II. Indications
- Severe active Rheumatoid Arthritis refractory to DMARDs
- Plaque Psoriasis
- Crohns Disease
- Hidradenitis Suppurativa
III. Contraindications
IV. Mechanism
- See Tumor Necrosis Factor Inhibitor
- Monoclonal Antibody against human Tumor Necrosis Factor alpha
- Similar to Infliximab and Etanercept
V. Precautions
- See TNF Inhibitor
- TNF Inhibitors predispose to serious infections and malignancy
- Prepare for TNF Inhibitor use with infection screening (e.g. Tuberculosis) and Immunizations
VI. Medications
- Humira (Adalimumab)
- Original prototype drug with release in 2003 for Rheumatoid Arthritis, with expanding indications since
- Multiple biosimilar agents pending release in 2023
- Abrilada
- Amjevita
- Cyltezo
- Hulio
- Hyrimoz
- Yusimry
VII. Dosing
- See Monoclonal Antibody for preparation for use
- Background
- Injection sites include thigh or Abdomen
- Refrigerate and protect from light
- Stable at room Temperature for up to 14 days
- Allow to warm to room Temperature for 15 to 30 minutes before injection (decreased pain)
-
General adult (and children weight >40 to 60 kg) dosing protocol
- Dosing protocols vary by indication and in children
- Active Disease (Induction)
- Start 160 mg SQ as a single dose (or split, given 80 mg on 2 consecutive days)
- Maintenance
- Every other week: 40 mg SQ
VIII. Adverse Effects
- See Tumor Necrosis Factor Inhibitor
-
Immunosuppression
- Use caution in any patient prone to infection
- Headache
- Rash
- Injection site inflammation
- Gastrointestinal upset
- Other effects
IX. Safety
- Considered safe in Lactation
- Pregnancy
- First trimester use benefit outweighs risk if indicated
- Unknown safety after first trimester, but exposure risk increases after 20 weeks (monitored by registry)
X. Pharmacokinetics
- Metabolism by proteolysis
XI. Resources
- Adalimumab Injection Kit (DailyMed)
XII. References
- (2003) Lexi-Comp Drug Database
- (2023) Biologics for Crohn's Disease, Presc Lett, #390826
- (2023) Drugs for Inflammatory Bowel Disease, Med Lett Drug Ther 65: 105-12
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Related Studies
| humira (on 6/21/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| HUMIRA 40 MG/0.8 ML SYRINGE | $3,121.27 each | |
| HUMIRA PEN 40 MG/0.8 ML | $3,119.47 each | |
| HUMIRA PEN CROHN'S-UC-HS STARTER 40 MG/0.8 ML | $3,115.25 each | |
| HUMIRA PEN PSORIASIS-UVEITIS-ADOL HS STARTER 40 MG/0.8 ML | $3,115.30 each | |
| HUMIRA(CF) 40 MG/0.4 ML SYRINGE | $3,123.51 each | |
| HUMIRA(CF) PEN 40 MG/0.4 ML | $3,121.75 each | |
| HUMIRA(CF) PEN 80 MG/0.8 ML | $6,721.88 each | |