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What to Know When Starting Humira?

4 min read

With over a decade of use in treating various autoimmune conditions, Humira is a potent biologic medication that requires careful consideration before treatment begins. This comprehensive guide covers everything a patient needs to know when starting Humira, from initial health screenings and injection training to potential risks and cost-saving options.

Quick Summary

This article details the essential information for patients beginning Humira, covering important safety warnings, the proper injection process, and necessary lifestyle considerations to ensure a successful start to therapy.

Key Points

  • Required Screenings: You must be tested for tuberculosis (TB) and hepatitis B before starting Humira, and monitored throughout treatment.

  • Injection Training is Vital: Your first injection must be supervised by a healthcare professional, who will train you to properly use the prefilled pen or syringe at home.

  • Be Aware of Serious Risks: Humira has boxed warnings for an increased risk of serious infections and certain cancers, including lymphoma.

  • Know Your Medications: Never combine Humira with other TNF blockers or certain immunosuppressants, and avoid live vaccines.

  • Store Properly for Safety: Humira must be refrigerated and protected from freezing and light, with a strict 14-day limit for room temperature storage.

  • Explore Financial Assistance: Significant savings and patient assistance programs are available to help manage the high cost of Humira.

In This Article

Before You Begin: Medical Screenings and Disclosures

Before starting Humira, a thorough medical evaluation is critical to ensure your safety and minimize risks. As an immunosuppressant, Humira lowers your body's ability to fight infection, which can reactivate dormant infections or increase the risk of new ones.

Required Pre-Treatment Checks

  • Tuberculosis (TB) Screening: All patients must be screened for TB before starting Humira and monitored closely during therapy, as the medication can reactivate latent TB.
  • Hepatitis B (HBV) Testing: Patients who are carriers of the HBV may experience a reactivation of the virus while on Humira. Blood tests are necessary to check for HBV before starting and regularly throughout treatment.
  • Up-to-date Vaccinations: Since live vaccines (e.g., nasal flu spray, MMR, chickenpox) are not safe to receive while on Humira, children and adults should be current on all immunizations before therapy begins.

Full Medical History Disclosure

Inform your doctor about any history of the following conditions:

  • Cancer or previous cancer treatment.
  • Congestive heart failure, as Humira can worsen the condition.
  • Demyelinating diseases, such as multiple sclerosis (MS) or Guillain-Barré syndrome.
  • Diabetes, as it can increase the risk of infection.
  • Any history of serious or recurring infections.

Your First Injection: What to Expect

The first injection of Humira must be given under the supervision of a healthcare professional. You will be trained on how to self-administer the medication at home using either a prefilled pen or syringe.

Preparing for Your First Injection

  1. Warm to room temperature: Take the Humira pen or syringe out of the refrigerator 15 to 30 minutes before injecting. Cold medication can cause more discomfort. Do not use any artificial heating methods, such as a microwave or hot water.
  2. Gather supplies: Have your Humira device, an alcohol swab, a cotton ball or gauze, and an FDA-approved sharps container ready.
  3. Inspect the liquid: Before use, check the liquid in the window of the pen or syringe. It should be clear and colorless. Do not use if it is cloudy, discolored, or contains particles.

Injection Technique

  • Choose and prepare the site: The recommended injection sites are the front of your thighs or your abdomen, at least two inches away from the belly button. Wipe the chosen site with an alcohol swab and let it dry completely.
  • Alternate injection sites: To prevent skin irritation, rotate your injection site with each dose.
  • Injecting with the pen: The pen is designed for ease of use. Once positioned correctly on the skin, press the activation button. You will hear a loud "click" as the injection begins. Continue holding the pen in place for a slow count of 10 to ensure the full dose is delivered. A yellow indicator will confirm completion.

Potential Side Effects and Serious Warnings

It is important to be aware of both common and rare side effects when starting Humira. While common side effects are often mild, serious side effects require immediate medical attention.

Common vs. Serious Side Effects

Side Effect Category Common Side Effects Serious Side Effects
Infections Upper respiratory infections (sinus infections) Tuberculosis (TB), sepsis, fungal infections
Skin Injection site reactions (redness, pain, bruising, rash), headache New or worsening psoriasis, skin cancer (non-melanoma)
Gastrointestinal Nausea, stomach pain Liver problems, hepatitis B reactivation
Immune System Lupus-like syndrome (joint pain, rash)
Nervous System Headaches Numbness, tingling, vision problems, nerve disorders
Cardiovascular New or worsening heart failure
Blood Low blood counts, easy bruising, unusual bleeding
Cancer Increased risk of certain cancers, including lymphoma

Storage, Other Medications, and Cost

Managing your Humira therapy involves more than just the injection itself. Adhering to proper storage guidelines, disclosing all medications, and understanding financial resources are key for a successful experience.

Drug Interactions and Alcohol

Always inform your doctor of any medications you are taking, including over-the-counter drugs and supplements. Humira should not be taken with other TNF blockers (like Remicade or Enbrel), Kineret, Orencia, or live vaccines due to an increased risk of serious infections. While no direct interaction with alcohol has been noted, moderation is often advised, especially if you also take other medications like methotrexate that can affect the liver.

Storage and Travel

  • Refrigeration: Humira should be stored in the refrigerator between 36°F and 46°F (2°C to 8°C) in its original carton to protect it from light.
  • Room Temperature: If traveling, Humira can be stored at room temperature (up to 77°F/25°C) for a maximum of 14 days. Once removed from the refrigerator for longer-term room temperature storage, it must be used within 14 days and not returned to the fridge.
  • Disposal: Dispose of used pens and syringes in an FDA-approved sharps container immediately after use. Do not put them in household trash.

Cost and Patient Assistance

Humira is expensive, but several options exist to help manage costs.

  • Savings Card: Eligible, commercially insured patients can use the HUMIRA Complete Savings Card to pay as little as $0 per month.
  • Patient Assistance Program: The manufacturer, AbbVie, offers a patient assistance program called myAbbVie Assist for uninsured or underinsured patients who meet certain income criteria.
  • Biosimilars: Less expensive biosimilar versions of adalimumab are now available.

Conclusion

Starting a new medication like Humira is a significant step in managing your condition. By following your doctor's instructions, understanding the potential side effects and serious risks, and preparing for the injection process, you can approach this new treatment with confidence. Consistent communication with your healthcare team is vital to ensure you stay on track and manage any issues that arise. It is a long-term treatment, not a cure, but it can significantly improve your quality of life. For more information on support resources, you can visit the official Humira Complete website.

Frequently Asked Questions

Humira (adalimumab) is a prescription biologic medication that blocks tumor necrosis factor (TNF), a protein that causes inflammation. It is used to treat various autoimmune and inflammatory conditions, including rheumatoid arthritis, Crohn's disease, plaque psoriasis, and ulcerative colitis.

The time it takes for Humira to work varies by individual and condition. Some patients may notice symptom relief within 2 to 12 weeks, but for some conditions, it may take several months to see the full effect.

You can inject Humira into your abdomen (belly) or the front of your thighs. You should rotate the injection site with each dose to avoid irritation and always inject at least one inch away from the previous site.

There is no known direct interaction between Humira and alcohol. However, since Humira can affect the liver, and alcohol can too, it is wise to discuss moderate alcohol consumption with your doctor. If you take other medications that impact the liver, like methotrexate, your doctor may advise against alcohol entirely.

If you forget to take your dose, inject it as soon as you remember. Then, take your next dose at your regular scheduled time. Do not take a double dose to make up for a missed one. If you are unsure, contact your doctor or pharmacist.

Common side effects include injection site reactions such as redness, pain, bruising, or itching. Other common issues are headaches, rash, and upper respiratory tract infections.

Yes, Humira's manufacturer, AbbVie, offers patient assistance programs like the Humira Complete Savings Card for commercially insured patients and the myAbbVie Assist program for those without insurance who meet eligibility criteria.

References

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Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice.