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
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