Adalimumab HUMIRA®

Like all drugs, adalimumab can have side effects, although not everybody will get them. Some side effects can happen almost immediately, others may develop later. It can take up to six months after the last dose for adalimumab to completely leave the body, so some effects might appear even after stopping treatment.

Some adalimumab side effects are likely to be quite mild and may go away on their own. Others can be more serious and will require treatment, or may mean that adalimumab is not suitable for you.

IMMEDIATE REACTIONS

• Reactions to the injection such as pain or swelling, redness, bruising and itching. This can be very common, affecting at least one in 10 people. Using the adalimumab when it is at room temperature or cooling your skin with an ice pack may help. Your doctor or IBD nurse should also be able to advise you on how to reduce this sort of reaction
• Symptoms that mean you are having an allergic reaction to adalimumab. For example, rashes, hives (a raised itchy rash that appears on the skin), a swollen face, hands and feet, or trouble breathing and shortness of breath
• Some of the more common side effects of adalimumab include abdominal pain, nausea, headaches, fatigue and joint pain

WHAT ARE THE MOST LIKELY SIDE EFFECTS?

• A greater chance of suffering from infections such as colds and flu and also some more serious infections such as pneumonia and sepsis (general inflammation and problems with blood clotting). You may also be at greater risk of developing tuberculosis (TB), or of having underlying TB reactivated while on adalimumab. Symptoms of an infection often include feeling very tired, fever, cough, and warm painful skin. You may need to stop the adalimumab if you have an infection, so check with your medical team first if you think you have or are developing an infection
• Blood problems. Your body may not make enough of the blood cells that help fight infections or help to stop bleeding. Symptoms include a fever that does not go away, bruising or bleeding very easily, sore throat, or looking very pale
• Liver problems, you should contact your doctor if your skin or eyes look yellow, you feel very tired with a lack of appetite, or you have a persistent pain on the right hand side of your stomach. Adalimumab can also activate viral hepatitis if you carry it in your blood. Your doctor should check whether you are a carrier before you start treatment, and continue with blood tests while you are on the drug to make sure it does not activate
• Skin reactions such as psoriasis (scaly patches) and eczema, other skin rashes and ulcers. Some of these can be treated without stopping your adalimumab
• Some types of skin cancer. You must tell your doctor if you have a bump or open sore which is not healing. There have also been reports of other cancers including lymphoma (cancer of the lymph glands) as an uncommon side effect of adalimumab, and more rarely still, leukaemia. You may be more at risk if you are also taking immunosuppressive drugs such as azathioprine or methotrexate. However, it is difficult to know what the exact risk is, as cancers in these circumstances happen rarely and very few people are affected
• New heart failure or worsening of heart failure you already have. Call your doctor right away if you get new or worsening symptoms of heart failure while taking adalimumab, including shortness of breath, swelling of your ankles or feet, or sudden weight gain
• Other very rare complications that have been linked to taking adalimumab include demyelination (damage to nerves) and some rare inflammatory conditions, such as lupus (an autoimmune condition). Many of these serious side effects are reversible if the drug is stopped

TELL YOUR DOCTOR IMMEDIATELY IF YOU DEVELOP ANY OF THE FOLLOWING SYMPTOMS

• A severe rash, hives (swollen red patches of skin) or other signs of allergic reaction
• Swollen face, hands and feet
• Trouble breathing or swallowing
• Shortness of breath
• Persistent fever, bruising, bleeding or paleness
• Fatigue, cough, or flu-like symptoms

Overall, it is best to let your doctor or IBD nurse know about any new symptoms you develop while on adalimumab, whenever they occur. Your IBD team should also be able to help with any queries and concerns.

References