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
- 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.
- Gather supplies: Have your Humira device, an alcohol swab, a cotton ball or gauze, and an FDA-approved sharps container ready.
- 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.