Frequently asked questions

Whether you have already started on HUMIRA or are considering it, here are some questions you may have.
Take a look below to find some answers to frequently asked questions and discuss your treatment options with your doctor.

What is HUMIRA and how does it work?

HUMIRA (adalimumab) belongs to a group of medicines called biologics. Biologics are injectable protein-based therapies (often antibodies), which have been developed through genetic engineering (DNA technology).

HUMIRA is a fully human monoclonal antibody. Monoclonal antibodies are proteins that recognise and bind to other unique proteins.

Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, polyarticular juvenile idiopathic arthritis, Crohn’s disease, and psoriasis are all types of autoimmune diseases.

The cause of autoimmune diseases is currently unknown but it has been found that increased levels of a protein called TNF plays a key role in the excessive inflammation that is a feature of these diseases. TNF triggers inflammation as part of the body’s normal immune system response, however extra TNF can attack normal, healthy body tissue and cause inflammation.

HUMIRA binds to TNF and helps block the pain and inflammation associated with autoimmune diseases.

Would I have to pay for HUMIRA?

The government medicine funding agency PHARMAC fully subsidises HUMIRA if your condition has not fully responded to other medicines prescribed by a specialist, and you meet other criteria required by PHARMAC. Your specialist will discuss these with you. Usual doctor’s consultation fees, and pharmacy prescription charges remain payable by you.

How do I use HUMIRA?

HUMIRA is available in either a single-use syringe or, a single-use auto-injector pen. Both the syringe and pen come preloaded with the exact dose of medicine inside, ready for you to inject.

HUMIRA is injected under the skin of your tummy or thigh. At first you may not like the idea of an injection, but your doctor or nurse will be able to help you with this and be with you for your first injection. You will probably give the injection yourself before very long, but if not, it can be given by a healthcare professional or a family member or friend after they have been trained to give injections.

AbbVie, the makers of HUMIRA, offer the AbbVie Care support programme for people taking HUMIRA. You may be able to have a home visit from an AbbVie Care nurse to offer additional support with self-injecting # or, receive supportive telephone calls from an AbbVie Care nurse to address specific concerns you may have. See AbbVie Care support programme for more information.

# Not all of New Zealand is covered by a home visit, your AbbVie Care nurse will be able to discuss this with you when you enrol.

Refer to the Taking HUMIRA section for further information on injecting technique.

Always use HUMIRA exactly as your doctor has instructed you. You should check with your doctor or pharmacist if you are unsure.

Can I use HUMIRA if I’m taking other medicines?

Yes, you can take other medicines if your doctor has prescribed them, or has told you it’s okay to take them while you’re using HUMIRA. You can still take other types of medicines for your condition at the same time as HUMIRA, for example, methotrexate, steroids, non-steroidal anti-inflammatories and painkillers; this is something your specialist will advise you on.

Make sure to tell your specialist about all medicines you are taking including other prescription medicines, any medicines purchased from a pharmacy or supermarket, painkillers, herbal medicines, and vitamin and mineral supplements you are taking. If you have any questions, you should ask your specialist.

HUMIRA is supplied in a single-use, pre-filled syringe or pre-filled auto injector pen. It should NOT be mixed with any other medicine (such as insulin), nor should any other medicines be added to the syringe or pen.

You should not take HUMIRA if you are taking abatacept (Orencia®), anakinra (Kineret®), etanercept (Enbrel®) or infliximab (Remicade®) as taking the two medicines together may increase the risk of infection.

When should I use HUMIRA?

Some people find it helpful to inject HUMIRA in the morning or at bedtime. However, once you find a time that you prefer, using the medicine at a consistent time can help you remember to take it. It’s also a good idea to mark your calendar with the dates of your treatment as this may help you remember when to use it. Always follow your doctor’s instructions on when and how often to use HUMIRA.

If you forget to use HUMIRA when you’re supposed to, inject the next dose as soon as you remember. Then inject your next dose as you would have on your originally scheduled day, had you not forgotten the dose.

Do not give yourself two injections to make up for the injection that you missed.

If you have any questions, ask your doctor or pharmacist.

How should I store HUMIRA?

Keep HUMIRA in the outer carton until it is time to use it. You will need to keep HUMIRA at the right temperature.

HUMIRA should be kept in the refrigerator (+2° C to +8° C) but don’t allow it to freeze.
HUMIRA may be stored at room temperature (below +25° C) for a maximum period of 14 days, but it must be protected from light. This can be useful when travelling or going away form home when a dose is due.

Once removed from the refrigerator and stored at room temperature, the pre-filled pen or pre-filled syringe must be used within 14 days or discarded, even if it is returned to the refrigerator.

Do not use the pre-filled pen or pre-filled syringe if the expiry date has passed.
Do not leave the pre-filled pen or pre-filled syringe in direct sunlight.
Do not use the pre-filled pen or pre-filled syringe if the liquid is not clear and colourless.

How often and for how long will I have to use HUMIRA?

The recommended dose of HUMIRA depends on the conditons being treated, and in the case of children, their age and weight.

You should talk to your specialist about the dosage and frequency of your injections. Do not inject HUMIRA more often than prescribed.

HUMIRA is available in either a pre-filled single-use syringe or, a pre-filled single-use auto-injector pen. Both the syringe and pen come preloaded with the exact dose of medicine inside, ready for you to inject.

If you stop taking HUMIRA your immune system may, once again, become over-active and cause inflammation so it is important that you continue to use HUMIRA for as long as your specialist tells you to.

Will HUMIRA cure my disease?

Unfortunately, currently there are no treatments available that can cure rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, polyarticular juvenile idiopathic arthritis, Crohn’s disease, or psoriasis. HUMIRA will not cure your condition but can help with your symptoms.

When should I expect to see and feel an improvement?

HUMIRA can act quickly; most people can expect to see improvement in their symptoms within 3 months and in some cases as early as two weeks.1-9

You’ll need to be patient and stay on track with your dosing schedule.

What should I do with my used pen or syringe after I use HUMIRA? Can I reuse the needle?

HUMIRA comes in single-dose, pre-filled pens or in pre-filled syringes. The needle is not removable or reusable. Do not recap pen or syringe to avoid accidental injury.

Dispose of used HUMIRA single-use pens and syringes in a responsible way. As part of the AbbVie Care Support Programme, sharps containers are provided to ensure you have a readily available and convent way to dispose of your used sharps via participating pharmacies nationwide.

Never dispose of used pens, syringes or sharps containers in the household rubbish bin.

Items used in the preparation of your injection, such as gauze, cotton balls and caps from the pen and / or syringe may be placed in the rubbish, unless otherwise instructed by your specialist, nurse, or pharmacist. The outer packaging may be recycled.

For more detailed instructions on taking HUMIRA and self-injection with HUMIRA, refer to the Taking HUMIRA page. If you have any questions about using HUMIRA please contact your pharmacist, nurse or specialist.

What is the most important information I should know about HUMIRA?

You should discuss the potential benefits and risks of HUMIRA with your doctor, even though not everyone will experience side effects.

Because of the way HUMIRA works, you may become more likely to develop infections. It is important to tell your doctor if you get symptoms of infections such as fever, wounds, feeling tired or dental problems. Usually these infections are mild – like a cold or a sinus infection, but occasionally they can be very serious, even life-threatening, for example tuberculosis (TB) or hepatitis B. That’s why doctors monitor patients carefully for serious infections while they are taking HUMIRA and why your specialist and general practitioner (GP) may encourage you to get treatment early for any infection, even a minor one, like a cold or a graze, so they don’t become serious infections.

HUMIRA may increase the risk of getting lymphoma or other cancers. There have been cases of unusual cancers in children, teenagers, and young adults using TNF blockers. Some people have developed a rare type of cancer called hepatosplenic T-cell lymphoma. This type of cancer often results in death.

There have been very rare cases of two types of skin cancer (basal cell and squamous cell) in people treated with HUMIRA. These types are generally not life-threatening if treated.

HUMIRA may increase the chance of diseases that affect the nervous system such as multiple sclerosis.

There have been cases of psoriasis and worsening of existing psoriasis.

For more information on what you need to tell your doctor before starting HUMIRA and other safety information, please refer to the Safety section and to What information should I share with my doctor before starting HUMIRA?.

Also refer to Consumer Medicine Information (CMI) which is available at Medsafe New Zealand and in the link at the bottom of this page.

Refer to your doctor for more information or to discuss any concerns.

How will I know if I’m allergic to HUMIRA?

Symptoms of an allergic reaction may include:

  • chest tightness
  • shortness of breath, wheezing or difficulty breathing or swallowing
  • swelling of the face, lips, tongue or other parts of the body eg. hands or feet, hives, itching or skin rash.

If you experience any of these symptoms you should seek urgent medical attention.

Are there any foods that interact with HUMIRA?

Since HUMIRA is injected under the skin (subcutaneously), rather than taken by mouth, food and drink should not affect HUMIRA. If you have questions, talk to your doctor.

Can I drink alcohol when using HUMIRA?

There is insufficient information on the effects of alcohol on HUMIRA. If you have questions, talk to your doctor.

Should I get a flu vaccination (“flu shot”) if I am taking HUMIRA?

Tell your doctor if you are scheduled for any vaccines. It is recommended that patients be brought up to date with all immunisations in agreement with current immunisation guidelines prior to initiating HUMIRA therapy.

Your specialist or GP may encourage you to have vaccinations for flu annually and pneumonia to help protect you, or to try to reduce the severity of these infections.

Patients receiving HUMIRA should not receive live vaccines.

If you have any questions about any of this information, ask your doctor.

Who shouldn’t use HUMIRA?

  • If you have an allergy to any medicine containing HUMIRA or any of the product’s ingredients
  • If you currently have a severe active infection for example, tuberculosis
  • If you are already using anakinra (Kineret®), abatacept (Orencia®), etanercept (Enbrel®) or infliximab (Remicade®)
  • If you have moderate to severe heart failure

If you have any questions about any of this information, ask your doctor.

What information should I share with my doctor before starting HUMIRA?

Tell your doctor if you have, or have had, any of the following:

  • an infection, including a long-term or localised infection (for example, leg ulcer)
    a history of recurrent infections or other conditions that increase the risk of infections
  • tuberculosis, or if you have been in close contact with someone who has had tuberculosis
  • hepatitis B virus, or you suspect you may be infected
  • a fungal infection
  • multiple sclerosis and other demyelinating disease
  • allergic reactions such as chest tightness, wheezing, dizziness, swelling or rash
  • blood disorders
  • a suppressed immune system
  • heart conditions including congestive heart failure, heart attack or worsening of existing heart conditions
  • cancer or autoimmune disease
  • kidney or liver problems
  • allergy to rubber or latex.

As cases of tuberculosis have been reported in patients treated with HUMIRA, your doctor will check you for signs and symptoms of tuberculosis before starting this medicine. This will include a thorough medical history, a chest x-ray and tuberculin test.

HUMIRA can cause reactivation of hepatitis B in people who carry this virus. In some rare cases, especially if you are taking other medicines that suppress the immune system, reactivation of hepatitis B virus can be life-threatening.

Tell your doctor if you are scheduled for any vaccines. It is recommended that patients be brought up to date with all immunisations in agreement with current immunisation guidelines prior to initiating HUMIRA therapy. Patients receiving HUMIRA should not receive live vaccines.

Tell your doctor if you are currently taking or have previously taken any medication that lowers the body’s resistance to disease. You might get infections more easily while you are receiving HUMIRA treatment. These infections may be serious and include tuberculosis, infections caused by viruses, fungi or bacteria, or other opportunistic infections and sepsis that may, in rare cases, be life-threatening.

If you get an infection your doctor may recommend temporary discontinuation of HUMIRA. Also tell your doctor if you live(d) or have travelled to countries where there is more risk for certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, blastomycosis). These infections may develop or become more severe if you take HUMIRA.

Tell your doctor if you are a psoriasis sufferer who has undergone phototherapy.

You should tell your doctor if you are pregnant, become pregnant, or are thinking about becoming pregnant. Tell your doctor if you are breastfeeding, or plan to breastfeed.

If you have any questions about any of this information, ask your doctor.

What are the possible side effects with HUMIRA?

All medicines have risks and benefits. It is important to be aware of these side effects, even though not everyone will experience them. If you have any questions about any of this information, ask your specialist, GP or pharmacist. Remember to tell your doctor if you experience side-effects from any medicine you are taking.

The most common side effects of the medicine are listed below and usually mild and short lived:

  • Respiratory tract infections – upper (eg. cold, sinus infection, sore throat), lower (eg. bronchitis, pneumonia)
  • Other infections – skin (eg. cellulitis), ear, mouth (inflammation or ulcers), urinary tract, fungal (eg. thrush) and viral infections (eg. influenza, cold sore blisters, chicken pox, shingles)
  • Injection site reactions
  • Headache
  • Nausea, diarrhoea and /or abdominal pain
  • Muscle ache
  • Rash
  • Lower than normal number of white blood cells (leucopaenia)
  • Lower than normal number of red blood cells (anaemia)
  • Increased lipids
  • Higher than normal liver enzymes
  • Fatigue

For more information refer to the Consumer Medicine Information (CMI) which is available at Medsafe New Zealand and in the link at the bottom of this page and the Safety section of this website.

Can I use HUMIRA if I’m pregnant or breast feeding?

Tell your doctor if you are pregnant or planning to become pregnant. There is no information available from clinical trials for pregnant women being treated with HUMIRA and therefore the use of this medicine during pregnancy is not recommended and should be discussed with your doctor.

Administration of live vaccines to infants exposed to HUMIRA during pregnancy is not recommended for five months following the mother’s last HUMIRA injection during pregnancy.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if HUMIRA passes into breast milk and breast feeding is not recommended for at least 5 months after the last HUMIRA treatment. If you are breastfeeding, your doctor may advise you to stop breastfeeding while you are using this medicine.

If you have any questions about any of this information, ask your doctor.

What support is available when I am on HUMIRA?

AbbVie, the makers of HUMIRA, offer a support programme called AbbVie Care for people taking HUMIRA. You may be able to have a home visit from an AbbVie Care nurse to offer additional support with self-injecting # or, receive supportive telephone calls from an AbbVie Care nurse to address specific concerns you may have. Refer to Taking HUMIRA for more information on AbbVie Care.

# Not all of NZ is covered by a home visit, your AbbVie Care nurse will be able to discuss this with you when you enrol.

What else can I do to take care of my disease besides taking medications?

To better manage your disease, it may be helpful to eat a healthy diet, get adequate rest and lose any excess weight.

It’s also a good idea to exercise regularly, which can help build strength, endurance and mobility. Many people find stress management beneficial, too. Always consult your doctor before beginning any diet or exercise programme.

References

  1. Weinblatt M E, et al. Arthritis Rheum 2003;48(1):35-45
  2. Keystone E C, et al. Arthritis Rheum 2004;50(5):1400-1411
  3. Mease P, et al. Arthritis Rheum 2005;52(10):3279-3289
  4. Menter A, et al. J. Am. Acad. Dermatol. 2008;58:106-15
  5. Saurat J H, et al. Br J Dermatol 2008;158:558-566
  6. Hanauer S B, et al. Gastroenterology 2006;130:323-333
  7. Colombel J F, et al. Gastroenterology 2007;132:52-65
  8. van der Heijde D, et al. Arthritis Rheum 2006;54(7):2136-2146
  9. Lovell D J. N Engl J Med 2008;359:810-20

Orencia is a registered trade mark registered to Bristol-Myers Squibb. Kineret is a registered trade mark licensed by Swedish Orphan Biovitrum. Enbrel is a registered trade mark registered to Pfizer New Zealand. Remicade is a registered trade mark registered to Janssen Cilag.

NZ-HUM-0116 TAPS PP9594 Prepared May 2017