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Certolizumab injection may decrease your ability to fight infection and increase the risk that you will get a serious or life-threatening infection including severe fungal, bacterial, and viral infections that may spread through the body. These infections may need to be treated in a hospital and may cause death. Tell your doctor if you often get any type of infection or if you have or think you may have any type of infection now. This includes minor infections (such as open cuts or sores), infections that come and go (such as cold sores), and chronic infections that do not go away. Also tell your doctor if you have or have ever had diabetes, hepatitis B (a viral infection that affects the liver), human immunodeficiency virus (HIV), or any condition that affects your immune system, and if you live or have ever lived in areas such as the Ohio and Mississippi River valleys where severe fungal infections are more common. Ask your doctor if you do not know if these infections are common in your area. Tell your doctor if you are taking medications that slow the activity of the immune system such as abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), methotrexate (Otrexup, Rasuvo, Trexall), natalizumab (Tysabri), rituximab (Rituxan), steroids including dexamethasone, methylprednisolone (Medrol), prednisolone (Prelone), and prednisone (Rayos), and tocilizumab (Actemra).
Your doctor will monitor you for signs of infection during and after your treatment. If you have any of the following symptoms before you begin your treatment or if you experience any of the following symptoms during or shortly after your treatment, call your doctor immediately: sore throat; cough; coughing up bloody mucus; fever; stomach pain; diarrhea; flu-like symptoms; open cuts or sores; weight loss; weakness; sweating; difficulty breathing; difficult, frequent, or painful urination; or other signs of infection.
You may already be infected with tuberculosis (TB; a serious lung infection) or hepatitis B (a virus that affects the liver) but not have any symptoms of the disease. In this case, using certolizumab injection may make your infection more serious and cause you to develop symptoms. Your doctor will perform a skin test to see if you have an inactive TB infection and may order a blood test to see if you have an inactive hepatitis B infection. If necessary, your doctor will give you medication to treat this infection before you start using certolizumab. Tell your doctor if you have or have ever had TB, if you have lived in or visited a country where TB is common, or if you have been around someone who has TB. If you have any of the following symptoms of TB, or if you develop any of these symptoms during your treatment, call your doctor immediately: cough, weight loss, loss of muscle tone, or fever. Also call your doctor immediately if you have any of these symptoms of hepatitis B or if you develop any of these symptoms during or after your treatment: excessive tiredness, yellowing of the skin or eyes, loss of appetite, nausea or vomiting, muscle aches, dark urine, clay-colored bowel movements, fever, chills, stomach pain, or rash.
Some children and teenagers who received medications similar to certolizumab injection developed severe or life-threatening cancers including lymphoma (cancer that begins in the cells that fight infection). Children and teenagers should not normally receive certolizumab injection, but in some cases, a doctor may decide that certolizumab injection is the best medication to treat a child's condition. If certolizumab injection is prescribed for your child, you should talk to your child's doctor about the risks and benefits of using this medication. If your child develops any of these symptoms during his treatment, call his doctor immediately: unexplained weight loss; swollen glands in the neck, underarms, or groin; or easy bruising or bleeding.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with certolizumab injection and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.
Talk to your doctor about the risks of using certolizumab injection.
WHY is this medicine prescribed?
Certolizumab injection is used to relieve the symptoms of certain autoimmune disorders (conditions in which the immune system attacks healthy parts of the body and causes pain, swelling, and damage) including the following:
HOW should this medicine be used?
Certolizumab injection comes as a powder to be mixed with sterile water and injected subcutaneously (just under the skin) by a doctor or nurse in a medical office and as a pre-filled syringe that you can inject subcutaneously by yourself at home. When certolizumab injection is used to treat Crohn's disease, it is usually given every two weeks for the first three doses and then every four weeks for as long as treatment continues. When certolizumab injection is used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, or axial spondyloarthritis, it is usually given every 2 weeks for the first three doses and then every 2 or 4 weeks for as long as treatment continues. When certolizumab injection is used to treat plaque psoriasis, it is usually given every 2 weeks. If you are injecting certolizumab injection yourself, follow the directions on your prescription label carefully. Do not inject more or less certolizumab than prescribed by your doctor.
If you will be injecting certolizumab injection by yourself at home or having a friend or relative inject the medication for you, ask your doctor to show you or the person who will be injecting the medication how to inject it. You and the person who will be injecting the medication should also read the written instructions for use that come with the medication.
Before you open the package containing your medication, check to be sure that the package is not torn, that the tamper-evident seals on the top and bottom of the package are not missing or broken and that the expiration date printed on the package has not passed. After you open the package, look closely at the liquid in the syringe. The liquid should be clear or pale yellow and should not contain large, colored particles. Call your pharmacist, if there are any problems with the package or the syringe. Do not inject the medication.
You may inject certolizumab injection anywhere on your stomach or thighs except your navel (belly button) and the area 2 inches around it. Do not inject the medication into skin that is tender, bruised, red, or hard, or that has scars or stretch marks. Do not inject the medication in the same spot more than once. Choose a new spot at least 1 inch away from a spot that you have used before each time you inject the medication. If your doctor has told you to inject two syringes of certolizumab for each dose, choose a different spot for each injection.
Do not reuse certolizumab pre-filled syringes and do not recap the syringes after use. Discard used syringes in a puncture-resistant container. Ask your pharmacist how to discard the container.
Certolizumab injection may help to control your symptoms, but it will not cure your condition. Do not stop using certolizumab injection without talking to your doctor.
Are there OTHER USES for this medicine?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What SPECIAL PRECAUTIONS should I follow?
Before using certolizumab injection,
What SPECIAL DIETARY instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do IF I FORGET to take a dose?
Inject the missed dose as soon as you remember it. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not inject a double dose to make up for a missed one.
What SIDE EFFECTS can this medicine cause?
Certolizumab injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical help:
Adults who receive certolizumab injection may be more likely to develop skin cancer, lymphoma, and other types of cancer than people who do not receive certolizumab injection. Talk to your doctor about the risks of receiving this medication.
Certolizumab injection may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( http://www.fda.gov/Safety/MedWatch ) or by phone (1-800-332-1088).
What should I know about STORAGE and DISPOSAL of this medication?
Keep the vials and prefilled syringes in the original carton it came in to protect them from light and out of reach of children. Store certolizumab injection in the refrigerator and do not freeze.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach.http://www.upandaway.org
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
What should I do in case of OVERDOSE?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online athttps://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
What OTHER INFORMATION should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to certolizumab injection.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are using certolizumab injection.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
AHFS® Consumer Medication Information. © Copyright, The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
Selected Revisions: May 15, 2019.
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