Your immune system is designed to protect you from life-threatening diseases. However, it does not always work perfectly, and as a result, bacteria and viruses can infect your organs and healthy tissues.
Therefore, sometimes it is necessary to equip your body with medication to help it fight infectious diseases.
Humira is one such drug that we will discuss in this article. This medicine aids in the treatment of a variety of inflammatory and skin diseases.
Humira works to strengthen the body’s defenses against foreign invaders. It is a biological treatment for rheumatoid arthritis and other inflammatory and autoimmune conditions.
Humira is classified as a biological drug because it contains Adalimumab, a TNF inhibitor. TNF, or Tumor Necrosis Factor, is a superfamily of proteins produced by the immune system. When you show symptoms of an infection or medical condition, it means that your immune system is making more TNF than usual. Humira is an immunosuppressive drug that prevents TNF molecules from binding to and attacking your body’s healthy cells. Keep in mind that the drug will not stop the production of immune cells, but it will help to reduce their adverse effects.
Your body’s immune system is your only defense against disease. When it fails to function, the body employs inflammatory markers such as TNF, which increases the risk of developing other diseases.
Humira was not used in clinical trials before the FDA approved it in 2002. Since then, it has become increasingly popular in treating rare autoimmune disorders for which no licensed drugs exist.
Uses of Humira
The US Food and Drug Administration (FDA) authorized the use of Humira in treating rheumatoid arthritis on December 31, 2002. It is also used in several gastrointestinal, spinal, and skin disorders. As a result, this drug has been authorized to treat approximately 10 conditions in Canada and 14 in other parts of the world.
Humira is administered to adults suffering from moderate to severe Rheumatoid Arthritis (a form of arthritis caused by autoimmune mechanisms).
Humira can help to slow down structural damage caused by the body’s immune system. In addition, it improves the physical functions of the body by introducing a clinical response. You can take the drug alone or in combination with other non-biological Disease-modifying Antirheumatic Drugs (DMARDs) like methotrexate.
In 2005, the FDA approved the use of Humira in the treatment of Psoriatic Arthritis (PsA) in adults.
The treatment for PsA is similar to that of Rheumatoid Arthritis. Doctors may administer the medication alone or in combination with non-biologic DMARDs.
Juvenile Idiopathic Arthritis
Doctors use Humira for children aged two and above to treat mild to severe Polyarticular Juvenile Idiopathic Arthritis. You can take the drug on its own or with methotrexate.
Humira was given another clearance in 2006 to treat adults with active Ankylosing Spondylitis – a disease that directly affects the spine.
Pediatric Crohn’s Disease
Humira is a prescription drug for Pediatric Crohn’s disease in patients aged six years and older. It maintains the remission of the disease while easing the symptoms. Immunomodulators, such as methotrexate and 6-mercaptopurine, have little effect on certain patients. In such cases, Humira can be of great help.
Adult Crohn’s Disease
Adult Crohn’s disease indicates those patients who do not show a response to other conventional treatments. Humira helps such patients sustain remission while reducing their symptoms.
In January 2008, Humira received the clearance to treat chronic Plaque Psoriasis. However, the drug was approved only after systemic treatments failed to improve the patient’s health.
Another use of Humira was added to the list in September 2012 to combat Ulcerative Colitis, a gastrointestinal condition. The drug was used to maintain remission in people with active Ulcerative Colitis who did not respond well to immunosuppressants.
Uveitis is a rare form of inflammation that affects the uvea – the middle pigmented layer of the eye. Humira was the first non-corticosteroid treatment approved by the FDA for adult patients in June 2016.
Hidradenitis Suppurativa is a chronic inflammatory skin condition that causes lesions around the breast, buttocks, groin, and armpit. Before Humira, there was no cure for this condition.
How Does Humira Work?
Rheumatoid Arthritis is a chronic condition that, if left untreated, can disrupt the equilibrium of the immune system.
When the immune system becomes overactive, inflammation in the body increases. This can cause joint pain and swelling, among other things. It can also lead to stiffness in the feet, shoulders, elbows, knees, and hands.
Rheumatoid Arthritis has no known cause. However, TNF-alpha is said to be a contributing factor in the disease.
TNF-alpha is a protein that controls inflammation and the immune system. It can, however, cause inflammation in the joints, which can lead to Rheumatoid Arthritis. Therefore, doctors commonly recommend Humira as a TNF-alpha inhibitor because it helps to reduce the adverse effects of the protein.
Typical Doses for Humira
Humira comes in liquid form and can be injected directly into the skin. The first dose is administered at the doctor’s office, after which you can inject it at home.
There are three forms of Humira:
- A single-dose vial (used when you receive the dose from the physician)
- A prefilled, single-dose syringe
- Humira pen, which is a prefilled, single-dose injection pen
Strengths of Humira
Humira is used in a variety of strengths, depending on the dosage. A single-dose vial of 40 mg in a 0.8 ml strength solution is available. Prefilled single-dose syringes can be found in the following strengths:
- 80 mg in a 0.8 ml solution
- 40 mg in a 0.8 ml solution
- 40 mg in a 0.4 ml solution
- 20 mg in a 0.5 ml solution
- 20 mg in a 0.2 ml solution
- 10 mg in a 0.2 ml solution
- 10 mg in a 0.1 ml solution
The Humira injection pen is also available in the following strengths:
- 80 mg in a 0.8 ml solution
- 40 mg in a 0.8 ml solution
- 40 mg in a 0.4 ml solution
Dosage for Uveitis
The loading dose to treat Uveitis is 80 mg. After the first week, you can inject a 40 mg dose of Humira on alternate weeks. The standard Humira dosage for children aged two or above is:
- 40 mg on alternate weeks for children weighing 30 kg
- 20 mg on alternate weeks for children weighing 15-20 kg
- 10 mg on alternate weeks for children weighing 10-14 kg
The exact dosage is applicable for children suffering from Juvenile Idiopathic Arthritis.
Dosage for Crohn’s Disease
The loading dosage for Crohn’s disease is 160 mg and can either be separated into two 80 mg doses or taken as a single dose.
After 14 days, the doctor will administer an 80 mg dose. After the first 29 days, you will start getting a 40 mg dose every other week.
Dosage for Ankylosing Spondylitis
You will need to inject 40 mg of Humira every other week to treat this disease.
Dosage for Psoriatic Arthritis
The doctor recommends 40 mg of Humira for this condition, which you should take every other week.
Dosage for Plaque Psoriasis
The loading dose for Plaque Psoriasis is 80 mg, followed by a dose of 40 mg every two weeks.
Dosage for Rheumatoid Arthritis
If you have Rheumatoid Arthritis, your doctor will prescribe you to take 40 mg of the dose every other week. However, the doctor may increase the dosage depending on your health condition.
Dosage for Hidradenitis Suppurativa
The first dose is a 160 mg loading dose that can be taken all at once or spread out over two days. After two weeks, the doctor will administer an 80 mg injection.
Following that, you will receive an 80 mg injection every other week or a 40 mg injection every week.
Dosage for Ulcerative Colitis
The starting dose for adults is 160 mg, which can be taken all at once or divided into 80 mg dosage over two days. For example, on day 14, the doctor will administer an 80 mg dose. Then, the doctor will inject a 40 mg dose every other week for the next two weeks.
For a child aged five years or above and weight between 29-39 kg, the standard dosage of Humira is:
- 80 mg dose on day one
- 40 mg dose after a week
- 40 mg dose on day fifteen
- 40mg dose on alternate weeks or 20 mg dose weekly on day 29
Precautions While Taking Humira
Before you start taking this immunosuppressant, make sure to consult your doctor about any pre-existing conditions you may have.
Humira can reduce the number of platelets and white blood cells in the blood. As a result, you will have to take some measures to avoid risks of bleeding or infection.
- Avoid any direct contact with an infected person. However, if you have close contact, consult a doctor as soon as possible.
- Avoid rubbing your nose or eyes if you have not washed your hands.
- Practice extra caution when using a toothpick, toothbrush, or dental floss.
- If you see any red spots on the skin, blood in your urine, or any other form of bleeding, inform your doctor about it at once.
- Be careful when using sharp objects like nail clippers or safety razors.
Does Humira Have Any Side Effects?
Fortunately, the majority of patients do not suffer any adverse side effects when taking Humira. The few side effects associated with this drug are relatively minor. However, if your symptoms are severe, you should contact your healthcare provider right away.
If you find any signs of allergic reactions, such as swelling of the mouth, ears, stomach, or tongue, you should contact your doctor. Hives and difficulty in breathing are also signs of an allergic reaction.
A few conditions that are sometimes associated with Humira include:
- Lupus-like syndrome
- Serious allergies and infections
- Congestive heart failure
- Reaction at injection sites
- Blood reactions
- Hepatitis B reactivation
- Neurological side effects
If you experience any of the following symptoms, contact your doctor immediately and stop taking Humira until you are told otherwise:
- Lack of appetite, unexpected weight loss, or a feeling of fullness after eating a small portion of food.
- Upper stomach pain and discomfort that can extend to your shoulders
- Fever, swollen glands, or night sweats; a typical feeling of illness
- Skin bruising, bleeding, skin rash, muscle or joint pain
- Cold hands and feet, shortness of breath, dizziness, and pale skin
How To Reduce The Risk Of Infection
Thankfully, none of the side effects mentioned above are common. You may experience minor symptoms, but even that is a rare occurrence. In this section, we will go over some ways in which Humira users can lower the risk of infection:
- Make sure you consume nutritious food that is cooked and stored in sanitary conditions.
- Maintain a clean and sanitary environment, especially in the bathroom and kitchen.
- Avoid being in close contact with people suffering from allergies or infections.
- Do not smoke.
- Brush your teeth regularly and keep your mouth as clean as possible
- Sanitize or wash your hands at regular intervals. You can also keep a small bottle of sanitizing gel with you on the go.
What Happens When I Stop Humira?
Whether you are already taking Humira or are planning to start soon, it is crucial to know how to stop taking it safely. In most cases, the doctor only prescribes this medication for long-term use.
As a result, it is not advisable to stop taking Humira on your own. After all, Humira is a biological maintenance drug. You may see a deterioration in your condition if you stop taking it all of a sudden.
When people stop using Humira abruptly, they typically go through a resurgence of inflammation and pain. So, unless your doctor advises it, do not stop taking Humira once you have started.
Humira can be used to treat various diseases and disorders characterized by inflammation and discomfort. As a consequence, your doctor is the most qualified person to assess the condition.
However, remember that no drug takes effect immediately. Humira provides relief to the majority of patients within 2-12 weeks of starting the treatment. Nonetheless, the outcome may differ from one individual to the next.
What Should My Doctor Know Before Prescribing Humira?
To have a safe and pleasant experience with Humira, you must tell your doctor about even the tiniest health concerns you may have. Make sure to report any underlying or pre-existing health problems before the doctor decides to prescribe them to you. For example, tell your doctor if you:
- Are undergoing treatment for an infection.
- Have diabetes.
- Are breastfeeding, planning a pregnancy, or are currently pregnant.
- Have TB, or are in close contact with someone who has TB.
- Are prone to infections and allergies.
- Live in an area with a high risk of infections.
- Have ever had hepatitis B or currently have it.
- Are scheduled for a vaccine or have recently taken one.
- Have any nervous system diseases or tingling and numbness.
- Are allergic to any of the Humira constituents.
Humira Costs in Canada
Medications such as Humira are specialty drugs with a high treatment cost. For example, Humira is currently available in Canada for about $800. This is one of the most expensive drugs in Canada and worldwide, even though it is quite common.
The cost of Humira has more than doubled between the years 2012 and 2018. As a result, many consumers cannot afford it even with coupons, rebates, and government intervention. Many Canadian employers, on the other hand, have agreed to cover the expenses.
It is becoming even more difficult for people who require a high dosage of the drug. It is also worth noting that other biosimilars are usually 15-30% less expensive than Humira. Despite this fact, people still prefer to use Humira because of its certified results.
A Guide To Injecting Humira
Humira is a drug that must be injected into the body. You can do this either in the comfort of your home or visit a clinic to receive the required dose.
If your doctor prescribes you a home injection of Humira, you will require some one-on-one preparation. In most cases, a nurse or a doctor will show you how to administer the treatment.
Humira also comes with an instruction pamphlet. If you are not sure how to self-inject the drug, you can also seek additional help.
Once you have started using Humira, make sure you do not forget to take it regularly. Here is how to take a Humira shot:
Step 1: Collect All Essentials
Have the following things ready when you are injecting Humira:
- A storage box to hold your Humira pen or syringe
- A gauze pad or cotton ball to put on your injection site and stop bleeding
- Your Humira pen, which you must not refrigerate for more than 30 minutes before the process
- An alcohol swab or disinfecting wipe to clean the site of injection
Step 2: Wash or Sanitize Your Hands
Washing or sanitizing your hands before starting the process is critical. Often, neglecting these minor things can lead to severe health problems.
A clean hand will keep the tools and injection site free of unwanted bacteria and reduce the risk of infection.
Step 3: Take a Seat
Some people also experience dizziness or fainting while taking the injection. So, although sitting is not necessary, it is advisable. Sitting in a firm position will help you concentrate on the task. Once you take a seat, you should also double-check the materials.
Step 4: Prepping the Injection Site
Take out the Humira pen and disinfecting wipes from their packaging.
Regardless of where you choose to inject the pen, you should clean the area with disinfecting wipes. It will prepare the site for the syringe and also eliminate the risk of infections.
If you are using a pen, make sure you do not remove the cover till right before administering the injection.
Similarly, if you are using a syringe, remove the needle cover only when you know you are ready. Again, try not to touch the tip once you have released it.
Step 5: Injecting
This is the most critical part of the whole process. You have to hold the Humira pen at a 90-degree angle while you are injecting it. You can then firmly and gradually press the needle into your skin.
If you are using a Humira syringe, pinch the skin slightly and hold it. Keep the needle against the injection site at a 45-degree angle.
With your finger, push on the trigger, which you will find at the top of your Humira pen. You will hear a ‘click’ when the injection starts. Keep holding the pen in place as you are injecting the medicine.
It will take about 10-12 seconds for the medicine to be fully injected. Then, when a yellow marker appears in the window, you will know that the process is over.
If you are using a Humira syringe, press down on the plunger with your finger. Make sure to push it gradually until all the liquid in the syringe has emptied.
Step 6: Removing The Injection
Once the window on your pen fills with a yellow marker or appears to be empty, you can remove the injection. First, you have to discard the syringe in a designated trash bin. Then place a sterilized cotton ball over the injection site.
This step will catch any extra fluid and also stop the bleeding. Apply slight pressure on the area for 20 seconds. Finally, discard the cotton ball in the trash.
Adalimumab or Humira is a beneficial drug used to minimize the development of inflammatory and skin conditions. However, it comes with different strengths and doses for children and adults, so consult your doctor before starting the treatment.
You now know how Humira can help in treating life-long diseases. So, if you are suffering from the above-mentioned inflammatory diseases, make sure to schedule an appointment with your doctor and get immediate treatment.