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Crohn's Disease Forum » Treatment » Humira/Adalimumab » Question about loading doses


01-28-2012, 01:31 PM   #1
littlemissh
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Question about loading doses

I am due to start Humira and have 'training' booked for the 6th Feb once all screening tests done.
I was supposed to get a patient information leaflet but it hasn't arrived.
So I have a couple of questions - does everyone get 4 injections for the loading dose. I read somewhere that some patients with crohn's only get 2. If it is 4, do you just inject one after the other or are they spread over the day?

For those in the uk. Does the training actually involve giving the actual drug? If so who provides the pen. I think she said I get the humira delivered to my house...do I have to take them along to the training session?

I should have asked the IBD nurse more questions when she rang to arrange the appointment, but I was so surprised how soon it was going to be, I didn't ask any!
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Diagnosed Crohns small bowel 2010,Gastroduodenal crohn's Jan 2012. Gastroparesis june 2014.
Duodenal perforation/peritonitis nov 2011. Portacath placed Nov 2013. Gastric pacemaker 2015.
Perforated jejenum/peritonitis oct 2015, PEJ for enteral feeding nov 2015

On Humira every 7 days, intermittent iv iron, regular blood transfusions :faint:
On TPN since March 2016.
01-28-2012, 08:59 PM   #2
Emily
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4 is the standard, really. Psoriasis & Rheumatoid Arthritis are different but with Crohn's it is 4. You even get a specific "Crohn's kit" which has 4 pens, different than the rest of the packs you will be receiving forward.

As for here in the US, I was required to have a nurse come to my house and she just helped me give myself the first 4 injections. She should have a practice pen so you can get a feel for holding it and hearing a click but it wont contain a needle. And these pens will be yours, so you should get them from the pharmacy before hand. Hope this helps a little!
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01-28-2012, 10:51 PM   #3
jlanier
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When i started, my gi's nurse taught me. She did the first one, and had me do the next 3 so she could make sure that i was doing it correctly. You get all 4 doses at the same time, one right after the other. Don't let this freak you out though. I think that it seems worse than it really is. The second round of the humira is 2 doses, then it's only 1 every other week after that. I have been thankful to be on humira. Every 2 weeks i take all of 10 seconds out of my day to give myself my injection, and then i dont have anything to worry about for 2 more weeks. Good luck with it.
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Diagnosed with crohns Aug '11.
Surgeries: 2 total. The first was removed part of my colon, part of my small intestine, removed my appendix, and was given an ileostomy. The second removed more of my small intestine, and reversed my ileostomy.

Current Medications: Azathioprine 50mg once a day, Prednisone 10mg once a day, Humira 40mg every 2 weeks.
01-30-2012, 06:22 PM   #4
Miss Underestimated
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Yep. 4 all at once. No big deal, don't let it freak you out. It's just click click click click - you're done.
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*Sick since 1987; managed on my own;
*diagnosed 2008 when I underwent emergency surgery;
*various meds and tests 2008-2012,
*Jan 2012-present, Humira. No symptoms, but scopes indicated disease.
*6MP for all of 2013.
*2014 &2015 complete mucosal healing.

**Staying on Humira for maintenance**

The statistics I see so far for my situation seem pretty good. There ARE long term statistics for the Anti-TNF drug treatments now. I'm here to make them longER.
01-31-2012, 06:28 AM   #5
littlemissh
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Thankyou everyone.
Can't wait to start now. The sooner I start the sooner it can get working.
01-31-2012, 04:34 PM   #6
Miss Underestimated
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Just did mine - two little stings. it's over.
01-31-2012, 04:49 PM   #7
littlemissh
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Just waiting for mine to be delivered now.
02-02-2012, 03:09 PM   #8
littlemissh
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Delivery set for wednesday then have to arrange with ibd nurse to give me the first injections on the day ward.
I hope the snow doesn't stop the delivery, the uk seems to grind to a halt with a speck of snow...
02-02-2012, 03:40 PM   #9
Grumbletum
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Hope it all goes well for you and that Humira is the one. How's the leg? And the kitties? X
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Previous: Prednisolone, Mesren, Omeprazole, Infliximab, Azathioprine
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02-02-2012, 04:48 PM   #10
littlemissh
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Helen,
Legs fine now.
Kitties are scoundrels- very big, white fluffy cheeky boys. We are trying to teach them how to use their newly installed catflap...any tips!!
02-23-2012, 02:51 AM   #11
Cordillia16
 
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Goodnesss! After reading this thread I'm a little mad. I got no help from my GI or any nurse coming to my house. My dad and I watched a DVD they provided, and then I had to give myself all 4 needles (of which I could only do the first 1 and my dad and husband had to do the rest).
But yes, I did 4 the first time in the legs, but am finding it much better to do them in the tummy.
Also, did anyone else find the pens hurt a lot? I switched to the syringes and they seem to be less painful for me.
02-23-2012, 11:23 AM   #12
Miss Underestimated
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Cordillia, I don't know about your location, but here, Abbott or Humana - not sure which - has contracted with a home care service to come out and teach people how to use the pens/syringes. I took mine to my doctor's office.

Are you kind of out in the boondocks? That might explain why you had to do it yourself.
02-23-2012, 11:45 AM   #13
imaboveitall
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Hi all,
Popping in from the parent's forum as Violet started Humira Feb 10 right along with most in here; some of you guys have posted in my threads over there
I'm wondering how you responses have been thus far?
So far Violet feels NO DIFFERENT.
Next two shots tomorrow.

By the way, she used the syringes for the loading dose and though she said it felt like "being stabbed with a knife dipped in acid", she said injecting VERY SLOWLY helped the pain of the drug going in a lot.

Julie
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Current tx:
Pediasure PEPTIDE 1000 cals nightly via NG tube
Imuran 150mg
Humira


Failed and/or past tx:
Remicade
methotrexate
prednisone
Flagyl
Pentasa
atenolol
Florinef
cyproheptadine
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02-23-2012, 12:05 PM   #14
littlemissh
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No change yet, second set of jabs today.(my D has improved and some weight gain with the elemental diet but still pain/ bleeding). GI says 4 weeks usually the earliest you note any change.
02-23-2012, 12:45 PM   #15
Emily
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Hey Julie, it will take longer than these first two weeks for her to see a change, it took me 1-2 months. Humira isn't a drug that provides instant relief, it must build up in your system. But once you start feeling it working, it's great! Good luck today littlemissh and tomorrow to Violet! Remember after this, it'll never be more than 1 injection in a day again!
02-23-2012, 02:06 PM   #16
Miss Underestimated
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Make sure the alcohol is dry before injecting - it can add to the sting if it's still wet.
02-24-2012, 01:39 AM   #17
Cordillia16
 
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Miss Underestimated, I live in Canada. Don't know if that explains it, but I thought it was weird that everyone else (UK, USA) had a support system for this and here in Canada I got handed a DVD.
In all seriousness, I consulted my pharmacist when I picked it up. He opened the box and started to read me the directions. I almost cried, I was so nervous.
02-24-2012, 02:07 PM   #18
Miss Underestimated
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Maybe it's where in Canada you live? "Boondocks" is slang for way out in the country, away from metropolitan areas.

Bless your heart, you did it anyway! If you have any more problems call Abbott, the manufacturer - they are very helpful.
02-27-2012, 04:41 PM   #19
indianhart
 
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Waiting for the pharmacy to call for delivery...how much is everyone paying for their humira if you don't mind me asking?! Do you get to choose syringes or the pen? Anyone worried about the side effects? Does drinking alcohol interact with Humira?
02-27-2012, 04:57 PM   #20
Miss Underestimated
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I got assistance from Abbott for the start up doses of Humira - the co-payment was over $2000, and I couldn't afford it. Now my copayment fluctuates some depending on how much Humana pays for the drug. Once it was ~$300, this time about $100.

People who have their own prescription coverage can get a coupon so that their co-payment is only $5, but I can't use that because I'm on medicare.
02-27-2012, 05:11 PM   #21
littlemissh
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I'm from the uk so no direct cost to me-i pay through my taxes! You have to get approval from the local trust and fit strict criteria to get it.
I do worry a bit about side effects but am more worried about what crohns is doing to me.
02-27-2012, 05:33 PM   #22
Emily
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Waiting for the pharmacy to call for delivery...how much is everyone paying for their humira if you don't mind me asking?! Do you get to choose syringes or the pen? Anyone worried about the side effects? Does drinking alcohol interact with Humira?
I pay $5 through the Humira assistance program! It's great if your insured but still have a high copay since it costs $2,000 cash price! I started out with pens but chose to switch to syringes which my doctor said was fine and wrote me a new script. No side effects thus far over here...not a single one, I've been taking Humira over a year. And drinking alcohol and Humira do not interfere with one another. Hope that helps! Good luck!
02-27-2012, 06:49 PM   #23
indianhart
 
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Emily,
Where did you go to get your Humira funded? I will need help if it's $2000! Thanks for all your advice!
02-27-2012, 07:23 PM   #24
Miss Underestimated
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Get it here humira.com select "affording your medication" - the links thingy is messing with the URL.

Yours may not be that much. I have medicare part D, and it is different than most private insurance. It's very limited.

You can also just call 1.800.4.HUMIRA
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