass into breast milk in significant amounts. However, due to limited data on the long-term effects of Certolizumab on breastfed infants, it is important to discuss this with your healthcare provider. If you are breastfeeding or planning to breastfeed, consult with one of our telemedicine providers to determine the best course of action for both you and your baby.

Estimated Cost of Certolizumab

The estimated cost of a 30-day supply of Certolizumab without insurance, using a GoodRX coupon, ranges from approximately $4,000 to $5,000. Prices may vary depending on your location and the pharmacy you use. Be sure to check with your pharmacy for the most accurate pricing.

Possible Alternatives to Certolizumab

If Certolizumab is not the right option for you, there are alternative treatments 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 available to help you explore these options.

1. Rheumatoid arthritis: Alternatives include methotrexate, sulfasalazine, and biologics such as adalimumab (Humira) or etanercept (Enbrel). Physical therapy and regular exercise can also help manage symptoms.
2. Crohn’s disease: Other biologics like infliximab (Remicade) or ustekinumab (Stelara) may be used. Dietary changes, such as avoiding trigger foods, can also help manage symptoms.
3. Psoriatic arthritis: Alternatives include nonsteroidal anti-inflammatory drugs (NSAIDs), methotrexate, or biologics like secukinumab (Cosentyx). Regular exercise and maintaining a healthy weight can also improve symptoms.
4. Ankylosing spondylitis: NSAIDs, physical therapy, and biologics such as adalimumab (Humira) or infliximab (Remicade) are common alternatives. Staying active and practicing good posture can also help.
5. Ulcerative colitis: Alternatives include mesalamine, corticosteroids, or biologics like vedolizumab (Entyvio). Dietary adjustments and stress management techniques may also be beneficial.
6. Plaque psoriasis: Topical treatments, phototherapy, or biologics like secukinumab (Cosentyx) or ixekizumab (Taltz) are alternatives. Moisturizing regularly and avoiding skin irritants can help manage symptoms.
7. Juvenile idiopathic arthritis: Methotrexate, NSAIDs, and biologics such as etanercept (Enbrel) are common alternatives. Physical therapy and maintaining an active lifestyle are also important.
8. Systemic lupus erythematosus: Alternatives include hydroxychloroquine, corticosteroids, and immunosuppressants like azathioprine. Managing stress and avoiding sun exposure can also help reduce symptoms.
9. Behçet’s disease: Corticosteroids, immunosuppressants, and biologics like infliximab (Remicade) are alternatives. Avoiding triggers such as stress and certain foods may also help manage symptoms.
10. Sarcoidosis: Corticosteroids, methotrexate, and biologics like infliximab (Remicade) are common alternatives. Regular monitoring and a healthy lifestyle can also help manage the disease.

Recent Updates on Certolizumab Research

Recent studies continue to explore the long-term safety and effectiveness of Certolizumab in treating autoimmune conditions. A 2022 study published in the journal Rheumatology found that Certolizumab remains effective in controlling symptoms of rheumatoid arthritis and Crohn’s disease over several years, with a relatively low risk of serious infections. Ongoing research is also investigating the potential use of Certolizumab in other autoimmune conditions, such as uveitis and hidradenitis suppurativa. As new findings emerge, it is important to stay informed and discuss any updates with your healthcare provider. Our telemedicine team is available to answer any questions you may have about the latest research and how it may impact your treatment plan.

James Kingsley

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