Crohn's Disease Forum » Parents of Kids with IBD » Humira mixed with lidocaine

10-19-2013, 01:17 PM   #1
my little penguin
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Humira mixed with lidocaine

PURPOSE: To show that administration of adalimumab combined with injectable lidocaine pre-mixed in the syringe decreases the pain of injection and results in improved tolerance and acceptance of this therapy.
METHODS: Pediatric and adult rheumatology patients at our institution treated with adalimumab since 2006 were included in our study. Potential patients were prospectively identified when initiating adalimumab therapy. Patients with prior injection site pain, younger age, or injection anxiety symptoms were offered this innovation when using adalimumab therapy. 0.2 ml of lidocaine was added directly to the pre-filled syringe containing 0.8 ml of adalimumab. These agents were combined at room temperature and no precipitation occurred. There is no documented incompatibility of lidocaine with adalimumab. Patients were asked to rate the level of injection discomfort prior to and following the use of lidocaine and to base their answers on a 1-10 pain scale. Laboratory markers of inflammation, the CRP and ESR, and joint counts were reviewed to assess and ensure the continued efficacy of the adalimumab/lidocaine admixture. Results were compared before and after the addition of lidocaine.
RESULTS: Approximately 30 patients in the combined rheumatology practices were prescribed adalimumab therapy. Of this group, 15 patients used the mixture of lidocanie and adalimumab. Pain at the injection site was diminished following the addition of lidocaine. Patients report increased comfort level using this method. There were no significant changes in ESR/CRP or joint counts following the addition of the lidocaine. We noted no change in reports of infections or site reactions between the two groups.
CONCLUSTIONS: In order for adalimumab to be available in a pre-filled formulation, the addition of a preservative is required. This lowers the pH to 5.2 producing significant injection site discomfort for some patients. This is a major factor in patient/family willingness to initiate and continue therapy with this agent. With the addition of lidocaine, none of our patients discontinued the adalimumab due to this side effect. We have concluded that the addition of injectable lidocaine to the pre-filled adalimumab syringe is safe and results in decreased pain without sacrificing effectiveness of the drug. Patients using this combination are more willing to continue their therapy

The Addition of Injectable Lidocaine to Adalimumab Results in Decreased Injection Site Pain and Increased Acceptance of Therapy


I will say rhuemo prescribed lidocaine for DS after hearing about the pain of the shots.

WE tried it last night by injecting the lidocaine first then the humira injection.
we will try mixing it next time.
it definitely worked ---much better.
DS - -Crohn's -Stelara -mtx
10-19-2013, 02:19 PM   #2
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Maya142's Avatar
I wish we'd been able to do this for my daughter! So glad it's less painful for your son.
Mom of M (20)
diagnosed with Crohn's Disease at 16
Juvenile Idiopathic Arthritis at 12
Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
Ankylosing Spondylitis at 18
10-19-2013, 02:53 PM   #3
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Mehita's Avatar
Join Date: Nov 2011
Location: Minnesota

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Very interesting. I've always thought there would be no way DS could ever handle Humira based on the stories here and his issue with needles and pain. Maybe this would be an option after all.
Mom of DS, age 17, dx Crohn's and Celiac Oct 2008
- Remicade, started Nov 2013
- added Methotrexate/Folate March 2016
- Multivitamins, Probiotics, Vit D
- Small bowel resection, Jan 2013
10-19-2013, 11:01 PM   #4
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Join Date: Jun 2011
Location: Ontario

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I'm so glad it helped with his injection!!!
Tess, mom to S
Diagnosed May 2011

May-July 2011 - 6 wks Exclusive EN via NG tube - 2000 ml/night, 1 wk IV Flagyl
July 2011-July 2013 - Supplemental EN via NG, 1000 ml/night, 5 nites/wk, Nexium, 40 mg
Feb. 2013-present - Remicade, 5 mg/kg every 6 wks
Supplements: 1-2 Boost shakes, D3 - 2000 IUs, Krill Oil
10-20-2013, 11:06 AM   #5
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kimmidwife's Avatar
Wow that is amazing!!! Caitlyn couldn't handle the pain of the shots either

Crohn's Dx'ed Sept 08
Allerg Imuran Sept 08
Fail Remicade Jan 09
Methotrex Oct 09-Aug 11
Pentasa stopped - nosebleeds
EENOct 31 - Nov 28th. Too hard!
Retried Remicade Dec 11
Stopped due 2 Anaphylactic Reaction
LDN Jan 2012-June 2014 Got My daughter back!
New secondary diagnosis: Gastroporesis Dec 2013
Lost remission June 2014
Started Entyvio April 2015. Decreased to every 4 weeks October 2015. Praying for remission.

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