Home Drug Guide Adalimumab-aqvh

Drug Guide

Generic Name

Adalimumab-aqvh

Brand Names Yusimry

Classification

Therapeutic: Immunosuppressant, TNF inhibitor

Pharmacological: Monoclonal antibody

FDA Approved Indications

Crohn's Disease
Ulcerative Colitis
Rheumatoid Arthritis
Psoriatic Arthritis
Ankylosing Spondylitis
Plaque Psoriasis
Hidradenitis Suppurativa
Juvenile Idiopathic Arthritis

Mechanism of Action

Adalimumab is a recombinant IgG1 monoclonal antibody that binds specifically to tumor necrosis factor-alpha (TNF-α), a cytokine involved in systemic inflammation. By inhibiting TNF-α, it reduces inflammation and immune system activity.

Dosage and Administration

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

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

Geriatric: Adjust based on comorbidities and tolerability; no specific dose reduction recommended solely due to age.

Renal Impairment: No specific dosage adjustment required.

Hepatic Impairment: No specific dosage adjustment required.

Pharmacokinetics

Absorption: Subcutaneous absorption with bioavailability approximately 64%.

Distribution: Distributed primarily in the vascular and extravascular compartments.

Metabolism: Metabolized via proteolytic degradation to small peptides and amino acids.

Excretion: Eliminated through proteolytic degradation pathways; not primarily renal.

Half Life: Approximately 2 weeks.

Contraindications

Hypersensitivity to adalimumab or its components.
Active infections, including tuberculosis.

Precautions

Screen for latent TB before initiation.
Monitor for infections during therapy.
Assess for heart failure symptoms; use with caution in patients with NYHA Class III/IV.

Adverse Reactions - Common

Injection site reactions (Common)
Upper respiratory infections (Common)

Adverse Reactions - Serious

Serious infections (e.g., sepsis, pneumonia) (Less common)
Malignancies (e.g., lymphoma) (Rare)
Demyelinating diseases (Rare)
Heart failure exacerbation (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, TB screening results, injection site reactions.

Diagnoses:

Risk for infection

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

Evaluation: Assess for reduction in disease symptoms, monitor for adverse effects.

Patient/Family Teaching

Report signs of infection or unusual symptoms immediately.
Do not receive live vaccines during therapy.
Understand the importance of adherence to dosing schedule.

Special Considerations

Black Box Warnings:

Serious infections including tuberculosis and fungal infections.
Malignancies, including lymphoma and other cancers.

Genetic Factors: Limited data on genetic influences on response.

Lab Test Interference: May affect immune markers; interpret results cautiously.

Overdose Management

Signs/Symptoms: Possible severe infections, hypersensitivity reactions.

Treatment: Supportive care, monitor vital signs, ensure airway patency, consult poison control.

Storage and Handling

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

Stability: Stable until the expiration date when refrigerated; can be kept at room temperature for up to 14 days.