Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
Anemia: Certolizumab pegol may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired or pale skin, contact your doctor as soon as possible.
Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.
Bleeding: This medication may affect your body's ability to produce enough of certain types of blood cells, including the ones that help you stop bleeding. If your experience unusual bruising or bleeding, increased nosebleeds, bleeding gums, or you notice blood in your urine, contact your doctor as soon as possible. If you notice signs of bleeding in the stomach such as bloody, black, or tarry stools, vomiting blood or material that looks like coffee grounds, get medical attention immediately.
If you have an increased risk of bleeding, your doctor should closely monitor your blood counts while you are using this medication.
Cancer: Rarely, cases of cancer (including skin cancer, leukemia [blood cancer] and lymphoma) have been reported among people taking this medication. Talk to your doctor about cancer screening and your risk of cancer, and see your doctor if you have a bump or sore that does not heal.
Congestive heart failure (CHF): People taking medications in the same family as certolizumab pegol may develop CHF or find that their CHF gets worse. If you have a history of CHF or are at risk of developing CHF, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Tell your doctor if you have CHF. If you develop shortness of breath or swelling of the legs or feet (symptoms of CHF), contact your doctor right away.
Hepatitis B: Certolizumab pegol, like other tumour necrosis factor blockers, has been associated with reactivation of hepatitis B infections, which can be fatal. If you have a history of hepatitis B infections, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Immune system problems: Rarely, people taking medications in the same family as certolizumab pegol may develop symptoms similar to the symptoms of lupus (rash on the cheeks or other body areas; sun sensitivity; joint or muscle pain; fatigue; chest pain; shortness of breath; or swelling of the feet, ankles, or legs). Contact your doctor if you develop these symptoms.
Laboratory tests: This medication may interfere with certain laboratory tests. If you are scheduled for lab tests, let your doctor know that you are using certolizumab pegol.
Neurological effects: Rarely, people taking medications in the same family as certolizumab pegol may develop nervous system diseases such as multiple sclerosis (MS). Contact your doctor right away if you notice vision changes, dizziness, arm or leg weakness, and numbness or tingling in any part of your body.
Serious infections: Certolizumab pegol can affect the way your body's natural defences work to fight infection. This makes the body more likely to develop infections due to bacteria, viruses, and fungi. This effect is increased if you are taking certolizumab with other medications that reduce the body's ability to fight infection. For some people, these infections have been fatal.
If you have a history of chronic or frequent infections, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Stop taking the medication and tell your doctor right away if you notice symptoms of a serious infection, such as fever, chills, headache, flu-like symptoms, feeling tired, cough, blood in the sputum, shortness of breath, night sweats, weight loss, nausea, vomiting, diarrhea, frequency or burning while passing urine, redness or swelling of skin or joint, cold sores, tooth pain, and new or worsening pain in any part of the body.
Severe Allergy: Certolizumab pegol is known to cause severe allergic reactions. Contact your doctor immediately if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.
Surgery: If you have surgery planned, let your surgeon and other health care professionals know that you are taking certolizumab pegol.
Tuberculosis: Some people who have had tuberculosis (a lung infection) in the past have had this infection return when they are using certolizumab pegol. If you have a history of tuberculosis, or have come into recent contact with someone who has tuberculosis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Vaccinations: People taking this medication should not receive certain vaccines. Talk to your doctor about whether any vaccines you are scheduled to take may be used with this medication.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Women who may become pregnant while using this medication should use effective birth control while using certolizumab pegol and for 5 months after the last dose. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if certolizumab pegol passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.