Adalimumab - ImmunomodulatorDrug Name:
Adalimumab - Immunomodulator
List Of Brands:
Indication Type Description:
Dosages/ Overdosage Etc
Pregnancy and lactation
Drug interaction- summary-
Anakinra + adalimumab
Adalimumab + Anakinra
Coadmin of anakirna with another TNF- blocking agent has risk of serious infections.Concurrent use not recommended
Methotrexate + Adalimumab
methorexate reduced adalimimab clearance after single and multiple dosing. Dosage adjustment necessary
Ankylosing spondylosis, Corhn's disease
Juvenile idiopathic arthiritis, Plaque psoriasis
Psoriatic arthiritis, Rheumatoid arthiritis
Adverse reactions reported in Rheumatoid arthiritis < 5%
GI - abdominal pain 6%, Nausea 8%
GU- hematuria 5% urinary tract infection 7%
Respiratory- sinusitis 10%, upper respirarory tract infection 15%
Miscellaneous - accidental injury 8%, back pain 5%, flu syndrome 6%
headache 10%, hypertension 5%, pain at injection site 10%
injecction site reaction 7% rash 10%
Lab test abnormalites- alkaline phosphate increased 4%, hyperlipderma 6%
Recurrent infections- Serious infections occurred in patients on concomittant immunosuppressive therapy .
Excercise caution when considering use of adalimumab in patients with a history of recurrent infection or patients predisoposed to this condition
Tuberculosis- before initiating therapy, evaluate patients for tuberculosis risk factors and test for latent tuberculosis infection prior to staring therapy with adalimumab
Haematologic effects- rare cases of pancycytoma have been reported with TNF- blocking agents. advice patients to seek immediate medical attention if they develop signs or symptoms of blood dyscrasis or infection eg. bleeding, bruising, persistent fever etc.
Immunizations- patients on adalimumab can receive concurent vaccinations, except live vaccines. It is recommended that juvenile idiopathic arthiritis patients, be brought up to date with immunization guidelines before initiating adalimumab therapy
Pregnancy- use during pregnancy only if needed
Lactation- Decide whether to discontinue breast -feeding or the drug depending on the importance of the drug to the mother.
Children- safety and efficacy in children not established
Elderly- because of higher incidence of infections malignancies in elderly population, use caution before administering on elderly patients
Dosages/ Overdosage Etc:
Ankylosing spondylosis, Crohn's disease, Juvenille idiopathic arthiritis, plaque psoriasis, posriatic arthiritis, rheumatoid arthiritis
Ankylosing spondylisis - 40mg subcutaneously every other week
Crohn's disease- 160mg initially at day 1 ( given as four mg subcutaneous injection 1 day or as two 40mg subcutaneous inj per day for 2 consecutive days followed by 80mg 2 weeks later
Plaque psoriasis - 80mg subcutaneously every other week
Psoriatic arthiritis - 40mg subcutaneously very other week
Rheumatois arthiritis - 40mg suncutaneously every other week
1. Inform patients that adalimumab may lower their ability of their immune system to fight infections.
2. Advice patients to see or inform their doctor, if they suffer any symptoms of allergic reaction.
3. Advice patients to report to their doctor if any new signs of worsening medical condition such as heart disease
Pregnancy and lactation:
Use during pregnancy only if needed
Decide whether to discontinue breast -feeding or the drug depending on the importance of the drug to the mother.
Safety and efficacy in children not established
Because of higher incidence of infections malignancies in elderly population, use caution before administering on elderly patients