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Gastroenterology patients starting on adalimumab

What is Adalimumab?

Adalimumab is a medicine used to treat a variety of conditions including Crohn’s disease. It works by reducing the inflammatory process in the intestinal tract, making you feel better. Adalimumab is known as a monoclonal antibody. Monoclonal antibodies are proteins that recognise and bind to other proteins. When you have Adalimumab, the proteins in the medicine stick to a specific protein that your body has produced in response to increased levels of inflammation.

Why has my child been started on Adalimumab?

Your consultant will have discussed with you that Adalimumab is appropriate, as other medications have not worked for you.

How do you give Adalimumab?

Adalimumab is given as a subcutaneous injection (an injection just under the skin). The common places for you to have the Adalimumab injection are around the tummy button or the tops of your thighs. It is important to alternate the injection site to prevent the area becoming sore.

How often is Adalimumab given?

Adalimumab is given at two weekly intervals, initially over a three month period. You will have an appointment on Medical Day-care at Sheffield Children’s for the first three doses. If you wish, the nurses there can teach you how to administer Adalimumab, so you can take it at home rather than come to the hospital. The nurse looking after you will monitor your heart rate, breathing rate and temperature for a couple of hours after the injection has taken place. If you are ok, you can go home.

How long will it be until I start to feel better?

You should start to feel better within the first 2-3 weeks but you may not feel the full effects for up to 3 months.

Can Adalimumab be taken with other medications?

If you are already on Methotrexate, steroids, medicine for pain relief including non-steroidal, such as Ibuprofen, this is safe to carry on unless otherwise directed by your doctor.

Where can I get the Adalimumab from if I am having it at home?

This medication is only available from the pharmacy at Sheffield Children’s. You will need to contact the gastro nurses at least a week before you run out of medication to order a repeat prescription. You will then be able to collect the medication from our pharmacy. Alternatively we can register you with Healthcare at Home who can deliver your injections to your house. Please be aware that for your safety we can only issue repeat prescriptions if your blood tests are up to date.

Should I take any precautions when taking Adalimumab?

Adalimumab dampens down your immune system and therefore you may be more likely to catch infections. You will need to have regular blood tests and it is advisable that you try and keep away from people who you know have an infection.

Before staring Adalimumab, your doctor may request that you have a few tests to check your immunity to certain illnesses. These tests may include a chest x-ray and blood tests.

If you are due to have any dental treatment, please inform your dentist that you have been prescribed Adalimumab. You should not receive any live vaccines such as the MMR, Polio, chicken pox, yellow fever, Rubella (German measles) BCG whilst having Humira. We do advise that you have the annual flu vaccine (this must be the inactivated injectable form of the flu vaccine and not the live nasal spray) via your GP each year.

What are the side effects of Adalimumab?

As with any medicine you take, you may or may not experience side effects. The side effects of Adalimumab can occur up to five months after the last injection of Adalimumab. When taking Adalimumab, we advise that if you start to have any of the following, you contact the gastroenterology nurses on the number given at the end of the information sheet.

  • Tightness over the chest, wheezing, feeling dizzy, swelling or rash
  • Find that you or your child bruises or bleeds easily, pale
  • Feel generally unwell
  • Swollen hands or feet
  • Trouble breathing or swallowing
  • Shortness of breath with exertion or when lying down

If you notice any of the following symptoms, you need to contact your Gastroenterology nurse for further advice:

  • Feeling tired or weak
  • Tingling or numb sensation
  • Double vision
  • Arm or leg weakness
  • A cut that will not heal
  • Development of a fever, feeling sick or a burning sensation on urination

A common side effect that has been reported is that where the injection has been given, the surrounding area has become sore, red or itch. There have been rare cases reported of certain types of cancers, in particular Lymphoma’s. This type of cancer affects the Lymphatic system. If you are on Adalimumab, you may be at a higher risk of developing this. You can discuss any concerns you may have with your consultant.

Contact us

If you need any help or advice with the information in this resource, you can contact the gastroenterology nurses by telephoning 0114 271 7111 or 0114 271 7162 or by emailing: scn-tr.gastronurses@nhs.net

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Disclaimer

Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: GAS5

Resource Type: Article

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