What does it do?

Adalimumab is an immunosuppressant medicine used to treat inflammatory conditions such as rheumatoid arthritis, psoriasis and inflammatory bowel disease. It mops up extra protein that causes inflammation in your body called tumour necrosis factor alpha (TNF-alpha).

Before you start

• Tell your doctor if you have heart problems, multiple sclerosis, or a latex allergy.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
• Adalimumab weakens your immune system, making it harder for your body to fight infections. You may need tests before you start to make sure you don't have any infections like tuberculosis (TB), HIV, or hepatitis B and C.
• Ask your doctor what vaccines you might need before you start and while you are taking adalimumab. You should not have a live vaccine while taking adalimumab.

How should you use it?

Inject adalimumab under the skin regularly as directed, usually in the stomach or thigh. Choose a new place to inject each time (at least 3 cm away from the last place) so that you do not become sore in one area. You, or the person giving the injections, will be given training on how to use the injections.

What if you forget a dose?

If it is nearly time for your next dose, skip the missed dose and inject your next dose at the usual time. Otherwise, inject the missed dose as soon as possible. Do not inject two doses at the same time.

Can you take other medicines?

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products or recreational drugs.

What side effects might you notice?

Side Effects	Recommended action
Symptoms of allergy including: skin rash, itching, swelling, trouble breathing Reduced number of blood cells that fight infections or help your blood to clot - symptoms include: fever, chills, sore throat or generally feeling unwell, or easy or unusual bruising or bleeding Tingling or numbness, muscle weakness or pain	Tell your doctor immediately
Swollen feet or legs, short of breath	Tell your doctor
Headache Stomach upset	Tell your doctor if troublesome
Irritation or pain at injection site	Take it out of the fridge 15 minutes before using to let it warm up. Apply an ice pack to the area before or after the injection.

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

• It is important to tell anyone who gives you medical or dental treatment that you are taking adalimumab.
• Adalimumab may increase the risk of some types of cancer, including lymphoma (a cancer of the immune system). Talk with your doctor about this risk compared to what adalimumab can do to treat your condition.
• Protect yourself from too much sunlight while taking immunosuppressant medicines (they may increase your risk of skin cancer). Always cover up and apply a thick layer of broad spectrum sunscreen (at least SPF30) when outside. Do not use sunbeds.
• Women using adalimumab for a long time may need cervical screening more often. Discuss with your doctor.
• Store adalimumab in the fridge. Keep it in the box to protect from light.
• Do not save partly used adalimumab syringes or pens – use once and then discard safely in a special ‘sharps’ container. Discuss how to do this with your health professional.
• You may not notice the effects of adalimumab straight away - it may take 2 weeks or up to 6 months.