HUMIRA® (adalimumab)
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What is Humira (adalimumab)?

Humira, known generically as adalimumab, is an injectable medication prescribed for the treatment of certain inflammatory conditions, most commonly those such as rheumatoid arthritis (RA),  psoriatic arthritis (PsA), plaque psoriasis (Ps), Crohn’s disease (CD), and many other autoimmune conditions. It may also be prescribed for additional off-label uses by your doctor as well.

How is Humira Used?

Humira is a subcutaneous medication that requires injection of the medicine underneath the skin, usually on the abdomen or the thigh. This medication is commonly injected once per week or bi-weekly, and this will be determined by your doctor and the condition being treated.

When removing your Humira from the refrigerator for use, it should be left to adjust to room temperature before injection. This typically takes about 15 to 30 minutes. Users of Humira should never attempt to warm up their medication with hot water, by placing it in the microwave, or by any other such means.

Patients should not use this medication if the liquid has discoloration, appears cloudy, or has any solid particles or flakes present. Do not shake the medication for any reason.

Users will need to use rubbing alcohol to clean their preferred injection site before using this medication to avoid contamination or possible infection. It is also recommended that patients change the site of the injection to reduce the risk of damage in certain areas of the body. When injecting into a new area on the body, this should be done at least a minimum of 1 inch (or 2.5 cm) from a prior injection site.

Patients should not inject Humira into any areas that are red, bruised, sore, or hard.

Storage

Humira is required to be refrigerated when stored and kept in a temperature range of 36°F to 46°F until it is used. Patients will also need to be sure the medication is stored in its original container as well as kept away from light. Humira that has been properly refrigerated can be used until the printed expiration date on the packaging has been reached.

If needed, for example when traveling, Humira may be stored at room temperature up to a maximum of 77°F (25°C) for a period of up to 14 days, with protection from light. Humira should be discarded if not used within the 14-day period. Record the date when Humira is first removed from the refrigerator in the spaces provided on the carton and dose tray.

Humira should never be frozen or stored in a freezer. If your medication has been frozen, do not use it even if it has been thawed.

Keep this medication out of the reach of children at all times.

Uses

Humira is prescribed for a variety of inflammatory conditions in adults, including but not limited to:

  • Rheumatoid Arthritis (RA)
  • Juvenile Idiopathic Arthritis (JIA)
  • Psoriatic Arthritis (PsA)
  • Ankylosing Spondylitis (AS)
  • Crohn’s Disease (CD)
  • Ulcerative Colitis (UC)
  • Plaque Psoriasis (Ps)
  • Hidradenitis Suppurativa (HS)
  • Uveitis (UV)

Humira may also be prescribed for children with the following conditions:

  • Crohn’s disease (CD)
  • Hhidradenitis suppurativa (HS)
  • Juvenile idiopathic arthritis (JIA)
  • Uulcerative colitis (UC)
  • Uuveitis (UV)

Doctors may also prescribe Humira for other symptoms and conditions not listed above.

How Does Humira Work?

Humira is a monoclonal antibody that works by targeting and binding to tumor necrosis factor-alpha (TNF-?), a cytokine involved in the inflammatory process. By binding to TNF-?, Humira prevents it from interacting with its receptors on cell surfaces, thereby blocking the inflammatory signaling pathways. This inhibition reduces inflammation, leading to a decrease in symptoms associated with autoimmune diseases such as pain, swelling, and tissue damage.

Humira may take 4 to 12 weeks to improve the symptoms of a patient’s inflammatory condition resulting from TNF-alpha proteins.

Dosage

Humira is available in different dosage forms: single-dose prefilled pens (Humira Pen) and single-dose prefilled glass syringes.

Prefilled Humira pens come in dosages sizes of:

  • 40 mg/0.8 mL (40 mg of adalimumab/0.8 mL of sterile solution)
  • 40 mg/0.8 mL (40 mg of adalimumab/0.4 mL of sterile solution)
  • 80 mg/0.8 mL (80 mg of adalimumab/0.8 mL of sterile solution)

Single-dose prefilled glass syringes come in the following dosage sizes:

  • 10 mg/0.1 mL (10 mg of adalimumab/0.1 mL of sterile solution)
  • 10 mg/0.2 mL (10 mg of adalimumab/0.2 mL of sterile solution)
  • 20 mg/0.2 mL (20 mg of adalimumab/0.2 mL of sterile solution)
  • 20 mg/0.4 mL (20 mg of adalimumab/0.4 mL of sterile solution)
  • 40 mg/0.8 mL (40 mg of adalimumab/0.8 mL of sterile solution)
  • 40 mg/0.4 mL (40 mg of adalimumab/0.4 mL of sterile solution)
  • 80 mg/0.8 mL (80 mg of adalimumab/0.8 mL of sterile solution)

Overdose

It’s important to follow your doctor’s instructions exactly when taking Humira. This medication is part of a personalized treatment plan, and exceeding the prescribed dosage can lead to serious side effects. If you accidentally take too much Humira, contact your doctor or Poison Control Center right away. In case of severe side effects, call 911 or seek immediate emergency medical attention.

Side Effects

Due to its immunosuppressive properties, patients who are taking Humira are at an increased risk of infection.

The most common side effects of taking Humira are as follows:

  • Rashes
  • Upper respiratory infections (i.e., sinus infections or colds)
  • Headaches
  • Sinus inflammation
  • Nausea
  • Urinary tract infection (UTI) or bladder infection
  • Reactions at the site of injection
    • Bleeding
    • Pain
    • Itching
    • Swelling
    • Redness

Please contact your doctor for further information if you experience any of the following rare side effects as these can potentially lead to serious health concerns:

  • Double vision
  • Chest pain
  • Cough
  • Difficulties with breathing
  • Pain or weakness in the limbs
  • Abdominal pain
  • Night sweats
  • Joint pain
  • Fever
  • Flu-like symptoms
  • Pus-filled bumps on the skin
  • Red or scaley skin patches
  • Cold sores
  • Oral ulcers (sores)
  • Changes in skin color
  • Numbness or tingling sensations
  • Weight loss
  • Difficulty with swallowing

Patients should also be wary of any symptoms when taking Humira that may indicate heart problems, liver trouble, a urinary tract infection, anemia, or generalized infection. Unusual bleeding (such as bleeding gums, blood in the urine, nosebleeds, coughing up blood, cuts that will not stop bleeding, or unusual or excessive bruising) may also indicate a serious medical condition that needs to be addressed with a healthcare professional.

If any of the following symptoms occur when taking this medication, patients should stop taking Humira and immediately seek out medical attention as soon as possible:

  • Shortness of breath accompanied by swelling of the feet or hands
  • Signs of severe infection (rapid heartbeat, skin rash, fever, chills, shakiness, rapid breathing, confusion)
  • Symptoms of a severe allergic reaction
    • Anaphylaxis: trouble breathing, facial swelling, swelling of the throat
    • Hives
  • indications of a blood clot in the leg, arm, or lungs
    • Limbs: pain, tenderness, redness, swelling, warmth
    • Lungs: coughing, trouble breathing, sweating, coughing up blood, sharp chest pain worsened by inhalation, unconsciousness

Additionally, there may also be side effects caused by Humira that have not been documented. Contact your doctor with any questions regarding symptoms you may experience after taking Humira.

Warnings & Precautions

It’s important to have an open conversation with your doctor before starting Humira.  This includes sharing information about any current medications, allergies, and medical conditions.  It’s also important to discuss if you’re pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed.  Your doctor will need a complete picture of your health to ensure Humira is the right treatment for you.

Additionally, if you experience a serious infection while taking Humira, be sure to tell your doctor right away.  They may need to adjust or discontinue your Humira treatment.

Allergic Reactions

As with any medication, some individuals have reported experiencing allergic reactions when taking Humira. If you begin taking this medication and experience symptoms of anaphylaxis or other signs of a severe allergic reaction (i.e., rash, hives, breathing difficulties), contact your doctor immediately.

Patients should also notify their prescribing physician of any latex or rubber allergies as the prefilled syringes come with a needle cover made with dry natural rubber.

Cancer

Studies have shown that individuals taking Humira may have a slightly increased risk of developing lymphoma, a cancer of the immune system. Lymphoma is a general term for cancers that develop in the body’s lymphatic system. This risk appears to be further elevated for patients who have also been treated with medications like azathioprine, infliximab, or mercaptopurine. It’s important to note that long-term use of immunosuppressant medications in general, even without Humira, carries an increased risk of lymphoma development. If you are taking Humira, be sure to talk to your doctor about any new or concerning symptoms, such as unexplained weight loss, night sweats, unusual fatigue, enlarged lymph nodes, chills, fever, or a decrease in appetite. Early detection is crucial for managing any potential complications.

Children

Although children may be prescribed Humira for certain conditions, it should not be administered to any child younger than two years of age. For children receiving treatment for Crohn’s disease, this age restriction applies to those six years of age and under. Additionally, any child taking this medication should be up to date on all of their immunizations. For children who may be on an alternative vaccination schedule, please consult with a pediatrician regarding the safety and appropriate use of this medication.

Infections

While Humira offers relief for many conditions, it’s important to be aware of a potential increased risk of infections, particularly fungal and bacterial infections like pneumonia and tuberculosis.  If you experience any signs of infection, such as fever, chills, cough, or unusual redness or swelling, report them immediately to your doctor. Before starting Humira, your doctor will also need to know about any existing infections or a history of recurring infections that could worsen with this medication.  Additionally, there’s a chance of hepatitis B reactivation in individuals who carry the virus.  Your doctor will discuss this risk with you and monitor you closely throughout treatment.  Be sure to mention any symptoms of liver problems you experience while taking Humira, such as fatigue, nausea, or yellowing of the skin or eyes.  Open communication with your doctor is key to managing your health effectively.

Nervous System Disorders

Patients should contact their doctor immediately if experiencing weakness, dizziness, vision trouble, tingling sensations, or numbness as these symptoms may be indicative of nervous system disorders. These disorders are rare but may occur when patients take TNF blockers such as Humira.

Immune System Disorders

Humira, while effective for many conditions, can in rare cases induce a lupus-like syndrome in some patients. This means your body may develop antibodies that attack healthy tissues, mimicking symptoms of lupus. Be on the lookout for signs like a butterfly-shaped rash on your face that worsens in sunlight, difficulty breathing, joint pain, or chest pain. If you experience any of these, contact your doctor right away. Early diagnosis and potential discontinuation of Humira can help manage this condition.

Heart Failure

Humira may potentially cause the development of congestive heart failure or worsen symptoms of CHF in some patients. If you have already been diagnosed with this condition, you will need to be closely monitored for the duration of your treatment with Humira. Contact your physician immediately if you experience symptoms such as shortness of breath or swelling of the ankles or feet.

Blood Disorders

Humira may occasionally cause certain blood cell deficiencies in some patients taking the medication. Patients should seek immediate medical attention if experiencing symptoms of infection, anemia, or issues associated with bleeding.

Surgery

If patients taking Humira require surgery, they should disclose to all relevant healthcare professionals that they are currently taking this medication. These individuals may be at an increased risk of infection due to the immunosuppressant qualities of Humira, and there is very little information currently available regarding patient safety when having surgical procedures while taking this medication.

Breastfeeding

Humira may be passed through breast milk. Patients taking this medication and either currently or planning on breastfeeding should discuss the risks and any other options available with their doctor.

Pregnancy

Humira should not be used during pregnancy, and patients who become pregnant while taking Humira should contact their doctor immediately. In some cases, the benefits may outweigh the risks of taking this medication during pregnancy, but proper use should be determined by a healthcare professional based on the patient’s pre-existing condition(s) being treated with Humira as well as their tolerance for the medication.

Psoriasis

Some individuals taking Humira have reported worsening or even new development of psoriasis while taking this medication. Contact your doctor if you begin to experience pus-filled bumps or scaly red patches on your skin while taking Humira.

Seniors

Individuals above the age of 65 years old may be at an increased risk of side effects when taking Humira. If you fall into this age group, discuss any potential concerns with your doctor to determine if Humira is the right course of treatment for you.

Vaccines

It’s important to ensure you’re current on all recommended vaccinations before starting Humira or similar medications.  Humira, a TNF-alpha inhibitor, can dampen the immune system’s response, making live vaccines (like those for typhoid, cholera, BCG, yellow fever, and varicella) potentially less effective or even risky.  Discuss your vaccination history with your doctor before starting Humira to determine if any updates are needed. They can also advise on the best timing for receiving non-live vaccinations while on this medication.

Drug Interactions

Speak to your doctor or pharmacist about any medications or herbal supplements you are currently taking before beginning treatment with Humira. Discuss any concerns you may have with your doctor or a trusted pharmacist.

Drugs That Should Not Be Used with Humira

The following medications should not be used alongside Humira:

  • Cimzia (certolizumab pegol)
  • Enbrel (etanercept)
  • Kineret (anakinra)
  • Orencia (abatacept)
  • Remicade (infliximab)
  • Simponi (golimumab)

Speak to your doctor before starting Humira if you currently take any supplements or additional medications, including any prior use of Imuran (azathioprine), Purinethol (mercaptopurine, 6-MP), or Rituxan (rituximab).

Alternative Medications

For patients who are unable to take Humira or experiencing significant adverse side effects, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed:

  • Actemra (tocilizumab)
  • Arava (leflunomide)
  • Azulfidine (sulfasalazine)
  • Benlysta (belimumab)
  • Cimzia (certolizumab pegol)
  • Enbrel (etanercept)
  • Imuran (azathioprine)
  • Kevzara (sarilimumab)
  • Kineret (anakinra)
  • Methotrexate
  • Neorol (cyclosporine)
  • Olumiant (baricitinib)
  • Orencia (abatacept)
  • Plaquinil (hydroxychloroquine)
  • Remicade (infliximab)
  • Rinvoq (upadacitinib)
  • Rituxan (rituximab)
  • Simponi (golimumab)
  • Taltz (ixekizumab)
  • Xeljanz (tofacitinib)

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Frequently Asked Questions

Humira contains the active ingredient, adalimumab, a monoclonal antibody that works by targeting and binding to tumor necrosis factor-alpha (TNF-?).
Humira is available in one form as a liquid to be injected. Humira comes in three different packages with multiple strengths available.
Humira is approved for the treatment of
  • Plaque psoriasis (Ps) in patients 18 years of age and older
  • Psoriatic arthritis (PsA) in patients 18 years of age and older
  • Rheumatoid arthritis (RA) in patients 18 years of age and older
  • Juvenile idiopathic arthritis (JIA) in patients 2 years of age and older
  • Crohn’s disease (CD) in patients 6 years of age and older
  • Ulcerative colitis (UC) in patients 5 years of age and older
  • Hidradenitis suppurativa (HS) in patients 12 years of age and older
  • Ankylosing Spondylitis (AS) in patients 18 years of age and older
  • Uveitis (UV) in patients 2 years of age and older
People who should not use Humira include:
  • Those with allergies: Anyone with a known allergy to Humira or any of its ingredients should avoid it.
  • Those with active infections: Due to its impact on the immune system, Humira is not recommended for people with active infections or a high risk of infection.
  • Pregnant or breastfeeding women: The safety of Humira during pregnancy and breastfeeding is not fully established. It’s crucial to discuss the risks and benefits with your doctor before using Humira if you’re pregnant or planning to become pregnant, or if you’re breastfeeding.
  • People with certain medical conditions: Humira may not be suitable for individuals with specific medical conditions like heart failure, multiple sclerosis, or a history of cancer.
You should get injection training from your healthcare provider or care team. If you haven’t received training, contact your clinic or call 1-800-4HUMIRA. Do not attempt to inject Humira on your own until you are confident in doing it safely and correctly. Additional resources, such as the Instructions for Use and instructional videos from the manufacturer, can also be helpful.
Humira must be disposed of in a sharps disposal container. If you do not have a sharps disposal container, contact your doctor or pharmacist for alternative solutions.
While individual responses may vary, studies suggest Humira typically takes 4 to 12 weeks to show noticeable improvement in symptoms. This is because it dampens the inflammatory response, and reducing inflammation takes time. It’s important to manage expectations and communicate with your doctor throughout the treatment process. They can monitor your response and adjust the treatment plan as needed.
Do not miss any doses of Humira unless your doctor says it is okay. If you forget to take Humira, inject a dose as soon as you remember. Then, take your next dose at your regular scheduled time. This will put you back on schedule. In case you are not sure when to inject Humira, call your doctor or pharmacist.
If you accidentally take more Humira than prescribed, don’t take any more and monitor yourself for side effects like infection, stomach pain, headache, or fever. Contact your doctor or poison control immediately if you experience any concerning effects. Remember to always follow your doctor’s prescribed Humira dosage.
Yes, with a prescription, you can purchase Humira online. Buying medications online is convenient and often less expensive than purchasing at your local pharmacy.
The risk of side effects with Humira is consistent throughout treatment and not necessarily higher when you first start. If you experience any unusual or unpleasant side effects, be sure to contact your doctor or pharmacist for advice. They can help you determine if the side effects are related to Humira and recommend the best course of action.
Humira injections typically don’t damage your skin long-term. While some people experience temporary reactions like rash, bruising, or redness at the injection site, these usually heal without scarring. Talk to your doctor if you have any concerns about injection site reactions.
Humira may slightly increase the risk of certain cancers, especially lymphoma. This risk is particularly important to discuss with your doctor if you have a personal or family history of cancer. They can weigh the risks and benefits of Humira to determine if it’s the right treatment for you.
Individuals with hepatitis B may take Humira, but this medication can cause the virus to be reactivated in some individuals. If you have hepatitis B or have had it in the past, speak to your doctor about this condition before beginning treatment with Humira.
Alcohol does not directly interact with Humira, but both can affect liver health. Drinking alcohol while on Humira increases the risk of liver damage. Additionally, many conditions treated with Humira can be aggravated by alcohol. Therefore, patients are advised to drink alcohol in moderation and discuss it with their healthcare provider.
Humira is a treatment for psoriasis, not a cause. While uncommon, some people may develop a new psoriasis-like rash after starting Humira. Talk to your doctor if you experience any new skin issues while taking Humira.
While traces of Humira itself can linger in the body for up to six months after the last dose, the medication’s active effects typically cease much sooner. Most people experience a decline in Humira’s ability to influence the immune system and reduce inflammation within 3 months. This means that even though some amount of Humira may be detectable for a longer period, its anti-inflammatory effects have subsided after 3 months.
Humira is a biologic medication derived from living cells and engineered to target specific parts of the immune system. It is not a steroid or a non-steroidal anti-inflammatory drug (NSAID).
Your doctor will provide you with instructions for injection as well as the schedule you should stick to for taking this medication. Typically, most individuals administer their Humira injection in the front side of their thigh or in their abdomen. Many report that the abdomen is a less painful region to inject this medication.
Humira can prevent or improve brain fog by reducing inflammation and its associated pain.  If you experience brain fog and are considering Humira, discuss it with your doctor. They can assess your health to determine if Humira might be a suitable treatment option for your underlying condition and any associated brain fog.
As with many injections, Humira can cause a stinging or burning sensation when injected. The level of pain varies among individuals but is generally considered tolerable. Humira now offers a citrate-free formula that is suggested to reduce the level of discomfort caused by injecting the medication.
Humira does not cause any type of weight loss or weight gain. However, patients taking Humira are at an increased risk of infection, and developing an infection may cause a patient taking Humira to lose weight. Talk to your doctor if you notice any weight changes.
Taking Humira slightly increases your infection risk. If you experience any signs of infection (fever, chills, cough, unusual redness/swelling/pain, trouble breathing, urinary tract infection symptoms) while taking Humira, contact your doctor immediately. Early diagnosis and treatment are crucial. Your doctor might adjust your Humira dosage or temporarily stop it to allow your body to fight the infection.
Most patients taking Humira prefer the prefilled pen over the syringe due to less pain being caused by injecting with the pen. However, some patients have noted difficulty with pain caused by the pen in some cases and prefer the ease of using the prefilled syringe instead. Talk to your healthcare provider to determine which formulation is best for you.
Humira is typically considered a long-term medication for managing chronic inflammatory conditions.  It helps control symptoms and prevent flare-ups.  In most cases, your doctor will recommend staying on Humira for continued benefit. It’s important to understand that stopping Humira suddenly can cause your original symptoms to return.  Never stop taking Humira without first discussing it with your doctor. They can help you determine the best course of action for your situation, including tapering the dosage gradually if needed.

Disclaimer

Pharma Giant provides medical information to help you better understand medications and medical conditions.This content is for informational use only and does not replace advice from a licensed medical practitioner. Consult your doctor or pharmacist before starting or changing any medication. All our partners follow strict safety standards set by their country’s health authorities to make sure you receive safe and high-quality medications.

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Sean Moshrefi, PharmD, MS

Sean Moshrefi, PharmD, MS, is a licensed pharmacist based in California. He holds a Doctor of Pharmacy degree from the University of California, San Francisco (UCSF) and a Master of Science in Regulatory Sciences from the University of Southern California (USC). With expertise in medical writing and medical communications, Sean adeptly provides written and verbal drug information to healthcare professionals and patients, contributing significantly to the healthcare landscape and empowering healthcare professionals and patients alike with actionable insights.