Makindo Medical Notes.com

Patients on adalimumab should not be given any of the 'live' vaccines such as those for polio, rubella (German measles) and yellow fever, although inactivated vaccines are safe.

About: Always check the BNF link here

• Fully human monoclonal anti-TNF-alpha antibody
• Assuming 26 doses per year, the annual cost of adalimumab is £9155.64

Action

• Blocks stimulation of TNF receptors and down-regulates inflammatory response
• Adalimumab does not work immediately and it may be 3-12 weeks before benefit.
• Profile similar to Infliximab

Indications

• Rheumatoid arthritis, Severe psoriasis or Psoriatic arthritis
• Ankylosing spondylitis, Crohn's disease. Juvenile idiopathic arthritis.

Dose

• Adalimumab is administered subcutaneously as a 40 mg dose every other week

Dose range: It must be stored in a refrigerator (at 2-8°C).

Side effects

• Respiratory tract infections, leukopenia, anaemia, increased lipids
• Headache, abdominal pain, nausea and vomiting
• Elevated liver enzymes, rash, musculoskeletal pain and injection site reaction.

Contraindications

• Adalimumab is contraindicated in people with active tuberculosis or other severe infections, and people with moderate or severe heart failure
• Active tuberculosis should be treated with standard treatment for at least 2 months before starting adalimumab
• Patients on adalimumab should not be given any of the 'live' vaccines such as those for polio, rubella (German measles) and yellow fever, although inactivated vaccines are safe.
• Pharmacologic inhibition of tumour necrosis factor-α (TNF-α) for the treatment of chronic inflammatory disease such as Crohn’s or psoriasis increases the risk of developing active tuberculosis among those with latent infection.

References

• Adalimumab in BNF