Home Drug Guide Golimumab

Drug Guide

Generic Name

Golimumab

Brand Names Simponi, Simponi Aria

Classification

Therapeutic: Antirheumatic, Tumor Necrosis Factor (TNF) inhibitor

Pharmacological: Monoclonal antibody against TNF-alpha

FDA Approved Indications

  • Rheumatoid arthritis (moderate to severe) in adults
  • Psoriatic arthritis in adults
  • Ankylosing spondylitis in adults
  • Ulcerative colitis in adults

Mechanism of Action

Golimumab is a monoclonal antibody that binds specifically to tumor necrosis factor-alpha (TNF-alpha), a pro-inflammatory cytokine, thereby inhibiting its activity and reducing inflammation.

Dosage and Administration

Adult: Typically 50 mg subcutaneously once monthly. Dosage may vary based on condition.

Pediatric: Not approved for pediatric use.

Geriatric: Adjust dosage with caution in elderly; renal or hepatic impairment considerations are minimal.

Renal Impairment: No specific adjustments necessary; available data limited.

Hepatic Impairment: Use with caution; no specific dosage adjustments are established.

Pharmacokinetics

Absorption: Approximately 53% bioavailable after subcutaneous injection.

Distribution: Limited data, presumed to stay within the vascular and interstitial spaces.

Metabolism: Metabolized via proteolytic pathways into small peptides and amino acids.

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

Half Life: Approximately 14 days.

Contraindications

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

Precautions

  • Screen for tuberculosis before initiation, as TNF inhibitors can reactivate latent TB.
  • Use caution in patients with heart failure, demyelinating diseases, or active infections.

Adverse Reactions - Common

  • Upper respiratory infections (Frequent)
  • Hypertension (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Serious infections (e.g., sepsis, opportunistic infections) (Infrequent)
  • Lupus-like syndrome (Rare)
  • Malignancies (e.g., lymphoma) (Rare)

Drug-Drug Interactions

  • Other immunosuppressants, corticosteroids, live vaccines

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, screen for TB prior to therapy.

Diagnoses:

  • Risk for infection
  • Impaired skin integrity

Implementation: Administer subcutaneously as prescribed, monitor patient response, and watch for adverse effects.

Evaluation: Assess for reduction in disease activity and monitor for adverse effects.

Patient/Family Teaching

  • Report signs of infection immediately.
  • Use caution with live vaccines during therapy.
  • Maintain regular follow-up appointments.

Special Considerations

Black Box Warnings:

  • Serious infections, including tuberculosis, invasive fungal infections, and bacterial/viral infections that can be fatal.
  • Malignancies, including lymphoma.
  • Demyelinating disease.

Genetic Factors: None specified.

Lab Test Interference: May suppress inflammatory markers like ESR or CRP, which are used to assess disease activity.

Overdose Management

Signs/Symptoms: Unusual infections, hypersensitivity reactions.

Treatment: Supportive care; no specific antidote. Discontinue golimumab and provide symptomatic management.

Storage and Handling

Storage: Refrigerate between 2°C to 8°C (36°F to 46°F). Protect from light.

Stability: Stable until the expiration date; do not freeze or shake vigorously.

🛡️ 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.