How to take adalimumab
Adalimumab for inflammatory bowel disease
You or a family member inject the medicine under the skin (subcutaneous).
Doses (the amount of medicine)
Adalimumab is supplied in 40mg doses.
When starting treatment, the usual dose for adults is 4 injections (160mg).
2 weeks later, this will reduce to 2 injections (80mg).
For ongoing treatment, the usual dose is 1 injection (40mg) every other week.
Your doctor may increase how often you have adalimumab to 1 injection (40mg) every week. This depends on blood tests and your response to the medicine.
If you forget to take a dose
If you remember within 12 hours of your dose being due, take your dose as normal.
If it's more than 12 hours, then take the next dose as planned. Do not double your dose if you have forgotten.
Try not to forget any doses. If you regularly forget the medicine, you will have a lower level in your blood and this might make it less effective
How to give the injection
You will be trained to give the injections to yourself, and it might be possible to also train someone else, such as a family member.
Adalimumab comes in a pre-filled syringe or injection pen which is ready to use. Most people feel more comfortable using the pens. However, you can switch to the pre-filled syringe if you are having difficulties.
If you use a syringe, the injection will take 2 to 5 seconds to give. If you use a pen it will take about 10 seconds.
If your skin hurts or is swollen after the injection, it may help to apply an ice pack or cold, damp towel to the area for about 10 to 15 minutes.
- give the injection under the skin of your thigh or stomach
- give the injection 3cm or more away from recent injection sites
- if you use a syringe, insert the needle quickly in a single motion and inject the medicine slowly
- take the medicine out of the fridge 15 minutes before you use it so it's at room temperature
- apply an ice pack for 2 to 3 minutes to the area you are going to inject. Place a tea towel between the ice pack and your skin
- do not inject anywhere the skin is reddened, bruised or hard
- Adalimumab syringes and pens should be stored in a fridge (2 to 8C)
- Keep them in the outer carton in order to protect them from light.
- Do not freeze adalimumab.
- Keep this medicine out of the sight and reach of children.
- Do not use this medicine after the expiry date on the packet. The expiry date refers to the last day of that month.
After you remove adalimumab from the fridge
When you need it, you can remove a single adalimumab syringe or pen from the refrigerator.
- It can be stored at room temperature (up to 25C) for up to 14 days.
- Make sure it is protected from light.
- Once removed from the refrigerator the syringe must be used within 14 days or discarded, even if it is returned to the fridge.
- Record the date when the syringe is first removed from fridge and the date when it should be discarded (14 days later).
Safely disposing of your medicine
Do not throw any medicines away. Ask your doctor or pharmacist how to safely throw away medicines you no longer want.
You will be provided with a yellow sharps bin to dispose of any used pre-filled pens or syringes.
Taking adalimumab with other medicines
Adalimumab is normally given with other medicines that suppress the body’s immune response (immunosuppressants) such as azathioprine, mercaptopurine, tioguanine or methotrexate.
Sometimes we prescribe a short course of steroids to reduce your IBD symptoms.
Before you start taking adalimumab, let your doctor know about all the medicines you take. This should include anything prescribed for you and any medicines you buy from a shop or pharmacy (including herbal and homeopathic).
If you take anakinra or abatacept
Adalimumab should not be taken with the medicines anakinra or abatacept.
You should tell any other doctor, dentist or health professional treating you that you are being treated with adalimumab.
When you have started treatment, you should always check with your doctor or pharmacist before starting any new medicines.
Vaccinations and adalimumab
Avoid 'live' vaccines when you are taking adalimumab and for at least 3 months after stopping it. If you consider having vaccinations check with your doctor or pharmacist first. If anyone in your family or household is due to have a live vaccine, check with your IBD team whether you need to take any special precautions.
We should arrange an annual flu jab with your GP, as well as a 5-yearly pneumonia vaccination, while being treated with adalimumab.
Resource number: 4501/VER3
Date published: May 2022
Review date: September 2023