Adalimumab

(a da LIM yoo mab)

How does this drug come?

• This drug comes as an injection.

Pharmacologic Category

• Antirheumatic, Disease Modifying
• Gastrointestinal Agent, Miscellaneous
• Monoclonal Antibody
• Tumor Necrosis Factor (TNF) Blocking Agent

What key warnings do I need to know about before giving this drug to my child?

• TB (tuberculosis) has been seen in patients started on adalimumab. These patients were exposed to TB in the past, but never had the infection. Your child will be tested to see if he/she has been exposed to TB.
• This drug may add to your child's chance of getting lymphoma or other cancers.
• Very bad infections have happen in patients who take these types of drugs. Talk with the doctor.
• Unsafe reactions may happen. This drug cannot be given while your child is taking some other drugs. Check all the drugs your child is taking with your child's doctor.
• Please read the medication guide.

Is it safe for my child to take this drug?

• Not if your child has an allergy to adalimumab or any other part of this drug.
• Be sure to let the doctor know if your child has any allergies or reactions to drugs, food preservatives, or dyes. Make sure to tell about the allergy and what signs your child had. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
• Not if your child has an infection.
• If your child has a latex allergy, talk with the doctor.

Why does my child need this drug?

• It is used to treat arthritis. The arthritis is most often moderate to very active and may not have been helped with other kinds of care.

How does this drug work?

• It is an arthritis-changing drug. It lowers swelling and helps lower signs and protect joints from more harm.
• It helps swelling.
• It lowers the body's harmful response to diseases of the immune system.
• It helps lower GI (gastrointestinal) swelling and other signs.

How is this drug given?

• It is given as a shot into the fatty part of the skin.
• Your child's doctor will teach you how to give the shot.
• Wash your hands before and after use.
• Follow how to give closely if you are giving the shot at home.
• Throw syringe away after use. Do not use more than one time.
• Throw away needles in a needle/sharp disposal box and take the box back to your doctor when it is full.

How long does this drug take to work?

• It may take a few months to see the full effect.

What do I do if my child misses a dose? (does not apply to patients in the hospital)

• Give a missed dose as soon as you think about it.
• If it is close to the time for your child's next dose, skip the missed dose and go back to your child's normal time.
• Do not give two doses or extra doses.
• Do not change the dose or stop your child's drug. Talk with your child's doctor.

What safety measures do I need to take when my child is using this drug?

• Talk with the doctor before your child gets any vaccines. Use with this drug may either raise the chance of very bad infection or make the vaccine not work as well.
• Hepatitis B testing may be done. A hepatitis B infection may get worse during care.
• Long-term use may raise your child's chance of cancer.
• Very bad infections have been reported with use of this drug. If your child has any infection, has many infections, or is taking antibiotics, talk with the doctor.
• Check all drugs your child is taking with your child's doctor. This drug may not mix well with some other drugs.
• If your child has high blood sugar (diabetes), talk with the doctor. Your child may be more likely to get infections.

What are some side effects of this drug?

• Chance of getting an infection. Avoid people with infections, colds, or flu.
• Headache.
• Flu-like signs. These include headache, weakness, fever, shakes, aches, pains, and sweating. Your child may be given drugs before this shot to avoid these signs.
• Irritation where the shot is given.

What do I need to watch for when my child is using this drug?

• Change in the health problem being treated. Is it better, worse, or about the same?
• For unwanted reactions to the drug.
• Follow up with the doctor.

When do I need to call my child's doctor?

• If any of this news causes you to be worried, any of the unwanted reactions happen, or if your child's is not better after taking this drug.
• If you think there was an overdose, call your local poison control center or ER right away.
• If your child shows signs of a very bad reaction, call your child's doctor or the ER right away. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; swelling of face, lips, tongue, or throat; or if your child is not acting normal.
• If your child shows any signs of infection. These include a fever of 100.5°F (38°C) or higher, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color, pain with passing urine, mouth sores, wound that will not heal, or anal itching or pain.
• If your child has trouble breathing.
• If your child has chest pain or pressure.
• If your child has a bad headache.
• If your child is not able to eat.
• If your child has very bad belly pain.
• If your child has a very bad upset stomach or is throwing up.
• If your child is feeling very tired or weak.
• If your child has very bad back pain.
• If your child has numbness or tingling in his/her hands or feet.
• If your child has any bruising or bleeding.
• If your child has dark urine or yellow skin or eyes.
• If your child has night sweats.
• If your child has a big weight loss.
• If your child has a fever that does not go away.
• If your child gets a rash.
• If your child’s health problem does not get better or if you believe your child’s health problem is worse.

How do I store and/or throw out this drug?

• Store in a refrigerator. Do not freeze.
• Protect from light.

General drug facts

• If your child has a very bad allergy, he/she needs to wear an allergy ID at all times.
• You can get this drug by drug order only. If there are refills, call your pharmacy. If your child does not have refills left, you may need to call your child's doctor.
• Get rid of this drug when your child no longer needs it or if the drug is outdated.
• Most drugs can be thrown away in household trash after mixing with coffee grounds or kitty litter and sealing in a plastic bag.
• In Canada, take any unused drugs to the pharmacy. Also, visit http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th
• Do not share your child's drug with others and do not give anyone else's drug to your child.
• Keep all drugs out of the reach of children and pets.
• Many drugs do not work with other drugs. Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
• Call your doctor for help with any side effects. You may also call the FDA at 1-800-FDA-1088 or Health Canada's Vigilance Program at 1-866-234-2345.
• Talk with the doctor before giving your child any new drug, including OTC, natural products, or vitamins.
• If you do not use a drug the right way, it may not be safe. Follow what your child’s doctor tells you.

Copyright © 1978- Lexi-Comp Inc., The Children's Hospital, Denver, CO., and Pediatric Pharmacy Advocacy Group, Inc. All Rights Reserved. This information is protected under US and international copyright law. Unauthorized use or reproduction is prohibited.