Before you begin using 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 use this medication.
Allergic reactions: In rare cases, some people may develop an allergic reaction to this medication. Signs of an allergic reaction include a severe rash, hives, swollen face or throat, or difficulty breathing. If these occur, contact your doctor immediately. The needle cover on the prefilled syringe contains dry natural rubber. Before you start injections, tell your doctor if you have an allergy to rubber or latex.
Blood disorders: Rarely, people taking this medication have become deficient in certain types of blood cells. If you notice signs of infection (such as fever, shaking or chills, fast heartbeat, or quick breathing) or bleeding (such as easy bruising, blood in the stools, black tarry stools, or vomiting blood or material that looks like coffee grounds), seek immediate medical attention.
Cancer: Compared to the general population, people taking adalimumab have a slightly greater risk of developing a cancer of the immune system (known as lymphoma). However, the risk is still small. In general, people with severe rheumatoid arthritis who take medications that suppress the immune system over long periods of time may also have a higher risk of developing lymphoma, even if they don't take adalimumab. If you experience any of the following or other unusual symptoms, contact your doctor immediately:
- decreased appetite
- night sweats
- one or more enlarged lymph node
- unusual fatigue
- weight loss
Signs and symptoms of lymphoma can vary depending on the extent of the disease and the parts of the body involved (e.g., chest, abdomen, or bowel).
Dizziness: Adalimumab may cause dizziness and fatigue. Do not drive or operate machinery until you know that adalimumab does not affect your ability to perform these tasks safely.
Heart failure: Adalimumab may cause congestive heart failure (CHF) or worsen existing CHF. If you have CHF, you should be monitored closely by your doctors. Symptoms to watch out for include swelling of the feet and ankles and shortness of breath. If you notice these symptoms, contact your doctor immediately.
Immune system disorders: Some people who take this medication have developed lupus-like syndrome, an autoimmune disease (a condition where the body is attacked by its own immune system). Symptoms of lupus-like syndrome include chest pain, joint pain, difficulty breathing, and a skin rash (usually on the cheeks and arms) that is sensitive to the sun. If you develop these symptoms, contact your doctor as soon as possible.
Infections: This medication or other TNF blockers can increase the risk of developing serious bacteria and fungi infections, such as tuberculosis and various types of pneumonia. If you notice signs of an infection such as fever, chills, pain, swelling, or pus, contact your doctor as soon as possible.
Tell your doctor if you have an infection or have a history of infections that keep coming back or other conditions that might increase your risk of infections, including fungal infections prior to initiating therapy. This medication should not be used in combination with anakinra, as this can increase the risk of severe infections.
People infected with hepatitis B virus (an infection that can damage the liver) may have a relapse of their condition while taking this medication. If you are at risk for hepatitis B, your doctor may test you for this infection before starting treatment with adalimumab and will follow your condition closely while you are taking the medication. If you notice symptoms of liver problems, such as abdominal pain, yellow eyes or skin, loss of appetite, fatigue, or dark urine, contact your doctor immediately.
Nervous system diseases: Rare cases of disorders that affect the nervous system have been reported by people taking adalimumab or other TNF blockers. If you are experiencing numbness and tingling, vision problems, weakness in your legs, and dizziness, contact your doctor immediately.
Vaccines: Live vaccines (e.g., yellow fever, BCG, cholera, typhoid, varicella) should not be given when you are taking adalimumab.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Contact your doctor if you become pregnant while taking adalimumab.
Breast-feeding: It is not known if adalimumab 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 less than 4 years of age. When children and teenagers have been treated with adalimumab, some have developed lymphoma (cancer of the immune system) and other types of cancer.