Home Drug Guide Adalimumab-aaty

Drug Guide

Generic Name

Adalimumab-aaty

Brand Names Yuflyma

Classification

Therapeutic: Immunosuppressant, Anti-TNF alpha agent

Pharmacological: Monoclonal antibody, Tumor necrosis factor (TNF) alpha inhibitor

FDA Approved Indications

Rheumatoid arthritis
Crohn's disease
Ulcerative colitis
Juvenile idiopathic arthritis
Plaque psoriasis
Hidradenitis suppurativa
Ankylosing spondylitis
Pyoderma gangrenosum

Mechanism of Action

Adalimumab-aaty binds specifically to tumor necrosis factor alpha (TNF-alpha), a pro-inflammatory cytokine, thereby inhibiting its activity and reducing inflammation and immune response involved in autoimmune diseases.

Dosage and Administration

Adult: Dosed based on condition; often 40 mg every other week or weekly subcutaneously. Specific dosing varies per indication and patient response.

Pediatric: Dosing varies by indication and weight; typically 20 mg or 40 mg every other week or weekly.

Geriatric: Similar to adult dosing; monitor for increased risk of infections.

Renal Impairment: No specific adjustment needed but caution advised.

Hepatic Impairment: No specific adjustment needed.

Pharmacokinetics

Absorption: Bioavailability approximately 64% after subcutaneous injection.

Distribution: Widely distributed with a volume of distribution approximately 4 liters.

Metabolism: Broken down into peptides and amino acids via proteolytic pathways.

Excretion: Metabolized to amino acids; no specific renal or hepatic clearance pathways.

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

Contraindications

Hypersensitivity to adalimumab or excipients
Active infections, including tuberculosis

Precautions

Screen for latent tuberculosis before initiation
Monitor for signs of infection during therapy
Use with caution in patients with demyelinating disease, heart failure, or history of cancer

Adverse Reactions - Common

Infections (upper respiratory infections) (Common)
Injection site reactions (Common)
Headache (Common)

Adverse Reactions - Serious

Serious infections (sepsis, pneumonia) (Less common)
Lymphoma and other malignancies (Rare)
Demyelinating diseases (Rare)

Drug-Drug Interactions

Other immunosuppressants, live vaccines

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, injection site reactions, and development of antibodies.

Diagnoses:

Risk for infection
Risk for impaired skin integrity

Implementation: Administer as prescribed, monitor patient response, educate about infection risk.

Evaluation: Assess for therapeutic response and adverse reactions.

Patient/Family Teaching

Report signs of infection such as fever, cough, or sore throat.
Inform about potential injection site reactions.
Advise on the importance of routine screening for infections.
Discuss the need for regular medical follow-ups.

Special Considerations

Black Box Warnings:

Increased risk of serious infections, including tuberculosis, and malignancies, especially lymphoma.

Genetic Factors: Genetic predisposition may affect immune response.

Lab Test Interference: Can affect certain lab tests, such as tuberculin skin tests.

Overdose Management

Signs/Symptoms: Unknown; likely immunosuppression, increased infection risk.

Treatment: Supportive care; immediate medical attention.

Storage and Handling

Storage: Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze.

Stability: Stable until the expiration date printed on the label when stored properly.