Home Drug Guide Adalimumab-adaz

Drug Guide

Generic Name

Adalimumab-adaz

Brand Names Hyrimoz

Classification

Therapeutic: Immunosuppressant / Anti-TNF alpha monoclonal antibody

Pharmacological: Tumor necrosis factor (TNF) inhibitor

FDA Approved Indications

  • Rheumatoid arthritis
  • Crohn's disease
  • Ulcerative colitis
  • Psoriasis (plaque psoriasis, psoriatic arthritis)
  • Ankylosing spondylitis
  • Hidradenitis suppurativa
  • Juvenile idiopathic arthritis
  • Ankylosing spondylitis

Mechanism of Action

Adalimumab-adaz is a monoclonal antibody that binds to and neutralizes tumor necrosis factor-alpha (TNF-alpha), thereby reducing inflammation and immune response associated with autoimmune diseases.

Dosage and Administration

Adult: Variable dosing depending on condition; typically 40 mg every other week subcutaneously.

Pediatric: Dosing varies by condition and weight; consult specific prescribing information.

Geriatric: No specific dosage adjustment necessary, but monitor closely due to potential increased risk of infection.

Renal Impairment: No specific dosage adjustment required.

Hepatic Impairment: No specific dosage adjustment required.

Pharmacokinetics

Absorption: Subcutaneous absorption with peak concentrations in about 4-8 days.

Distribution: Limited volume of distribution, primarily extracellular fluid.

Metabolism: Proteolytic catabolism to peptides and amino acids; not metabolized by cytochrome P450 enzymes.

Excretion: Excreted via proteolytic pathways, not renal excretion.

Half Life: Approximately 2 weeks (around 10-20 days).

Contraindications

  • Hypersensitivity to adalimumab or its components.
  • Active severe infections.

Precautions

  • Screen for latent TB before initiation.
  • Monitor for signs of infection during therapy.
  • Potential for increased risk of lymphoma and other malignancies.
  • Use with caution in patients with demyelinating disease, heart failure, or hepatic impairment.

Adverse Reactions - Common

  • Injection site reactions (pain, erythema) (Common)
  • Upper respiratory infections (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Serious infections (pneumonia, sepsis) (Rare but serious)
  • Lymphoma or other malignancies (Rare)
  • Demyelinating disorders (Rare)
  • Hepatitis B reactivation (Rare)

Drug-Drug Interactions

  • Other immunosuppressants (e.g., methotrexate, azathioprine)
  • Live vaccines (avoid during therapy)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, TB screening prior to therapy, liver function tests.

Diagnoses:

  • Risk for infection
  • Impaired skin integrity

Implementation: Administer as prescribed subcutaneously, educate patient about infection signs, ensure TB testing is current.

Evaluation: Monitor for effectiveness (reduction in disease symptoms), adverse effects, and signs of infection.

Patient/Family Teaching

  • Report any signs of infection, unusual rash, or allergic reactions.
  • Follow schedule for injections.
  • Avoid live vaccines during therapy.
  • Inform about possible side effects and when to seek medical attention.

Special Considerations

Black Box Warnings:

  • Serious infections, including tuberculosis and invasive fungal infections.
  • Lymphoma and other malignancies.
  • Demyelinating disease.

Genetic Factors: Not specifically indicated.

Lab Test Interference: May affect inflammatory markers such as CRP and ESR.

Overdose Management

Signs/Symptoms: Injection site reactions, hypersensitivity.

Treatment: Supportive care; no specific antidote. Discontinue drug and provide symptomatic treatment.

Storage and Handling

Storage: Refrigerate at 2-8°C (36-46°F); do not freeze.

Stability: Stable until the expiration date on the vial. Protect from light.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.