Adalimumab-Atto (Subcutaneous Route)

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of adalimumab-atto injection in the elderly. However, this medicine may cause serious infections and cancer more often in the elderly, which may require caution in patients receiving adalimumab-atto injection.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abatacept
• Adenovirus Vaccine
• Anakinra
• Bacillus of Calmette and Guerin Vaccine, Live
• Cholera Vaccine, Live
• Infliximab
• Influenza Virus Vaccine, Live
• Measles Virus Vaccine, Live
• Mumps Virus Vaccine, Live
• Poliovirus Vaccine, Live
• Rilonacept
• Rotavirus Vaccine, Live
• Rubella Virus Vaccine, Live
• Smallpox Vaccine
• Typhoid Vaccine
• Varicella Virus Vaccine, Live
• Yellow Fever Vaccine
• Zoster Vaccine, Live

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For injection dosage forms (autoinjector or prefilled syringe):
  • For Crohn’s disease:
    • Adults—At first (week 0), 160 milligrams (mg) injected under the skin in divided doses. This may be given as four shots in 1 day or as two shots per day for 2 days. Then 2 weeks later, a dose of 80 mg is given. A maintenance dose of 40 mg is given at week 4 and every other week thereafter.
    • Children—Use and dose must be determined by your doctor.
  • For juvenile idiopathic arthritis:
    • Children 4 to 17 years of age weighing 30 kilograms (kg) or more—40 milligrams (mg) injected under the skin every other week.
    • Children 4 to 17 years of age weighing between 15 to less than 30 kg—20 mg injected under the skin every other week.
    • Children younger than 4 years of age—Use and dose must be determined by your doctor.
  • For plaque psoriasis:
    • Adults—At first, 80 milligrams (mg) injected under the skin, then 40 mg 1 week after the initial dose and every other week thereafter.
    • Children—Use and dose must be determined by your doctor.
  • For psoriatic arthritis, rheumatoid arthritis, or ankylosing spondylitis:
    • Adults—40 milligrams (mg) injected under the skin every other week. Your doctor may adjust your dose if needed.
    • Children—Use and dose must be determined by your doctor.
  • For ulcerative colitis:
    • Adults—At first (week 0), 160 milligrams (mg) injected under the skin in divided doses. This may be given as four shots in 1 day or as two shots per day for 2 days. Then 2 weeks later, a dose of 80 mg is given. A maintenance dose of 40 mg is given at week 4 and every other week thereafter.
    • Children—Use and dose must be determined by your doctor.

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.