Side effects of adalimumab

Adalimumab for inflammatory bowel disease

Adalimumab works by suppressing your immune system. This means you might be more likely to get an infection. Contact your GP if you begin to feel unwell and think you might have caught an infection.

You might be at greater risk of becoming seriously ill from:

  • chickenpox
  • shingles
  • measles

Contact the IBD advice line if you come into contact with anyone with these conditions, even if you feel well. 

This is important if you are also taking other immunosuppressants such as azathioprine, mercaptopurine or steroids.

Make sure that you carry the alert card given to you by the manufacturer at all times while you are using adalimumab and for 4 months after your last dose. 

Call 999 or go to A&E if

you develop any of the following symptoms:

  • a severe rash, hives (swollen red patches of skin) or other signs of allergic reaction 
  • swollen face, hands and feet 
  • trouble breathing or swallowing 
  • shortness of breath 
  • persistent fever, bruising or bleeding

Everyone responds differently to the medicines but possible side effects include the following.

  • Reactions at the injection site such as pain, swelling, redness, bruising or itching. This happens in about 1 in 10 people and your IBD nurse can office advice to reduce this.
  • Increased risk of infections such as colds and flu, as well as more serious infections such as pneumonia and septicaemia (infection in the blood). You may also be at greater risk of developing TB, or of reactivating underlying TB.
  • Skin reactions such as psoriasis (scaly patches, often on the palms of hands or soles of feet), eczema or other types of rash. Some of these can be treated without stopping adalimumab. 
  • Feeling sick (nausea), especially at the start of treatment. We may need to make changes to how and when you take the medicines.
  • Flu-like symptoms including headache, muscle ache and feeling generally unwell. You might feel like this at the beginning of treatment but this often goes away within a few weeks.
  • Headache.
  • Diarrhoea (runny poo).
  • Dizziness.
  • Hair loss, although this can often get better while you continue treatment.
  • Rashes.

These medicines increase the skin’s sensitivity to the sun and so increases the risk of certain types of skin cancer. Wear protective clothing and use a high sun protection factor (SPF 50) sun cream.

Lymphoma is a type of cancer affecting the lymph glands. The risk of getting this is higher than the general population but it remains very rare (1 in 2,500 people).

Damage to nerves (demyelination) and some inflammatory conditions such as lupus are also very rare. These side effects are often reversible if the drug is stopped.

Pregnancy and breastfeeding

The most important thing is that your IBD is as controlled as well as possible during pregnancy.

It's important that you tell us if you are pregnant or planning on getting pregnant so that we can review all of your medicines and monitor you more closely.

Our team will be able to discuss the risks and benefits of continuing with adalimumab during pregnancy. Many people continue to take this medication safely throughout their pregnancy and while breast feeding.

There is very detailed factsheet about taking adalimumab during pregnancy on the bumps (best use of medicines in pregnancy) website.

Drinking alcohol

We recommend you keep well within the national recommended limits of alcohol (maximum of 14 units per week).

14 units is about the same as 6 pints of average-strength beer or 10 small glasses of lower-strength wine.

Any amount of alcohol can damage the liver, especially if you have an underlying condition. Depending on the state of your liver, your clinician may ask you to avoid alcohol completely.

Resource number: 4501/VER3
Date published: May 2022
Review date: September 2023

Contact us

If you have any questions or concerns, email the IBD advice line.

Email: [email protected]

Please include your name, hospital number, contact details and details of your enquiry. We will respond 9am to 5pm, Monday to Friday.

The gastroenterology department can also be contacted during office hours on 020 7188 2499 or 020 7188 1222.

If you are concerned outside these hours, contact a GP or call NHS 111.

If you have any questions or concerns about adalimumab, please email the IBD pharmacy team: [email protected]

Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

Is this health information page useful?