Home Drug Guide Certolizumab Pegol

Drug Guide

Generic Name

Certolizumab Pegol

Brand Names Cimzia

Classification

Therapeutic: Immunosuppressant, Tumor Necrosis Factor (TNF) Inhibitor

Pharmacological: Monoclonal antibody (TNF inhibitor)

FDA Approved Indications

  • Crohn's Disease
  • Rheumatoid Arthritis
  • Psoriatic Arthritis
  • Ankylosing Spondylitis
  • Uveitis

Mechanism of Action

Certolizumab Pegol binds to tumor necrosis factor-alpha (TNF-α), neutralizing its activity and thereby reducing inflammation.

Dosage and Administration

Adult: Typically 200 mg subcutaneously every 2 or 4 weeks, based on condition and response.

Pediatric: Use in pediatric patients is limited; dosing and safety should be determined by a specialist.

Geriatric: Adjust dose based on individual tolerance and response, no specific contraindication but monitor for infections.

Renal Impairment: No specific dosage adjustment needed; caution advised due to immunosuppression.

Hepatic Impairment: No specific adjustment needed.

Pharmacokinetics

Absorption: Subcutaneous absorption with a bioavailability of approximately 80%.

Distribution: Widespread distribution; primarily remains within vascular and interstitial spaces.

Metabolism: Metabolized via proteolytic pathways typical of IgG antibodies.

Excretion: Primarily via catabolism; not eliminated unchanged in urine or feces.

Half Life: Approximately 14 days.

Contraindications

  • Hypersensitivity to certolizumab pegol or excipients.
  • Active infections, including tuberculosis.

Precautions

  • Monitor for signs of infection.
  • Screen for latent TB prior to therapy.
  • Use with caution in patients with demyelinating diseases, heart failure, or history of cancer.

Adverse Reactions - Common

  • Infections (upper respiratory, urinary tract infections) (Common)
  • Headache (Common)
  • Nausea (Common)

Adverse Reactions - Serious

  • Serious infections (including opportunistic infections) (Less common, but serious)
  • Lymphoma and other malignancies (Rare)
  • Demyelinating disease episodes (Rare)
  • Liver enzyme elevations (Uncommon)

Drug-Drug Interactions

  • Other immunosuppressants, live vaccines, agents that increase risk of infection.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, tuberculosis reactivation, and hypersensitivity reactions.

Diagnoses:

  • Risk for infection
  • Impaired skin integrity

Implementation: Administer via subcutaneous injection, monitor injection site, educate patient about infection risks.

Evaluation: Assess for effectiveness, adverse effects, and any signs of infection or adverse reactions.

Patient/Family Teaching

  • Instruct on importance of regular health monitoring.
  • Advise to report signs of infection or allergic reactions immediately.
  • Discuss the importance of adherence to dosing schedule.
  • Educate about potential side effects and when to seek medical attention.

Special Considerations

Black Box Warnings:

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

Genetic Factors: No specific genetic factors reported affecting drug efficacy or safety.

Lab Test Interference: May cause falsely decreased tuberculin skin test responses.

Overdose Management

Signs/Symptoms: Symptoms not well established; monitor for signs of infection or immunosuppression.

Treatment: Supportive care; consider hospitalization for management of infections or adverse effects.

Storage and Handling

Storage: Store in the original container at 2°C to 8°C (36°F to 46°F). Do not freeze.

Stability: Stable until expiry date when stored properly. May be kept at room temperature up to 25°C (77°F) for a maximum of 14 days if necessary.

🛡️ 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.