Sulphasalizine
Anakinra - interleukin -1 antagonosts
Abatacept live vaccines

Injection site reactions-upper respiratory tract infections
serious infections, (pneumonia, cellilitis, pyelonephritis or cystisis , sepsis, encephalatis, or meningitis
fungal)
Worsening of CHF ,  urticaria,
Cutaneous vasculitis, rash, headache, dizziness,
Asthenia, abdominal pain,
Dyspepsia, fever
Allergic reactions if serious discontinue immediately
Increase  risk of malignencies, or accelrate its development
Cardiovascular symptoms,
Cholescystitis, pancreatitis,
GI  upset, or haemorrhage, bursitis,
Depression, dyspnea, seizures
Angioedema, blood and lymphatic disorders
CNS  demyelinating disorders including multiple sclerosis, and optic neuritis
Use in children may lead to moderate to severe infections and result in serious outcomess,
Including death and hospitalisation

Sepsis or  risk of sepsis
Active infection ( ensure adequate contraception)
Lactation
Concurrent cyclophosphamide therapy
Live vaccines

Special precautions-
History of recurrent infection
Predisposition to infection, tuberculosis, chronic infections, immunosppressants
Screen for active ot latent TB   and hepatitis prior to initiating therapy
Advise patients to report signs of TB  during and after treatment
Instruct patients to report symptoms of infection immediately
Investigate urgently
History of blood dyscrasias
Instruct patients to report symptoms of blood dyscrasias immediately
Investigate urgently and withdraw if blood dyscrasias is confirmed
Varicella exposure , disconitue temporily
Heart failure
Elderly

 

Indication-

Used in combination with methotrexate  to treat active rheumatoid arthiritis

25mg twice weekly  or 50mg once weekly  by sc injection

Children below 4 years not recommended
4 -18 years - 0.4mg/kg twice weekly by sc injection

Dose interval should be 3 -4 days
maximum 25mg per dose