Home Drug Guide Adalimumab-ryvk

Drug Guide

Generic Name

Adalimumab-ryvk

Brand Names Simlandi

Classification

Therapeutic: Immunosuppressant, TNF inhibitor

Pharmacological: Monoclonal antibody against tumor necrosis factor-alpha (TNF-α)

FDA Approved Indications

  • Juvenile idiopathic arthritis
  • Polyarticular juvenile idiopathic arthritis
  • Enthesitis-related arthritis
  • Crohn's disease (moderate to severe)
  • Ulcerative colitis
  • Plaque psoriasis
  • Hidradenitis suppurativa
  • Ankylosing spondylitis

Mechanism of Action

Adalimumab is a monoclonal antibody that binds specifically to TNF-alpha, a pro-inflammatory cytokine, thereby inhibiting its activity and reducing inflammation.

Dosage and Administration

Adult: Dosing varies based on condition; typically, an initial dose followed by maintenance doses every 2 weeks via subcutaneous injection.

Pediatric: Dose determined by weight and condition; administered subcutaneously, usually every 2 weeks.

Geriatric: Start with lower doses; monitor closely due to increased infection risk.

Renal Impairment: Use with caution; no specific dosage adjustment recommended.

Hepatic Impairment: No specific data; use caution.

Pharmacokinetics

Absorption: Subcutaneous absorption; bioavailability approximately 64%.

Distribution: Wide distribution; primarily in blood and tissues.

Metabolism: Metabolized via proteolytic degradation.

Excretion: Eliminated via proteolytic catabolism; no renal adjustment needed.

Half Life: Approximately 2 weeks.

Contraindications

  • Hypersensitivity to adalimumab or any excipients.
  • Active infections, including tuberculosis.

Precautions

  • Screen for latent TB before therapy.
  • Monitor for signs of infection during treatment.
  • Use with caution in patients with congestive heart failure.
  • Risk of malignancies; monitor for lymphomas and other cancers.

Adverse Reactions - Common

  • Injection site reactions (Common)
  • Infections (upper respiratory, urinary tract) (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Serious infections (bacterial, viral, fungal) (Uncommon)
  • Lymphomas or other malignancies (Rare)
  • Demyelinating diseases (Rare)
  • Heart failure exacerbation (Rare)

Drug-Drug Interactions

  • Other biologics, live vaccines, immunosuppressants

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, TB screening prior to initiation, assess injection sites for reactions.

Diagnoses:

  • Risk for infection
  • Impaired skin integrity

Implementation: Administer via subcutaneous injection as prescribed; educate patient on injection technique.

Evaluation: Assess effectiveness based on disease-specific parameters; monitor for adverse effects.

Patient/Family Teaching

  • Report signs of infection promptly.
  • Do not receive live vaccines during therapy.
  • Inform healthcare providers of adalimumab use before surgeries.
  • Use proper injection techniques.
  • Maintain regular follow-up appointments.

Special Considerations

Black Box Warnings:

  • Increased risk of infections, including tuberculosis and invasive fungal infections.
  • Risk of lymphoma and other malignancies.

Genetic Factors: None established specifically.

Lab Test Interference: May cause false-positive tuberculin skin tests; interferon-gamma release assays are preferred.

Overdose Management

Signs/Symptoms: Potential for severe infections, hypersensitivity reactions.

Treatment: Supportive care; no specific antidote. Immediate medical attention for overdose symptoms.

Storage and Handling

Storage: Refrigerate at 2°C to 8°C (36°F to 46°F); protect from light.

Stability: Stable until the expiration date when refrigerated. Do not freeze.

🛡️ 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.