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.