Adalimumab

What is adalimumab?

Adalimumab is a prescription-only biological medicine made from proteins similar to those naturally found in the body. It works by targeting and blocking a protein called tumour necrosis factor-alpha (TNF-α), which plays a major role in causing inflammation. The original medicine is available as the brand Humira and there are similar versions available (known as biosimilars) under the brands Amgevita, Hyrimoz, Idacio, Imraldi and Yuflyma[1]. 

What is adalimumab used for?

Adalimumab is prescribed to reduce inflammation in several autoimmune and inflammatory conditions, including[1]:

• Rheumatoid arthritis 

• Psoriatic arthritis 

• Ankylosing spondylitis and axial spondyloarthritis 

• Crohn’s disease and ulcerative colitis 

• Plaque psoriasis 

• Hidradenitis suppurativa 

• Non-infectious uveitis 

• Juvenile idiopathic arthritis, including cases with associated uveitis 

How does adalimumab work?

Adalimumab blocks TNF-α, a substance in the body responsible for triggering inflammation. By inhibiting TNF-α, it reduces inflammation, pain, and tissue damage caused by autoimmune diseases[1]. 

Who can take adalimumab?

Adalimumab is suitable for adults over 18 and some children (depending on the condition) who have not responded well to other treatments such as methotrexate or steroids. However, it should not be used by people who[1]: 

• Have active infections, including tuberculosis or been in contact with someone with tuberculosis 

• Have or ever had certain types of cancer 

• Have heart failure 

• Have hepatitis B 

• Have a nervous system condition like multiple sclerosis, optic neuritis, or Guillain-Barré syndrome 

• Have a high temperature or feel unwell 

• Are about to have surgery or a dental procedure 

• Are pregnant or trying to get pregnant 

• Are allergic to latex 

• Have ever had an allergic reaction to adalimumab 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].

What is the typical dosage of adalimumab?

Adalimumab comes as a pre-filled syringe or injection pen. The dose of adalimumab depends on your age and medical condition. Typically: 

• plaque psoriasis – the usual starting dose is 80mg, then 40mg after a week and then 40mg, taken every 2 weeks 

• rheumatoid arthritis – the usual dose is 40mg, taken every 2 weeks. You can take it weekly, or 80mg every 2 weeks, if you're not taking any other medicine for rheumatoid arthritis 

• psoriatic arthritis, axial spondyloarthritis or ankylosing spondylitis – the usual dose is 40mg, taken every 2 weeks 

• Crohn's disease – the usual starting dose is 80mg and then 40mg, taken every 2 weeks. It can be taken weekly if needed or 80mg every 2 weeks. If you need a higher dose, you can start with 160mg, then 80mg after 2 weeks and then 40mg every 2 weeks 

• ulcerative colitis – the usual starting dose is 160mg, then 80mg after 2 weeks and then 40mg, taken every 2 weeks. It can be taken weekly if needed or 80mg every 2 weeks 

• hidradenitis suppurativa – the usual starting dose is 160mg, then 80mg after 2 weeks and then after another 2 weeks you can take 40mg every week or 80mg every 2 weeks 

• non-infectious uveitis – the usual starting dose is 80mg, then 40mg after a week and then 40mg, taken every 2 weeks 

For children, the dose is based on body weight and specific condition. Always follow your doctor’s instructions, as doses may be adjusted according to your response and any side effects. When you start taking adalimumab you'll be given a patient alert card. Carry this with you all the time[1].

How do you take adalimumab?

Adalimumab is given as an injection under the skin (subcutaneous injection). It comes in pre-filled syringes or injection pens. You or a caregiver can be trained to administer it safely at home[1]. 

Can you stop taking adalimumab?

Stopping adalimumab is possible but must be done under medical supervision. Suddenly stopping treatment can cause your condition to flare up[1]. 

What do you do if you take too much adalimumab?

If you take too much adalimumab, contact 111 for advice immediately. Overdosing increases the risk of serious infections and immune system problems[1]. 

What do you do if you forget to take adalimumab?

If you miss a dose[1]:

• Take it as soon as you remember 

• If it is almost time for your next dose, speak to your specialist so they can let you know whether to skip the missed dose 

• Keeping a medication diary or setting reminders can help you stay on schedule 

What medicines can’t you take with adalimumab?

There are some medicines you should avoid while taking adalimumab[1]: 

• Live vaccines such as MMR, BCG, rotavirus and childrens nasal flu vaccine. Always check with your doctor or pharmacist when getting a vaccine 

• Other biological immunosuppressants, like anakinra or abatacept 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of adalimumab?

Adalimumab can cause side effects. The most common ones are[1]: 

• Reactions at the injection site such as redness, swelling, or pain 

• Headaches 

• Mild nose, throat, or sinus infection 

• Stomach pains 

• Muscle or bone pain 

• Nausea 

• Respiratory infections 

Serious side effects, which require urgent medical attention, include[1]: 

• Signs of severe infection like fever or sore throat, increased sweating, feeling unwell, diarrhoea, coughing up blood or mucus, shortness of breath, urinary problems, skin sores or wounds, severe muscle aches. 

• Signs of heart failure such as shortness of breath or oedema (swelling in the feet or ankles) 

• Blood disorders indicated by persistent fever, bruising or bleeding more easily 

• Nervous system symptoms such as numbness, dizziness, or vision changes 

• Signs of malignancy such as night sweats, swollen glands, unexplained weight loss, skin changes or severe itching 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2].

Frequently asked questions about adalimumab

How long does adalimumab take to work? 
It usually takes a few weeks, but this varies depending on the condition being treated[1]. 

Can I drink alcohol while on adalimumab? 
Yes, in moderation, unless you’re advised otherwise by a medical professional[1]. 

Can I take adalimumab during pregnancy? 
It may be continued in some cases. Discuss this with your doctor or pharmacist[1]. 

Does adalimumab weaken the immune system? 
Yes, it can increase your risk of infections[1]. 

Can I travel with adalimumab? 
Yes. Keep the medication refrigerated and carry a patient alert card[1]. 

Is adalimumab a lifelong treatment? 
Not always. Treatment length depends on your condition and how you respond[1]. 

For the official NHS guide to adalimumab, visit their website.