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Crohn's Disease Forum » Treatment » Humira/Adalimumab » Overview of Humira


12-02-2011, 05:27 PM   #1
DustyKat
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Overview of Humira

Adalimumab (Humira)

Adalimumab (Humira) is an anti-TNF agent similar to infliximab and decreases inflammation by blocking tumor necrosis factor (TNF-alpha). In contrast to infliximab, adalimumab is a fully humanized anti-TNF antibody (no mouse protein). Adalimumab is administered subcutaneously (under the skin) instead of intravenously as in the case of infliximab.

Rheumatologists have been using adalimumab for treating inflammation of the joints in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. Four clinical trials (involving almost 1,500 patients) comparing adalimumab to placebo, have demonstrated that adalimumab is also effective in treating inflammation in the intestines of patients with Crohn's disease and in reducing signs and symptoms of Crohn's disease. Adalimumab is not only effective in reducing disease activity but has also recently been found to be helpful in treating arthritis and arthralgias in patients with moderately or severely active Crohn's disease5.

Adalimumab is comparable to infliximab in effectiveness and safety for inducing and maintaining remission in patients suffering from Crohn's disease. Adalimumab is also effective in healing Crohn's anal fistulas. Adalimumab has been shown to be effective for patients who either failed or cannot tolerate infliximab.

The Food and Drug Administration approved Humira (adalimumab) in February 2007, to treat adult patients with moderately to severely active Crohn's disease. Adalimumab (Humira) is administered subcutaneously every two weeks.

The side effects of adalimumab (Humira)

Adalimumab generally is well-tolerated. The most common side effect is skin reactions at the site of injection with swelling, itching, or redness. Other common side effects include upper respiratory infections, sinusitis, and nausea.

TNF-alpha is an important protein for defending the body against infections. Adalimumab, like infliximab, increases the risk of infection. There have been cases of tuberculosis (TB) reported after the use of infliximab and adalimumab. It now is recommended that patients be tested for TB prior to receiving these agents. Patients who previously had TB should inform their physician of this before they receive these agents. Adalimumab, like infliximab, can aggravate and cause the spread of an existing infection. Therefore, it should not be given to patients with pneumonia, urinary tract infection, or abscess (localized collection of pus).

Rare cases of lymphoma (cancer of the lymphatic system) have been reported with the use of adalimumab. Rare cases of nervous system inflammation have been reported with the use of adalimumab. The symptoms may include numbness and tingling, vision disturbances, weakness in legs. Some patients receiving adalimumab may rarely develop symptoms that mimic systemic lupus; these symptoms include skin rash, arthritis, chest pain, or shortness of breath. These lupus-like symptoms resolve after stopping the drug.

There are some reports of worsening heart disease such as heart failure in patients who have received infliximab or adalimumab. The precise mechanism and role of these agents in the development of this side effect is unclear. As a precaution, individuals with heart disease should inform their physician of this condition before receiving infliximab or adalimumab.

Severe allergic reactions with rash, difficulty breathing, and severe low blood pressure or shock are rare, but serious allergic reactions can occur either after the first injection or after many injections. Patients experiencing symptoms of serious allergic reactions should seek emergency care immediately.

http://www.medicinenet.com/crohns_disease/page12.htm

Storage

Humira is refrigerated and is best kept between 2C - 8C (35.6F - 46.4C). Do not freeze Humira, and keep it out of sunlight. If taken out, Humira can last up to 14 days before efficacy becomes questionable.

Dosage

Humira is commonly prescribed as 40mg every other week. Some cases may have it administered 40mg every week, instead.

How Is Humira Given?

Humira is given subcutaneously, either by syringe or pre-loaded pen. If allergic to latex, make sure to tell your provider so that the pre-loaded pen is a latex-free one.

Always check the expiration date, as well as examine the fluid to make sure it is not yellowing or foggy. It should be clear. With pre-loaded pen, it is typical to see a small air bubble and this is not dangerous.

Typical instructions are to inject either in the thigh, or stomach (two inches either left or right of the bellybutton). Disinfect the area with wet wipes or cotton pads dabbed with rubbing alcohol, wiping the area in a circular motion without overlapping previous strokes. Pinch the area where you intend to give the injection, and while pinching the skin, administer the injection.

If using a pre-loaded pen, wait for at least ten seconds until you see that the yellow tab inside the pen has finished descending. Wait a few extra seconds to make sure it has finished injecting.

If using a syringe, you are able to administer the injection as quickly or as slowly as is comfortable.

The area may be sensitive directly after.

Make sure to change the area you inject in each time so as not to build up scar tissue.

Injection-Site Reactions

Injection-site reactions often appear as a raised red rash at the area of administration. It may also fade to an eventual hive. An injection-site reaction is typical to experience, and it is not indicative of allergic reaction.

Benadryl (or a similar antihistamine) is recommended to take before and after administration to help with injection-site reactions.

Travel

Because of its need to be kept cool, contact your Humira provider if you are traveling. They will help you so that you do not get in trouble with airlines for traveling with Humira, since it is fluid.

Tips

Some people find injections less painful if they leave Humira out of the fridge for at least half an hour, if not a little longer.

Dusty. & Added to by theOcean!
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Last edited by theOcean; 05-02-2014 at 03:02 PM.
06-13-2012, 05:35 AM   #2
Paul Cronk
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I am going to start taking Humira next week, the prescription will be written one day before I go on holiday (for one week within the same country). At the moment I am on prednisone but that is not doing the job. I am so keen to start the Humira treatment that I am trying to get the first jab in before I go away.

Is that stupid?
06-13-2012, 04:47 PM   #3
simpa
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i am also waiting for humira now. and am also excited. i hope it will work well so far i have heard only good things about it!
06-14-2012, 07:30 AM   #4
Paul Cronk
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That is what I am glad to hear!
09-23-2012, 02:58 AM   #5
FDK80
 
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Hi there,

I'm about to start taking Humira and i just need to know if Humira conflicts with any other medications?
like for example im taking Asacol at the moment, and i want to know if both can be taken together or one elemenates the other?


Thanks.
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Diagnosed 2002

Symptoms started 1997

Current medication:
Humira 40 Mg every 2 weeks
Omeprazole (Gasec) 2 x 20mg
Loperamide ( Imodium) twice a day

Pain killer:
- Tramadol hydrochloride (zaldiar)
-Celecoxib (celebrex): for joint pain.
09-23-2012, 06:36 AM   #6
Paul Cronk
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I have been on Humira for nearly three months and have just upped the dose to weekly 40mg. It seems to be better with the Humira than without it and I feel quite a lot more well although far from remission. I also started recently taking an anti Anxiety med and that has made a difference to the spasticity in my guts, which really makes you tired (never properly at rest). So the jury is still out but I am moving in a better direction than before. I had become very tired and down and this has been enough to give me back some fight, so it must be doing good.
09-23-2012, 12:50 PM   #7
simpa
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Hey! well...as much as i thought that i was excited to get humira...the excitment faded away with time..i was tired constantly and i also had fevers constantly, so i ended up in hospital and am no longer on humira and after one month am finally feeling great!(of course i am on other drugs-medrol, imuran) And to be able to do the things i wanted to do before is making me feel even better! I guess humira just wasn't my thing.
09-23-2012, 11:53 PM   #8
FDK80
 
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hi simpa how you doing?

I'm glad you're feeling good now.

It seems that Humira doesn't work for everybody and we all need a good specialist who can find exactly what kind of medication is suitable for everyone of us instead of trying them all !

Hang in there dear.
09-24-2012, 11:14 AM   #9
simpa
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i'm great now, thanks yeah..i think along the way i also got scared of the drug and lost faith in humira. And i believe that when it comes to this, the drug can not work cause you're subconsciously blocking it. But anyway, am happy that it's working for a lot of other people!! and as i am reunited with my all friends-imuran, i know that it will only get better and better!
01-20-2013, 04:49 PM   #10
Redfeather03
 
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Hello! I am new to the forum and I have an 11 yr old daughter, Lexi, diagnosed first with juvenile rheumatoid arthritis at age 3, then with ulcerative colitis at age 9 (now changed to "indeterminate colitis" about 2 mos. ago.) She was on Remicade for a year and a half before it stopped working, then switched to Cimzia in mid-Nov. Within a week she developed terrible joint pain (although no swelling so we knew it was not arthritis flare), thrush (that didn't go away after 2 weeks of nystatin so she was switched to oral fluconozole and she STILL has it all the way down her esophagus after 2 weeks of that), and a bad sinus infection. She's been hospitalized 4 times now since then (currently in hospital now), and has been on so much oral and IV steroid that she's now developed Cushings syndrome. The drs were giving her so much heavy pain meds but not getting to the bottom of her joint pain, so I researched and found that Cimzia's top 3 documented side effects are arthralgias, fungal infections, and upper respiratory infections!!! I brought this up to docs and they were hesitant to try switching her because nothing has worked for her colitis until the Cimzia. They are going to try switching her to Humira to see if it helps the side effects and can keep her colitis under control. Does anyone have experience with getting those same side effects from Cimzia? Anyone switched from Cimzia to Humira and if so how did it work for you? Thanks!!!!
01-21-2013, 08:53 AM   #11
Dukeis
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This useful also.


Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA. If your doctor feels you are at risk, you may be treated with medicine for TB.
01-21-2013, 04:59 PM   #12
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I just got back from the Dr and he is suggesting Humira since the Remicade gave me awful joint pain. I have to wait for approval from insurance has anyone had any trouble getting approved? I am nervous about having to give myself injections but I guess I will have to "suck it up "as they say. I am trying to stay positive.
01-21-2013, 07:43 PM   #13
Michelle89
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I just got back from the Dr and he is suggesting Humira since the Remicade gave me awful joint pain. I have to wait for approval from insurance has anyone had any trouble getting approved? I am nervous about having to give myself injections but I guess I will have to "suck it up "as they say. I am trying to stay positive.
I am having difficulties with insurance. However if you contact Humira to sign up for their assistance program before you even get your first dose, they are VERY helpful. I was just on the phone with them today after putting my prescription on hold with the pharmacy because they said my insurance wasn't going to cover it. My pharmacy then suggested I contact Humira and sign up for their assistanct programs. Humira is actually calling my insurance company for me and will be calling me back by Wednesday with the details as well as what Humira program I can use based on what they find out from my insurance company. They are open 8am-8pm est.
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Diagnosed Crohn's Disease 12/2000
Emergency Resection at Terminal Ileum in 12/2000
Past Meds:
Pentasa
Entocort
Prednisone when in flare
Currently on:
Imuran (100mg)
Prednisone for Flare
Humira
Also Taking: Vitamin D3, folate, Magnesium, Omega-3's, probiotic, general muliti-vitamin
01-30-2013, 06:48 PM   #14
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I just did my 3rd single maintence dose a few minutes ago. I must say it has really helped my crohns symptoms. I take it out of fridge 1 hour before and have my husband really pinch up the skin on my thigh and it doesn't hurt as bad that way. It is well worth the hassle and pain to not spend my life in the potty!
01-30-2013, 07:11 PM   #15
Sashawright
 
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I am having difficulties with insurance. However if you contact Humira to sign up for their assistance program before you even get your first dose, they are VERY helpful. I was just on the phone with them today after putting my prescription on hold with the pharmacy because they said my insurance wasn't going to cover it. My pharmacy then suggested I contact Humira and sign up for their assistanct programs. Humira is actually calling my insurance company for me and will be calling me back by Wednesday with the details as well as what Humira program I can use based on what they find out from my insurance company. They are open 8am-8pm est.
The humira people are awesome!!!
03-06-2013, 11:37 AM   #16
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Hi all, first post and I just wanted to say thanks for all the great information and support on the forum. Hopefully I will be given humira treatment soon as I have been in flare for three years and the drugs don't work!!
06-02-2013, 04:17 PM   #17
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Humira is working for me two years now injecting every 14 days.
09-04-2013, 06:55 PM   #18
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I am totally confused now, as I have been on prednisone (last week switched to Entocort) and Imuran for 6 months. My pain hasn't changed... actually likely worse, however my colonoscopy done recently shows that the inflammation has improved. Anyways, GI is wanting to put me on remicade however got a letter from my insurance and they are saying that they won't authorize remicade until Humira is tried.... ????? Anybody else have something like this happen. I have already gone through all of the preliminary preparations for the remicade... had myself psyched for it... now feel like I have to start over. SUGGESTIONS???
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Medication: Imuran, Entocort, Buscopan, Elavil, Humira, Vit D3, Vit B12, Folic Acid
Surgery: peri-anal fistualas x 2 2001 and 2005, bowel resection Feb 2014, scar tissue removal 2015
09-04-2013, 08:57 PM   #19
lblair
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Hi
I have been on Humira since June I have gone weekly but currently having issues getting off of predisone I have been on it since March I don't like this drug at all!!! I cant get past 20mg without getting massive loose stools with tons of mucous sorry if its TMI I started out on 70mg so I'm thankful and blessed that I'm only on 20mg!

I was down to 10mg this week and its been just awful!! So he put me back on 20mg today for 2 weeks then I will start the taper!!!

Joint pain is awful!!! Can't sleep at night!!! The GI will not address the pain who can I go to my Family Dr??????
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Blessing Lisa

Current Meds:
Randitine 150 mg twice a day!!!!
Effexor 37.5mg 2 tabs everyday
Cymbalta 60mg everyday
HZTC 25mg/12.5mg-high blood pressure
Glipizide 5mg before breakfast and dinner
Calcium-
Vitamin
Vitamin D
Gabapetin-300mg three times a day!!!
Fish oil

Meds that have not worked:
Humara
Prozac
Encort
Imura
Remicade
methotraxe

Bowel resection on 3/24/2014
09-04-2013, 11:21 PM   #20
jonique
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Hi
I have been on Humira since June I have gone weekly but currently having issues getting off of predisone I have been on it since March I don't like this drug at all!!! I cant get past 20mg without getting massive loose stools with tons of mucous sorry if its TMI I started out on 70mg so I'm thankful and blessed that I'm only on 20mg!

I was down to 10mg this week and its been just awful!! So he put me back on 20mg today for 2 weeks then I will start the taper!!!

Joint pain is awful!!! Can't sleep at night!!! The GI will not address the pain who can I go to my Family Dr??????
Hi Lisa,

for the joint pain you need to see a rheumatologist. Are you taking Methotrexate with the Humira? I find the combination of Humira and Methotrexate works well on the bowel and the joints.

Good luck!

Jonique
09-04-2013, 11:58 PM   #21
Traumanurse
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I've been on Humira for 3 months now post bowel resection of about 2 feet. That's my second bowel resection, so that may affect how the Humira is working.

The best part right now is that most of my abdominal pain is gone! Gained 20 pounds of the 30 I've lost in the last year, and feel much better altogether.

The down side right now is that I still have 5-10 D stools every day, and they are now the old maroon color that usually means blood for me.

Can't figure out why I'm feeling better, but still have these problems. Maybe having about 3-4 feet of bowel removed total is the cause. Not really sure. The Doc just increased the Humira to once a week. We will see what that does.

I also developed a rash on my face and uveitis in my eyes. The Doc thinks its the Crohns and not the Humira.

Why can't anything be clear-cut with this darn disease?
09-05-2013, 06:06 PM   #22
lblair
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jonique
I'm not on Methotrexate but that just might be on tap next!!! I'm going to see a rheumatologist just waiting for a referral from the Dr. I hate having Crohn's you just never know whats next!!!!!

Thanks
09-26-2013, 09:44 PM   #23
RJB95
 
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Hope all is well
10-06-2014, 03:04 PM   #24
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Simpa:
I just took my second injections of Humira and two days later was in bed with excruciating muscle and joint pain along with fevers on and off. Did you get that? My Pcp just did a bunch of labs but I need to call my GI before the next injection. Urgh.....any suggestions?
05-09-2015, 12:41 AM   #25
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Humira worked well for me at first, about 6 months. However, I got joint swelling/pain and eventually it seemed to stop working altogether. I actually have missed nearly a month of injections due to surgery. I can't inject in my legs from lack of fat (leads to a misfire every time), and I can't inject in my belly since that's where the surgery scars are. I was afraid of tightening my abs from the injection pain. I actually plan to restart my injections this weekend.
04-21-2017, 07:37 PM   #26
SCCrohnie
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I'm going to start Humira next week. I used Remicade successfully for seven years and Cimzia for two years most recently until I had bowel resection surgery almost a year ago.


04-21-2017, 07:51 PM   #27
ronroush7
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I'm going to start Humira next week. I used Remicade successfully for seven years and Cimzia for two years most recently until I had bowel resection surgery almost a year ago.
Hope it does great things for you.
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