United States - English - NLM (National Library of Medicine)

mylan specialty l.p. - adalimumab (unii: fys6t7f842) (adalimumab - unii:fys6t7f842) - adalimumab-fkjp is indicated for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active rheumatoid arthritis. adalimumab-fkjp can be used alone or in combination with methotrexate or other non-biologic disease-modifying anti-rheumatic drugs (dmards). adalimumab-fkjp is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis in patients 2 years of age and older. adalimumab-fkjp can be used alone or in combination with methotrexate . adalimumab-fkjp is indicated for reducing signs and symptoms, inhibiting the progression of structural damage, and improving physical function in adult patients with active psoriatic arthritis. adalimumab-fkjp can be used alone or in combination with non-biologic dmards. adalimumab-fkjp is indicated for reducing signs and symptoms in adult patients with active ankylosing spondylitis. adalimumab-fkjp is indicated for the treatment of moderately to severely active crohn’s disease in adults and pediatric patients 6 years of age and older . adalimumab-fkjp is indicated for the treatment of moderately to severely active ulcerative colitis in adult patients. limitations of use the effectiveness of adalimumab products has not been established in patients who have lost response to or were intolerant to tnf blockers [see clinical studies (14.7, 14.8)] . adalimumab-fkjp is indicated for the treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy, and when other systemic therapies are medically less appropriate. adalimumab-fkjp should only be administered to patients who will be closely monitored and have regular follow-up visits with a physician [see warnings and precautions (5)] . adalimumab-fkjp is indicated for the treatment of moderate to severe hidradenitis suppurativa in adult patients. hulio is indicated for the treatment of non-infectious intermediate, posterior, and panuveitis in adult patients . none. risk summary available studies with use of adalimumab during pregnancy do not reliably establish an association between adalimumab and major birth defects. clinical data are available from the organization of teratology information specialists (otis)/mothertobaby pregnancy registry in pregnant women with rheumatoid arthritis (ra) or crohn’s disease (cd) treated with adalimumab. registry results showed a rate of 10% for major birth defects with first trimester use of adalimumab in pregnant women with ra or cd and a rate of 7.5% for major birth defects in the disease matched comparison cohort. the lack of pattern of major birth defects is reassuring and differences between exposure groups may have impacted the occurrence of birth defects (see data) . adalimumab is actively transferred across the placenta during the third trimester of pregnancy and may affect immune response in the in-utero exposed infant (see clinical considerations) . in an embryo-fetal perinatal development study conducted in cynomolgus monkeys, no fetal harm or malformations were observed with intravenous administration of adalimumab during organogenesis and later in gestation, at doses that produced exposures up to approximately 373 times the maximum recommended human dose (mrhd) of 40 mg subcutaneous without methotrexate (see data) . the estimated background risk of major birth defects and miscarriage for the indicated populations is unknown. all pregnancies have a background risk of birth defect, loss, or other adverse outcomes. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively. clinical considerations disease-associated maternal and embryo/fetal risk published data suggest that the risk of adverse pregnancy outcomes in women with ra or inflammatory bowel disease (ibd) is associated with increased disease activity. adverse pregnancy outcomes include preterm delivery (before 37 weeks of gestation), low birth weight (less than 2500 g) infants, and small for gestational age at birth. fetal/neonatal adverse reactions monoclonal antibodies are increasingly transported across the placenta as pregnancy progresses, with the largest amount transferred during the third trimester (see data) . risks and benefits should be considered prior to administering live or live-attenuated vaccines to infants exposed to adalimumab products in utero  [see use in specific populations (8.4)] . data human data a prospective cohort pregnancy exposure registry conducted by otis/mothertobaby in the u.s. and canada between 2004 and 2016 compared the risk of major birth defects in live-born infants of 221 women (69 ra, 152 cd) treated with adalimumab during the first trimester and 106 women (74 ra, 32 cd) not treated with adalimumab. the proportion of major birth defects among live-born infants in the adalimumab-treated and untreated cohorts was 10% (8.7% ra, 10.5% cd) and 7.5% (6.8% ra, 9.4% cd), respectively. the lack of pattern of major birth defects is reassuring and differences between exposure groups may have impacted the occurrence of birth defects. this study cannot reliably establish whether there is an association between adalimumab and major birth defects because of methodological limitations of the registry, including small sample size, the voluntary nature of the study, and the non-randomized design. in an independent clinical study conducted in ten pregnant women with ibd treated with adalimumab, adalimumab concentrations were measured in maternal serum as well as in cord blood (n=10) and infant serum (n=8) on the day of birth. the last dose of adalimumab was given between 1 and 56 days prior to delivery. adalimumab concentrations were 0.16-19.7 mcg/ml in cord blood, 4.28-17.7 mcg/ml in infant serum, and 0-16.1 mcg/ml in maternal serum. in all but one case, the cord blood concentration of adalimumab was higher than the maternal serum concentration, suggesting adalimumab actively crosses the placenta. in addition, one infant had serum concentrations at each of the following: 6 weeks (1.94 mcg/ml), 7 weeks (1.31 mcg/ml), 8 weeks (0.93 mcg/ml), and 11 weeks (0.53 mcg/ml), suggesting adalimumab can be detected in the serum of infants exposed in utero for at least 3 months from birth. animal data in an embryo-fetal perinatal development study, pregnant cynomolgus monkeys received adalimumab from gestation days 20 to 97 at doses that produced exposures up to 373 times that achieved with the mrhd without methotrexate (on an auc basis with maternal iv doses up to 100 mg/kg/week). adalimumab did not elicit harm to the fetuses or malformations. risk summary limited data from case reports in the published literature describe the presence of adalimumab in human milk at infant doses of 0.1% to 1% of the maternal serum concentration. published data suggest that the systemic exposure to a breastfed infant is expected to be low because adalimumab is a large molecule and is degraded in the gastrointestinal tract. however, the effects of local exposure in the gastrointestinal tract are unknown. there are no reports of adverse effects of adalimumab products on the breastfed infant and no effects on milk production. the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for adalimumab-fkjp and any potential adverse effects on the breastfed child from adalimumab-fkjp or from the underlying maternal condition. the safety and effectiveness of adalimumab-fkjp have been established for: pediatric assessments for adalimumab-fkjp demonstrate that adalimumab-fkjp is safe and effective for pediatric patients in indications for which humira (adalimumab) is approved. however, adalimumab-fkjp is not approved for such indications due to marketing exclusivity for humira (adalimumab). due to their inhibition of tnfα, adalimumab products administered during pregnancy could affect immune response in the in utero -exposed newborn and infant. data from eight infants exposed to adalimumab in utero suggest adalimumab crosses the placenta [see use in specific populations (8.1)] . the clinical significance of elevated adalimumab concentrations in infants is unknown. the safety of administering live or live-attenuated vaccines in exposed infants is unknown. risks and benefits should be considered prior to vaccinating (live or live-attenuated) exposed infants. post-marketing cases of lymphoma, including hepatosplenic t-cell lymphoma and other malignancies, some fatal, have been reported among children, adolescents, and young adults who received treatment with tnf-blockers including adalimumab products [see warnings and precautions (5.2)] . juvenile idiopathic arthritis in study jia-i, adalimumab was shown to reduce signs and symptoms of active polyarticular jia in patients 4 to 17 years of age [see clinical studies (14.2)] . in study jia-ii, the safety profile for patients 2 to <4 years of age was similar to the safety profile for patients 4 to 17 years of age with polyarticular jia [see adverse reactions (6.1)] . adalimumab products have not been studied in patients with polyarticular jia less than 2 years of age or in patients with a weight below 10 kg. the safety of adalimumab in patients in the polyarticular jia trials was generally similar to that observed in adults with certain exceptions [see adverse reactions (6.1)] . the safety and effectiveness of adalimumab products have not been established in pediatric patients with jia less than 2 years of age. pediatric crohn’s disease the safety and effectiveness of adalimumab products for the treatment of moderately to severely active crohn’s disease have been established in pediatric patients 6 years of age and older. use of adalimumab products for this indication is supported by evidence from adequate and well-controlled studies in adults with additional data from a randomized, double-blind, 52-week clinical study of two dose concentrations of adalimumab in 192 pediatric patients (6 years to 17 years of age) [see adverse reactions (6.1), clinical pharmacology (12.2, 12.3), clinical studies (14.6)] . the adverse reaction profile in patients 6 years to 17 years of age was similar to adults. the safety and effectiveness of adalimumab products have not been established in pediatric patients with crohn’s disease less than 6 years of age. a total of 519 ra patients 65 years of age and older, including 107 patients 75 years of age and older, received adalimumab in clinical studies ra-i through iv. no overall difference in effectiveness was observed between these patients and younger patients. the frequency of serious infection and malignancy among adalimumab treated patients 65 years of age and older was higher than for those less than 65 years of age. consider the benefits and risks of adalimumab-fkjp in patients 65 years of age and older. in patients treated with adalimumab-fkjp, closely monitor for the development of infection or malignancy [see warnings and precautions (5.1, 5.2)] . adalimumab-fkjp pen injection for subcutaneous use 40 mg/0.8 ml single-dose prefilled pen for subcutaneous (under the skin) use only read these instructions carefully before using your pen. this information does not replace talking to your healthcare provider about your medical condition and your treatment. do not try to inject adalimumab-fkjp yourself until you have been shown the right way to give the injections and have read and understand this instructions for use. if your healthcare provider decides that you or a caregiver may be able to give your injections of adalimumab-fkjp at home, you should receive training on the right way to prepare and inject adalimumab-fkjp. it is important that you read, understand, and follow these instructions so that you inject adalimumab-fkjp the right way. it is also important to talk to your healthcare provider to be sure you understand your adalimumab-fkjp dosing instructions. to help you remember when to inject adalimumab-fkjp, you can mark your calendar ahead of time. call your healthcare provider if you or your caregiver has any questions about the right way to inject adalimumab-fkjp. for questions or assistance, call mylan at 1-877-446-3679 (1-877-4-info-rx) caution: never put your thumb, fingers, or hand over the orange activator after cap is removed. never press or push the orange activator with your thumb, fingers, or hand. the orange activator is where the needle comes out. if accidental injection to your fingers or hands occurs, apply first-aid and either call your healthcare provider or go to the nearest hospital emergency room if needed.   dosage: adalimumab-fkjp pen is for single dose (1-time) use only. important: do not use adalimumab-fkjp if frozen, even if it has been thawed. do not uncap your adalimumab-fkjp pen until you are ready to inject and will not be interrupted. do not recap. recapping your adalimumab-fkjp pen can damage the needle. a loud “click” will occur when the orange activator is pressed down to deliver your dose of adalimumab-fkjp. parts of the adalimumab-fkjp pen storing and handling the adalimumab-fkjp pen if needed, for example when traveling, adalimumab-fkjp may be stored at room temperature up to 77°f (25°c) for a period of up to 14 days, with protection from light. discard (throw away) adalimumab-fkjp if not used within the 14 day period. record the date on the carton and dose tray when adalimumab-fkjp is first removed from the refrigerator. gather supplies for injection find a quiet area with a well-lit, clean and flat work surface and gather all the supplies you will need to give yourself or receive an injection. supplies you will need: included in adalimumab-fkjp carton not included in adalimumab-fkjp carton if you do not have all the supplies you need to give yourself an injection, visit or call your local pharmacist. preparing the pen remove the pen from the refrigerator 30 minutes before using. check the viewing window to make sure: do not use the pen if medicine is not near the fill marker. use another pen or contact your healthcare provider. do not use the pen if it is cloudy, discolored, or has particles in it. choosing and preparing injection site your healthcare provider should show you proper injection site techniques. giving the injection caution: injection process must be completed without interruption. read all steps first before beginning injection. step 1 uncap important: step 2 squeeze and hold injection site the thigh injection site is shown here (see figure f). perform these steps the same way for abdomen (belly) injection sites. step 3 place pen step 4 begin injection step 5 hold down for 2nd “click”, orange indicator and 10 seconds continue pushing the body of the pen down against the injection site until: caution: make sure all three of these have occurred to ensure all medicine was delivered. if the needle did not retract or you do not think you received the full dose contact your healthcare provider for assistance. step 6 end of injection, remove adalimumab-fkjp pen dispose of the adalimumab-fkjp pen and cap put the used pen and cap in an fda-cleared sharps disposal container or puncture resistant container right away to avoid injury (see “how should i throw away (dispose of) the used adalimumab-fkjp pen and cap?” in step 7). pen is for single-dose only. do not reuse the pen if all of the medicine was not injected. do not try to recap the pen as it could lead to a needle stick injury. step 7 how should i throw away (dispose of) the used adalimumab-fkjp pen and cap? if you do not have an fda-cleared sharps disposal container, you may use a household container that is: when your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. there may be state or local laws about how you should throw away used needles and pens. for more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the fda’s website at: http://www.fda.gov/safesharpsdisposal. do not recycle your used sharps disposal container. step 8 write down the date you received your injection and the injection site used in the injection diary. injection diary date injection site used                     customer service for questions or assistance, call mylan at 1-877-446-3679 (1-877-4-info-rx) the brands listed are trademarks of their respective owners. the logo is a trademark of bgp products operations gmbh, a viatris company. © 2023 viatris inc. manufactured by: mylan pharmaceuticals inc. morgantown, wv 26505 u.s.a. manufactured for: mylan specialty l.p. morgantown, wv 26505 u.s.a. u.s. license no. 2210 product of japan this instructions for use has been approved by the u.s. food and drug administration. revised: 06/2023 pci:adalub:ifup:r2 725787 adalimumab-fkjp injection for subcutaneous use 20 mg/0.4 ml and 40 mg/0.8 ml single-dose prefilled syringe for subcutaneous (under the skin) use only read these instructions carefully before using your syringe. this information does not replace talking to your healthcare provider about your medical condition and your treatment. do not try to inject adalimumab-fkjp yourself until you have been shown the right way to give the injections and have read and understand this instructions for use. if your healthcare provider decides that you or a caregiver may be able to give your injections of adalimumab-fkjp at home, you should receive training on the right way to prepare and inject adalimumab-fkjp. it is important that you read, understand, and follow these instructions so that you inject adalimumab-fkjp the right way. it is also important to talk to your healthcare provider to be sure you understand your adalimumab-fkjp dosing instructions. to help you remember when to inject adalimumab-fkjp, you can mark your calendar ahead of time. call your healthcare provider if you or your caregiver has any questions about the right way to inject adalimumab-fkjp. for questions or assistance, call mylan at 1-877-446-3679 (1-877-4-info-rx) dosage: adalimumab-fkjp prefilled syringe is for single dose (1-time) use only. important: parts of the adalimumab-fkjp prefilled syringe (syringe) see figure a storing and handling the syringe if needed, for example when traveling, adalimumab-fkjp may be stored at room temperature up to 77°f (25°c) for a period of up to 14 days, with protection from light. discard (throw away) adalimumab-fkjp if not used within the 14-day period. record the date on the carton and dose tray when adalimumab-fkjp is first removed from the refrigerator. gather supplies for injection find a quiet area with a well-lit, clean and flat work surface and gather all the supplies you will need to give yourself or receive an injection. supplies you will need: included in the adalimumab-fkjp carton (taken from refrigerator 30 minutes prior to intended injection time to allow syringe to reach room temperature) not included in adalimumab-fkjp carton if you do not have all the supplies you need to give yourself an injection, visit or call your local pharmacist. preparing the syringe remove the syringe from the refrigerator 30 minutes before using. check the viewing window to make sure: do not use the syringe if medicine is not near the fill marker. use another syringe or contact your healthcare provider. do not use the syringe if it is cloudy, discolored, or has particles in it. choosing and preparing injection site your healthcare provider should show you proper injection site techniques. wait for it to dry on its own, do not fan or blow dry. giving the injection caution: injection process must be completed without interruption.               read all steps first before beginning injection. step 1 uncap caution: step 2 squeeze and hold injection site the thigh injection site is shown here (see figure f). perform these steps the same way for abdomen (belly) injection sites. step 3 insert needle into site at a 45° angle to the injection site, with your other hand use a quick dart-like motion to insert the needle into the site (see figure g). be careful to insert the needle so that it will not inject into your fingers holding the injection site. step 4 inject medicine after the needle is in, let go of squeezing the injection site. slowly push the plunger all the way down with your thumb until all the medicine is injected and the syringe is empty (see figure h). if the plunger is not pressed all the way down the needle safety feature will not activate afterwards to cover the needle. do not move, twist, or rotate syringe during injection. step 5 end of injection, remove syringe pull the syringe away from the injection site, then release your thumb from the plunger. the needle will retract and the needle safety feature will cover the needle (see figure i). caution : if the needle did not retract or you do not think you received the full dose, contact your healthcare provider for assistance. if the needle does not retract, carefully place the syringe into a sharps or puncture resistant container to avoid injury. dispose of the adalimumab-fkjp syringe and needle cap put the used syringe and needle cap in an fda-cleared sharps disposal container or puncture resistant container right away to avoid injury (see “how should i throw away (dispose of) the used adalimumab-fkjp prefilled syringe and needle cap?” in step 6). syringe is for single-dose only. do not reuse the syringe even if all of the medicine was not injected. do not try to recap the needle as it could lead to a needle stick injury. step 6 how should i throw away (dispose of) the used adalimumab-fkjp prefilled syringe and needle cap? if you do not have an fda-cleared sharps disposal container, you may use a household container that is: when your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. there may be state or local laws about how you should throw away used needles and syringes. for more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the fda’s website at: http://www.fda.gov/safesharpsdisposal. do not recycle your used sharps disposal container. step 7 write down the date you received your injection and the injection site used in the injection diary. injection diary date injection site used                          customer service for questions or assistance, call mylan at 1-877-446-3679 (1-877-4-info-rx) the brands listed are trademarks of their respective owners. the logo is a trademark of bgp products operations gmbh, a viatris company. © 2023 viatris inc. manufactured by: mylan pharmaceuticals inc. morgantown, wv 26505 u.s.a. manufactured for: mylan specialty l.p. morgantown, wv 26505 u.s.a. u.s. license no. 2210 product of japan this instructions for use has been approved by the u.s. food and drug administration. issued: 06/2023 pci:adalub:ifus:r2 725784

United States - English - NLM (National Library of Medicine)

sandoz inc - adalimumab (unii: fys6t7f842) (adalimumab - unii:fys6t7f842) - hyrimoz is indicated for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active rheumatoid arthritis. hyrimoz can be used alone or in combination with methotrexate or other non-biologic disease-modifying anti-rheumatic drugs (dmards). hyrimoz is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis in patients 2 years of age and older. hyrimoz can be used alone or in combination with methotrexate. hyrimoz is indicated for reducing signs and symptoms, inhibiting the progression of structural damage, and improving physical function in adult patients with active psoriatic arthritis. hyrimoz can be used alone or in combination with non-biologic dmards. hyrimoz is indicated for reducing signs and symptoms in adult patients with active ankylosing spondylitis. hyrimoz is indicated for the treatment of moderately

United States - English - NLM (National Library of Medicine)

pfizer laboratories div pfizer inc - adalimumab (unii: fys6t7f842) (adalimumab - unii:fys6t7f842) - abrilada is indicated for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active rheumatoid arthritis. abrilada can be used alone or in combination with methotrexate or other non-biologic disease-modifying anti-rheumatic drugs (dmards). abrilada is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis in patients 2 years of age and older. abrilada can be used alone or in combination with methotrexate. abrilada is indicated for reducing signs and symptoms, inhibiting the progression of structural damage, and improving physical function in adult patients with active psoriatic arthritis. abrilada can be used alone or in combination with non-biologic dmards. abrilada is indicated for reducing signs and symptoms in adult patients with active ankylosing spondylitis. abrilada is indicated for the treatment of moderately to severely active crohn's disease in adults and pediatric patients 6 years of age and older. abrilada is indicated for the treatment of moderately to severely active ulcerative colitis in adult patients. limitations of use the effectiveness of adalimumab products has not been established in patients who have lost response to or were intolerant to tnf blockers [see clinical studies (14.7)] . abrilada is indicated for the treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy, and when other systemic therapies are medically less appropriate. abrilada should only be administered to patients who will be closely monitored and have regular follow-up visits with a physician [see warnings and precautions (5)] . abrilada is indicated for the treatment of moderate to severe hidradenitis suppurativa in adult patients. abrilada is indicated for the treatment of non-infectious intermediate, posterior, and panuveitis in adult patients. none. risk summary available studies with use of adalimumab during pregnancy do not reliably establish an association between adalimumab and major birth defects. clinical data are available from the organization of teratology information specialists (otis)/mothertobaby pregnancy registry in pregnant women with rheumatoid arthritis (ra) or crohn's disease (cd) treated with adalimumab. registry results showed a rate of 10% for major birth defects with first trimester use of adalimumab in pregnant women with ra or cd and a rate of 7.5% for major birth defects in the disease-matched comparison cohort. the lack of pattern of major birth defects is reassuring and differences between exposure groups may have impacted the occurrence of birth defects (see data). adalimumab is actively transferred across the placenta during the third trimester of pregnancy and may affect immune response in the in utero exposed infant (see clinical considerations). in an embryo-fetal perinatal development study conducted in cynomolgus monkeys, no fetal harm or malformations were observed with intravenous administration of adalimumab during organogenesis and later in gestation, at doses that produced exposures up to approximately 373 times the maximum recommended human dose (mrhd) of 40 mg subcutaneous without methotrexate (see data). the estimated background risk of major birth defects and miscarriage for the indicated populations is unknown. all pregnancies have a background risk of birth defect, loss, or other adverse outcomes. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2–4% and 15–20%, respectively. clinical considerations disease-associated maternal and embryo/fetal risk published data suggest that the risk of adverse pregnancy outcomes in women with ra or inflammatory bowel disease (ibd) is associated with increased disease activity. adverse pregnancy outcomes include preterm delivery (before 37 weeks of gestation), low birth weight (less than 2500 g) infants, and small for gestational age at birth. fetal/neonatal adverse reactions monoclonal antibodies are increasingly transported across the placenta as pregnancy progresses, with the largest amount transferred during the third trimester (see data) . risks and benefits should be considered prior to administering live or live-attenuated vaccines to infants exposed to adalimumab products in utero [see use in specific populations (8.4)] . data human data a prospective cohort pregnancy exposure registry conducted by otis/mothertobaby in the u.s. and canada between 2004 and 2016 compared the risk of major birth defects in live-born infants of 221 women (69 ra, 152 cd) treated with adalimumab during the first trimester and 106 women (74 ra, 32 cd) not treated with adalimumab. the proportion of major birth defects among live-born infants in the adalimumab-treated and untreated cohorts was 10% (8.7% ra, 10.5% cd) and 7.5% (6.8% ra, 9.4% cd), respectively. the lack of pattern of major birth defects is reassuring and differences between exposure groups may have impacted the occurrence of birth defects. this study cannot reliably establish whether there is an association between adalimumab and major birth defects because of methodological limitations of the registry, including small sample size, the voluntary nature of the study, and the non-randomized design. in an independent clinical study conducted in ten pregnant women with ibd treated with adalimumab, adalimumab concentrations were measured in maternal serum as well as in cord blood (n=10) and infant serum (n=8) on the day of birth. the last dose of adalimumab was given between 1 and 56 days prior to delivery. adalimumab concentrations were 0.16–19.7 mcg/ml in cord blood, 4.28–17.7 mcg/ml in infant serum, and 0–16.1 mcg/ml in maternal serum. in all but one case, the cord blood concentration of adalimumab was higher than the maternal serum concentration, suggesting adalimumab actively crosses the placenta. in addition, one infant had serum concentrations at each of the following: 6 weeks (1.94 mcg/ml), 7 weeks (1.31 mcg/ml), 8 weeks (0.93 mcg/ml), and 11 weeks (0.53 mcg/ml), suggesting adalimumab can be detected in the serum of infants exposed in utero for at least 3 months from birth. animal data in an embryo-fetal perinatal development study, pregnant cynomolgus monkeys received adalimumab from gestation days 20 to 97 at doses that produced exposures up to 373 times that achieved with the mrhd without methotrexate (on an auc basis with maternal iv doses up to 100 mg/kg/week). adalimumab did not elicit harm to the fetuses or malformations. risk summary limited data from case reports in the published literature describe the presence of adalimumab in human milk at infant doses of 0.1% to 1% of the maternal serum concentration. published data suggest that the systemic exposure to a breastfed infant is expected to be low because adalimumab is a large molecule and is degraded in the gastrointestinal tract. however, the effects of local exposure in the gastrointestinal tract are unknown. there are no reports of adverse effects of adalimumab products on the breastfed infant and no effects on milk production. the developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for abrilada and any potential adverse effects on the breastfed child from abrilada or from the underlying maternal condition. the safety and effectiveness of abrilada have been established for: pediatric assessments for abrilada demonstrate that abrilada is safe and effective for pediatric patients in indications for which humira (adalimumab) is approved. however, abrilada is not approved for such indications due to marketing exclusivity for humira (adalimumab). due to their inhibition of tnfα, adalimumab products administered during pregnancy could affect immune response in the in utero -exposed newborn and infant. data from eight infants exposed to adalimumab in utero suggest adalimumab crosses the placenta [see use in specific populations (8.1)] . the clinical significance of elevated adalimumab concentrations in infants is unknown. the safety of administering live or live-attenuated vaccines in exposed infants is unknown. risks and benefits should be considered prior to vaccinating (live or live-attenuated) exposed infants. postmarketing cases of lymphoma, including hepatosplenic t-cell lymphoma and other malignancies, some fatal, have been reported among children, adolescents, and young adults who received treatment with tnf-blockers including adalimumab products [see warnings and precautions (5.2)] . juvenile idiopathic arthritis in study jia-i, adalimumab was shown to reduce signs and symptoms of active polyarticular jia in patients 4 to 17 years of age [see clinical studies (14.2)] . in study jia-ii, the safety profile for patients 2 to <4 years of age was similar to the safety profile for patients 4 to 17 years of age with polyarticular jia [see adverse reactions (6.1)] . adalimumab products have not been studied in patients with polyarticular jia less than 2 years of age or in patients with a weight below 10 kg. the safety of adalimumab in patients in the polyarticular jia trials was generally similar to that observed in adults with certain exceptions [see adverse reactions (6.1)] . the safety and effectiveness of adalimumab products have not been established in pediatric patients with jia less than 2 years of age. pediatric crohn's disease the safety and effectiveness of adalimumab products for the treatment of moderately to severely active crohn's disease have been established in pediatric patients 6 years of age and older. use of adalimumab products for this indication is supported by evidence from adequate and well-controlled studies in adults with additional data from a randomized, double-blind, 52-week clinical study of two dose concentrations of adalimumab in 192 pediatric patients (6 years to 17 years of age) [see adverse reactions (6.1), clinical pharmacology (12.2, 12.3), clinical studies (14.6)] . the adverse reaction profile in patients 6 years to 17 years of age was similar to adults. the safety and effectiveness of adalimumab products have not been established in pediatric patients with crohn's disease less than 6 years of age. a total of 519 ra patients 65 years of age and older, including 107 patients 75 years of age and older, received adalimumab in clinical studies ra-i through iv. no overall difference in effectiveness was observed between these patients and younger patients. the frequency of serious infection and malignancy among adalimumab-treated patients 65 years of age and older was higher than for those less than 65 years of age. consider the benefits and risks of abrilada in patients 65 years of age and older. in patients treated with abrilada, closely monitor for the development of infection or malignancy [see warnings and precautions (5.1, 5.2)] . abrilada (ah brill-ah-dah) (adalimumab-afzb) 40 mg/0.8 ml single-dose prefilled pen injection, for subcutaneous (under the skin) use keep this leaflet. these instructions show step by step directions on how to prepare and give an injection. storage information: keep abrilada, injection supplies, and all other medicines out of the reach of children. abrilada for injection comes in a disposable (throw away) single-use pen that contains a single dose of medicine. abrilada for injection can be given by a patient, caregiver or healthcare provider. do not try to inject abrilada yourself until you are shown the right way to give the injections and read and understand the instructions for use. if your healthcare provider decides that you or a caregiver may be able to give your injections of abrilada at home, you should receive training on the right way to prepare and inject abrilada. it is important that you read, understand, and follow these instructions so that you inject abrilada the right way. it is important to talk to your healthcare provider to be sure you understand your abrilada dosing instructions. to help you remember when to inject abrilada, you can mark your calendar ahead of time. call your healthcare provider if you or your caregiver have any questions about the right way to inject abrilada. step 1. supplies you need step 2. getting ready   questions and answers what should i do with my pen if it has been dropped? do not use it, even if it looks undamaged. dispose of your pen in the same way as a used pen. you will need to use a new pen to give your injection. can i use my pen straight from the refrigerator? yes, however you may find that using the pen at room temperature reduces stinging or discomfort. if you allow your pen to reach room temperature before use, you must keep it away from direct sunlight as this can damage your medicine. what should i do if i need to travel? when you are traveling, you may store your pen in its carton at room temperature up to 86°f (30°c) for up to 30 days. is it okay to shake my pen before i use it? no, do not shake your pen. shaking can damage your medicine. when you check your medicine, gently tilt your pen back and forth while looking carefully into the window. it is normal to see one or more air bubbles. do i need to remove any air bubbles before using my pen? no, do not attempt to remove air bubbles. drops of medicine have appeared at the needle tip. is this okay? yes, it is normal to see a few drops of medicine at the needle tip when you remove the cap. can i re-insert the needle if i change my mind where i want to inject? no, you should not re-insert the needle into your skin. if you change your mind, you will need a replacement pen if the needle has already been inserted into the skin. after the injection button has been pressed, you must not lift your pen from the skin until the injection has finished. i pushed my pen against the skin but could not press the button down. what should i do? take your finger off the injection button and push your pen down more firmly against the skin. then try pushing the button again. if this does not work, stretching the skin may make the injection site firmer, making pressing the injection button easier. can i pinch or stretch the skin at the injection area? yes, pinching or stretching the skin before injection may make the injection site firmer, making it easier to press the injection button. do i need to keep my finger pressed on the injection button for the whole injection? no, you can stop pressing the button when the injection has started. however, make sure you keep holding the pen firmly against the skin. the pen will continue to deliver your medicine. how long will the injection take? from the time the dose begins until you hear the 2nd click, it usually takes 3 to 10 seconds. after the 2nd click, you should continue to hold your pen in place for at least 5 more seconds to make sure you give the full dose. what should i do if i see more than a small drop of medicine on the skin after giving my injection? nothing this time, but for your next injection wait a little longer before removing the pen from the skin to make sure all of the medicine went into your skin. what should i do if i have any questions about my abrilada pen or medicine? contact your healthcare provider or pharmacist. this instructions for use has been approved by the u.s. food and drug administration. manufactured by pfizer inc. new york, ny 10001 distributed by pfizer labs division of pfizer inc. new york, ny 10001 us license no. 2001 lab-1352-3.0 revised: 06/2023 abrilada (ah brill-ah-dah) (adalimumab-afzb) 10 mg/0.2 ml, 20 mg/0.4 ml, 40 mg/0.8 ml single-dose prefilled syringe injection, for subcutaneous (under the skin) use only keep this leaflet. these instructions show step by step directions on how to prepare and give an injection. storage information: keep abrilada, injection supplies, and all other medicines out of the reach of children. abrilada for injection comes in a disposable (throw away) single use prefilled syringe that contains a single dose of medicine. abrilada for injection can be given by a patient, caregiver or healthcare provider. do not try to inject abrilada yourself until you are shown the right way to give the injections and read and understand the instructions for use. if your healthcare provider decides that you or a caregiver may be able to give your injections of abrilada at home, you should receive training on the right way to prepare and inject abrilada. it is important that you read, understand, and follow these instructions so that you inject abrilada the right way. it is important to talk to your healthcare provider to be sure you understand your abrilada dosing instructions. to help you remember when to inject abrilada, you can mark your calendar ahead of time. call your healthcare provider if you or your caregiver have any questions about the right way to inject abrilada. step 1. supplies you need step 2. getting ready wash your hands with soap and water, and dry completely. if you have any questions about your medicine, please contact your healthcare provider or pharmacist.   questions and answers what should i do with my prefilled syringe if it has been dropped? do not use it if it has been dropped or the carton containing your prefilled syringe has been dropped even if it looks undamaged. dispose of your prefilled syringe in the same way as a used prefilled syringe. you will need to use a new prefilled syringe to give your injection. can i use my prefilled syringe straight from the refrigerator? yes, however you may find that using the prefilled syringe at room temperature reduces stinging or discomfort. if you allow your prefilled syringe to reach room temperature before use, you must keep it away from direct sunlight as this can damage your medicine. what should i do if i need to travel? when you are traveling, you may store your prefilled syringe in its carton at room temperature up to 86°f (30°c) for up to 30 days. is it okay to shake my prefilled syringe before i use it? no, do not shake your prefilled syringe. shaking can damage your medicine. when you check your medicine, gently tilt your syringe back and forth while looking carefully into the window. it is normal to see one or more bubbles. do i need to remove any air bubbles before using my prefilled syringe? no, do not attempt to remove air bubbles. drops of medicine have appeared at the needle tip. is this okay? yes, it is normal to see a few drops of medicine at the needle tip when you remove the needle cover. can i re-insert the needle into my skin? no, you should not re-insert the needle into the skin. you will need a replacement prefilled syringe if the needle has already been inserted into the skin. how long will the injection take? dose delivery will take approximately 2 to 5 seconds. remember to hold your prefilled syringe in place for at least 5 seconds after the plunger has been pushed down all the way. what should i do if i have any questions about my prefilled syringe or medicine? contact your healthcare provider or pharmacist. this instructions for use has been approved by the u.s. food and drug administration. manufactured by pfizer inc. new york, ny 10001 distributed by pfizer labs division of pfizer inc. new york, ny 10001 us license no. 2001 lab-1353-3.0 revised: 06/2023

United States - English - NLM (National Library of Medicine)

pfizer laboratories div pfizer inc - adalimumab (unii: fys6t7f842) (adalimumab - unii:fys6t7f842) - abrilada is indicated for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active rheumatoid arthritis. abrilada can be used alone or in combination with methotrexate or other non-biologic disease-modifying anti-rheumatic drugs (dmards). abrilada is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis in patients 2 years of age and older. abrilada can be used alone or in combination with methotrexate. abrilada is indicated for reducing signs and symptoms, inhibiting the progression of structural damage, and improving physical function in adult patients with active psoriatic arthritis. abrilada can be used alone or in combination with non-biologic dmards. abrilada is indicated for reducing signs and symptoms in adult patients with active ankylosing spondylitis. abrilada is indicated for the treatment of moderately to severely active crohn's disease in adults and pediatric patients 6 years of age and older. abrilada is indicated for the treatment of moderately to severely active ulcerative colitis in adult patients. limitations of use the effectiveness of adalimumab products has not been established in patients who have lost response to or were intolerant to tnf blockers [see clinical studies (14.7)] . abrilada is indicated for the treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy, and when other systemic therapies are medically less appropriate. abrilada should only be administered to patients who will be closely monitored and have regular follow-up visits with a physician [see warnings and precautions (5)] . abrilada is indicated for the treatment of moderate to severe hidradenitis suppurativa in adult patients. abrilada is indicated for the treatment of non-infectious intermediate, posterior, and panuveitis in adult patients. none. risk summary available studies with use of adalimumab during pregnancy do not reliably establish an association between adalimumab and major birth defects. clinical data are available from the organization of teratology information specialists (otis)/mothertobaby pregnancy registry in pregnant women with rheumatoid arthritis (ra) or crohn's disease (cd) treated with adalimumab. registry results showed a rate of 10% for major birth defects with first trimester use of adalimumab in pregnant women with ra or cd and a rate of 7.5% for major birth defects in the disease-matched comparison cohort. the lack of pattern of major birth defects is reassuring and differences between exposure groups may have impacted the occurrence of birth defects (see data). adalimumab is actively transferred across the placenta during the third trimester of pregnancy and may affect immune response in the in utero exposed infant (see clinical considerations). in an embryo-fetal perinatal development study conducted in cynomolgus monkeys, no fetal harm or malformations were observed with intravenous administration of adalimumab during organogenesis and later in gestation, at doses that produced exposures up to approximately 373 times the maximum recommended human dose (mrhd) of 40 mg subcutaneous without methotrexate (see data). the estimated background risk of major birth defects and miscarriage for the indicated populations is unknown. all pregnancies have a background risk of birth defect, loss, or other adverse outcomes. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2–4% and 15–20%, respectively. clinical considerations disease-associated maternal and embryo/fetal risk published data suggest that the risk of adverse pregnancy outcomes in women with ra or inflammatory bowel disease (ibd) is associated with increased disease activity. adverse pregnancy outcomes include preterm delivery (before 37 weeks of gestation), low birth weight (less than 2500 g) infants, and small for gestational age at birth. fetal/neonatal adverse reactions monoclonal antibodies are increasingly transported across the placenta as pregnancy progresses, with the largest amount transferred during the third trimester (see data) . risks and benefits should be considered prior to administering live or live-attenuated vaccines to infants exposed to adalimumab products in utero [see use in specific populations (8.4)] . data human data a prospective cohort pregnancy exposure registry conducted by otis/mothertobaby in the u.s. and canada between 2004 and 2016 compared the risk of major birth defects in live-born infants of 221 women (69 ra, 152 cd) treated with adalimumab during the first trimester and 106 women (74 ra, 32 cd) not treated with adalimumab. the proportion of major birth defects among live-born infants in the adalimumab-treated and untreated cohorts was 10% (8.7% ra, 10.5% cd) and 7.5% (6.8% ra, 9.4% cd), respectively. the lack of pattern of major birth defects is reassuring and differences between exposure groups may have impacted the occurrence of birth defects. this study cannot reliably establish whether there is an association between adalimumab and major birth defects because of methodological limitations of the registry, including small sample size, the voluntary nature of the study, and the non-randomized design. in an independent clinical study conducted in ten pregnant women with ibd treated with adalimumab, adalimumab concentrations were measured in maternal serum as well as in cord blood (n=10) and infant serum (n=8) on the day of birth. the last dose of adalimumab was given between 1 and 56 days prior to delivery. adalimumab concentrations were 0.16–19.7 mcg/ml in cord blood, 4.28–17.7 mcg/ml in infant serum, and 0–16.1 mcg/ml in maternal serum. in all but one case, the cord blood concentration of adalimumab was higher than the maternal serum concentration, suggesting adalimumab actively crosses the placenta. in addition, one infant had serum concentrations at each of the following: 6 weeks (1.94 mcg/ml), 7 weeks (1.31 mcg/ml), 8 weeks (0.93 mcg/ml), and 11 weeks (0.53 mcg/ml), suggesting adalimumab can be detected in the serum of infants exposed in utero for at least 3 months from birth. animal data in an embryo-fetal perinatal development study, pregnant cynomolgus monkeys received adalimumab from gestation days 20 to 97 at doses that produced exposures up to 373 times that achieved with the mrhd without methotrexate (on an auc basis with maternal iv doses up to 100 mg/kg/week). adalimumab did not elicit harm to the fetuses or malformations. risk summary limited data from case reports in the published literature describe the presence of adalimumab in human milk at infant doses of 0.1% to 1% of the maternal serum concentration. published data suggest that the systemic exposure to a breastfed infant is expected to be low because adalimumab is a large molecule and is degraded in the gastrointestinal tract. however, the effects of local exposure in the gastrointestinal tract are unknown. there are no reports of adverse effects of adalimumab products on the breastfed infant and no effects on milk production. the developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for abrilada and any potential adverse effects on the breastfed child from abrilada or from the underlying maternal condition. the safety and effectiveness of abrilada have been established for: pediatric assessments for abrilada demonstrate that abrilada is safe and effective for pediatric patients in indications for which humira (adalimumab) is approved. however, abrilada is not approved for such indications due to marketing exclusivity for humira (adalimumab). due to their inhibition of tnfα, adalimumab products administered during pregnancy could affect immune response in the in utero -exposed newborn and infant. data from eight infants exposed to adalimumab in utero suggest adalimumab crosses the placenta [see use in specific populations (8.1)] . the clinical significance of elevated adalimumab concentrations in infants is unknown. the safety of administering live or live-attenuated vaccines in exposed infants is unknown. risks and benefits should be considered prior to vaccinating (live or live-attenuated) exposed infants. postmarketing cases of lymphoma, including hepatosplenic t-cell lymphoma and other malignancies, some fatal, have been reported among children, adolescents, and young adults who received treatment with tnf-blockers including adalimumab products [see warnings and precautions (5.2)] . juvenile idiopathic arthritis in study jia-i, adalimumab was shown to reduce signs and symptoms of active polyarticular jia in patients 4 to 17 years of age [see clinical studies (14.2)] . in study jia-ii, the safety profile for patients 2 to <4 years of age was similar to the safety profile for patients 4 to 17 years of age with polyarticular jia [see adverse reactions (6.1)] . adalimumab products have not been studied in patients with polyarticular jia less than 2 years of age or in patients with a weight below 10 kg. the safety of adalimumab in patients in the polyarticular jia trials was generally similar to that observed in adults with certain exceptions [see adverse reactions (6.1)] . the safety and effectiveness of adalimumab products have not been established in pediatric patients with jia less than 2 years of age. pediatric crohn's disease the safety and effectiveness of adalimumab products for the treatment of moderately to severely active crohn's disease have been established in pediatric patients 6 years of age and older. use of adalimumab products for this indication is supported by evidence from adequate and well-controlled studies in adults with additional data from a randomized, double-blind, 52-week clinical study of two dose concentrations of adalimumab in 192 pediatric patients (6 years to 17 years of age) [see adverse reactions (6.1), clinical pharmacology (12.2, 12.3), clinical studies (14.6)] . the adverse reaction profile in patients 6 years to 17 years of age was similar to adults. the safety and effectiveness of adalimumab products have not been established in pediatric patients with crohn's disease less than 6 years of age. a total of 519 ra patients 65 years of age and older, including 107 patients 75 years of age and older, received adalimumab in clinical studies ra-i through iv. no overall difference in effectiveness was observed between these patients and younger patients. the frequency of serious infection and malignancy among adalimumab-treated patients 65 years of age and older was higher than for those less than 65 years of age. consider the benefits and risks of abrilada in patients 65 years of age and older. in patients treated with abrilada, closely monitor for the development of infection or malignancy [see warnings and precautions (5.1, 5.2)] . abrilada (ah brill-ah-dah) (adalimumab-afzb) 40 mg/0.8 ml single-dose prefilled pen injection, for subcutaneous (under the skin) use keep this leaflet. these instructions show step by step directions on how to prepare and give an injection. storage information: keep abrilada, injection supplies, and all other medicines out of the reach of children. abrilada for injection comes in a disposable (throw away) single-use pen that contains a single dose of medicine. abrilada for injection can be given by a patient, caregiver or healthcare provider. do not try to inject abrilada yourself until you are shown the right way to give the injections and read and understand the instructions for use. if your healthcare provider decides that you or a caregiver may be able to give your injections of abrilada at home, you should receive training on the right way to prepare and inject abrilada. it is important that you read, understand, and follow these instructions so that you inject abrilada the right way. it is important to talk to your healthcare provider to be sure you understand your abrilada dosing instructions. to help you remember when to inject abrilada, you can mark your calendar ahead of time. call your healthcare provider if you or your caregiver have any questions about the right way to inject abrilada. step 1. supplies you need step 2. getting ready   questions and answers what should i do with my pen if it has been dropped? do not use it, even if it looks undamaged. dispose of your pen in the same way as a used pen. you will need to use a new pen to give your injection. can i use my pen straight from the refrigerator? yes, however you may find that using the pen at room temperature reduces stinging or discomfort. if you allow your pen to reach room temperature before use, you must keep it away from direct sunlight as this can damage your medicine. what should i do if i need to travel? when you are traveling, you may store your pen in its carton at room temperature up to 86°f (30°c) for up to 30 days. is it okay to shake my pen before i use it? no, do not shake your pen. shaking can damage your medicine. when you check your medicine, gently tilt your pen back and forth while looking carefully into the window. it is normal to see one or more air bubbles. do i need to remove any air bubbles before using my pen? no, do not attempt to remove air bubbles. drops of medicine have appeared at the needle tip. is this okay? yes, it is normal to see a few drops of medicine at the needle tip when you remove the cap. can i re-insert the needle if i change my mind where i want to inject? no, you should not re-insert the needle into your skin. if you change your mind, you will need a replacement pen if the needle has already been inserted into the skin. after the injection button has been pressed, you must not lift your pen from the skin until the injection has finished. i pushed my pen against the skin but could not press the button down. what should i do? take your finger off the injection button and push your pen down more firmly against the skin. then try pushing the button again. if this does not work, stretching the skin may make the injection site firmer, making pressing the injection button easier. can i pinch or stretch the skin at the injection area? yes, pinching or stretching the skin before injection may make the injection site firmer, making it easier to press the injection button. do i need to keep my finger pressed on the injection button for the whole injection? no, you can stop pressing the button when the injection has started. however, make sure you keep holding the pen firmly against the skin. the pen will continue to deliver your medicine. how long will the injection take? from the time the dose begins until you hear the 2nd click, it usually takes 3 to 10 seconds. after the 2nd click, you should continue to hold your pen in place for at least 5 more seconds to make sure you give the full dose. what should i do if i see more than a small drop of medicine on the skin after giving my injection? nothing this time, but for your next injection wait a little longer before removing the pen from the skin to make sure all of the medicine went into your skin. what should i do if i have any questions about my abrilada pen or medicine? contact your healthcare provider or pharmacist. this instructions for use has been approved by the u.s. food and drug administration. manufactured by pfizer inc. new york, ny 10001 distributed by pfizer labs division of pfizer inc. new york, ny 10001 us license no. 2001 lab-1352-3.0 revised: 06/2023 abrilada (ah brill-ah-dah) (adalimumab-afzb) 10 mg/0.2 ml, 20 mg/0.4 ml, 40 mg/0.8 ml single-dose prefilled syringe injection, for subcutaneous (under the skin) use only keep this leaflet. these instructions show step by step directions on how to prepare and give an injection. storage information: keep abrilada, injection supplies, and all other medicines out of the reach of children. abrilada for injection comes in a disposable (throw away) single use prefilled syringe that contains a single dose of medicine. abrilada for injection can be given by a patient, caregiver or healthcare provider. do not try to inject abrilada yourself until you are shown the right way to give the injections and read and understand the instructions for use. if your healthcare provider decides that you or a caregiver may be able to give your injections of abrilada at home, you should receive training on the right way to prepare and inject abrilada. it is important that you read, understand, and follow these instructions so that you inject abrilada the right way. it is important to talk to your healthcare provider to be sure you understand your abrilada dosing instructions. to help you remember when to inject abrilada, you can mark your calendar ahead of time. call your healthcare provider if you or your caregiver have any questions about the right way to inject abrilada. step 1. supplies you need step 2. getting ready wash your hands with soap and water, and dry completely. if you have any questions about your medicine, please contact your healthcare provider or pharmacist.   questions and answers what should i do with my prefilled syringe if it has been dropped? do not use it if it has been dropped or the carton containing your prefilled syringe has been dropped even if it looks undamaged. dispose of your prefilled syringe in the same way as a used prefilled syringe. you will need to use a new prefilled syringe to give your injection. can i use my prefilled syringe straight from the refrigerator? yes, however you may find that using the prefilled syringe at room temperature reduces stinging or discomfort. if you allow your prefilled syringe to reach room temperature before use, you must keep it away from direct sunlight as this can damage your medicine. what should i do if i need to travel? when you are traveling, you may store your prefilled syringe in its carton at room temperature up to 86°f (30°c) for up to 30 days. is it okay to shake my prefilled syringe before i use it? no, do not shake your prefilled syringe. shaking can damage your medicine. when you check your medicine, gently tilt your syringe back and forth while looking carefully into the window. it is normal to see one or more bubbles. do i need to remove any air bubbles before using my prefilled syringe? no, do not attempt to remove air bubbles. drops of medicine have appeared at the needle tip. is this okay? yes, it is normal to see a few drops of medicine at the needle tip when you remove the needle cover. can i re-insert the needle into my skin? no, you should not re-insert the needle into the skin. you will need a replacement prefilled syringe if the needle has already been inserted into the skin. how long will the injection take? dose delivery will take approximately 2 to 5 seconds. remember to hold your prefilled syringe in place for at least 5 seconds after the plunger has been pushed down all the way. what should i do if i have any questions about my prefilled syringe or medicine? contact your healthcare provider or pharmacist. this instructions for use has been approved by the u.s. food and drug administration. manufactured by pfizer inc. new york, ny 10001 distributed by pfizer labs division of pfizer inc. new york, ny 10001 us license no. 2001 lab-1353-3.0 revised: 06/2023

Israel - English - Ministry of Health

bristol, myers squibb (israel) limited, israel - abatacept - powder for concentrate for solution for infusion - abatacept 250 mg - abatacept - abatacept - orencia is indicated for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active rheumatoid arthritis. orencia may be used as monotherapy or concomitantly with disease-modifying antirheumatic drugs (dmards) other than tumor necrosis factor (tnf) antagonists. polyarticular juvenile idiopathic arthritis: orencia in combination with methotrexate is indicated for the treatment of moderate to severe active polyarticular juvenile idiopathic arthritis (jia) in paediatric patients 6 years of age and older who have had an insufficient response to other dmards including at least one tnf inhibitor. orencia has not been studied in children under 6 years old.orencia is indicated for the treatment of adult patients with active psoriatic arthritis (psa).orencia is indicated for the prophylaxis of acute graft versus host disease (agvhd), in combination with a calcineurin inhibitor and methotrexate, in adults and pediatric patients 6 years of age or older undergoing hematopoietic stem cell transplantation (hsct) from a matched or 1 allele-mismatched unrelated-donor.

Israel - English - Ministry of Health

bristol, myers squibb (israel) limited, israel - abatacept - solution for injection - abatacept 125 mg/ml - abatacept - abatacept - orencia is indicated for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active rheumatoid arthritis. orencia may be used as monotherapy or concomitantly with disease-modifying antirheumatic drugs (dmards) other than tumor necrosis factor (tnf) antagonists.orencia is indicated for the treatment of adult patients with active psoriatic arthritis (psa).

Australia - English - Department of Health (Therapeutic Goods Administration)

janssen-cilag pty ltd - golimumab, quantity: 100 mg/ml - injection, solution - excipient ingredients: sorbitol; histidine; polysorbate 80; water for injections - simponi,rheumatoid arthritis (ra),simponi, in combination with methotrexate, is indicated for:,the treatment of moderate to severely active rheumatoid arthritis in adult patients when the response to disease-modifying anti-rheumatic drug therapy, including methotrexate, has been inadequate. simponi has also been shown to inhibit the progression of joint damage as measured by x-ray.,psoriatic arthritis (psa),simponi, alone or in combination with methotrexate, is indicated for:,the treatment of active and progressive psoriatic arthritis in adult patients when the response to previous disease-modifying anti-rheumatic drug therapy has been inadequate. simponi has also been shown to inhibit the progression of peripheral joint damage as measured by x-ray in patients with polyarticular symmetrical subtypes of the disease, and improve physical function.,axial spondyloarthritis,ankylosing spondylitis (as),simponi is indicated for:,the treatment of active ankylosing spondylitis in adult patients. non-radiographic axial spondyloarthritis (nr-axial spa),simponi is indicated for the treatment of adults with active non-radiographic axial spondyloarthritis with objective signs of inflammation as indicated by elevated c-reactive protein (crp) and/or magnetic resonance imaging (mri) evidence, who have had an inadequate response to, or are intolerant to, nonsteroidal anti-inflammatory drugs (nsaids).,ulcerative colitis (uc),simponi is indicated for: the treatment of moderately to severely active ulcerative colitis in adult patients who have had an inadequate response to conventional therapy. patients should show a clinical response within 6 weeks of treatment to continue treatment beyond that time (see section 5.1 pharmacodynamic properties, clinical trials).