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, swollen face, chest pain, or difficulty breathing. If these occur, contact your doctor immediately.
Blood glucose: The intravenous form of this medication may affect blood glucose testing by giving falsely high blood glucose readings with certain types of blood glucose monitors. If you require blood glucose monitoring, talk to your doctor or pharmacist about using a blood glucose monitor that will not be affected by this medication. The subcutaneous form of this medication does not have the same effect.
Cancer: In clinical trials, people using abatacept reported developing lung cancer or a cancer of the immune system (known as lymphoma) more often than people who were given an inert treatment. Other types of cancer have also been reported. The number of reported cancer cases in people taking abatacept appears to be consistent with the expected number of cancer cases reported in people with rheumatoid arthritis. In general, people with severe rheumatoid arthritis who have had the condition for a long time may also have a higher risk of developing lymphoma. If you take abatacept or another rheumatoid arthritis biologic medication, your risk may increase. The role of abatacept in the development of cancer is not known.
Chronic obstructive pulmonary disease (COPD): People with COPD have a higher risk of experiencing side effects when they are using abatacept. If you have COPD, your doctor will monitor you for signs of worsening disease.
Infections: This medication can increase the risk of developing an infection. If you notice signs of an infection, such as fever, chills, pain, swelling, or pus, contact your doctor as soon as possible. Also, this medication should not be started while you have an active or chronic infection. This medication is not recommended for use by people who have active tuberculosis or if you come in contact with someone who has tuberculosis. Your doctor may examine you for tuberculosis and give you a skin test before you start abatacept.
People infected with hepatitis B virus (an infection that can damage the liver) have had a relapse of their condition while taking medications for rheumatoid arthritis. To determine if you are at risk for hepatitis B, your doctor may test you for this infection before starting treatment with abatacept 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.
Use with other biologics: This medication should not be used at the same time with a class of medications called biologic response modifiers ("biologics") and other such medications (e.g., anakinra, etanercept, infliximab, adalimumab, rituximab). Doing so could increase the risk of infections.
Vaccines: Live vaccines should not be given during treatment with abatacept or within 3 months of stopping abatacept. Children who have JIA or JRA should complete the recommended vaccination schedule before starting treatment with abatacept.
Pregnancy: There have been no studies on the use of abatacept by pregnant women. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if abatacept 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 the intravenous form of abatacept have not been established for children less than 6 years of age. The subcutaneous form of this medication has not been studied for use by children and adolescents. It is not recommended for this age group.
Seniors: Seniors may be more likely to experience serious infections and cancer with abatacept. Talk to your doctor about the risks and benefits of using this medication.