Alternate Name(s):
HULIO
Classification:
Disease-modifying Antirheumatic drug, Tumor Necrosis Factor (TNF) - Blocking agent
Original Date:
September 2008
Revised Date:
September 2023
Indications:
- Active rheumatoid arthritis (moderate-severe) and active psoriatic arthritis; may be used alone or in combination with disease-modifying antirheumatic drugs (DMARDs)
- Ankylosing spondylitis
- Active Crohn's disease (moderate - severe) in patients with inadequate response to conventional treatment, or patients who have lost response to or are intolerant of infliximab
- Juvenile idiopathic arthritis (moderate - severe)
Reconstitution and Stability:
- Available as 20 mg/0.4 mL and 40 mg/0.8 mL prefilled syringe and 40 mg/0.8 mL pen-injector
- Refrigerate - do not freeze
- Protect from light
- Needle and cap are NOT made with natural rubber latex
Compatibility:
-Solutions Compatible: No Information
-Additives/Above Cassette Compatible: No information
-Y-site Compatible: No information
Incompatible: No information
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | YES Rotate injection sites. Do not administer to skin which is red,tender,bruised, or hard |
| IM | NO |
| IV Push | NO |
| IV Intermittent Infusion | NO |
| IV Continuous Infusion | NO |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric:
- Juvenile idiopathic arthritis: Children >4 years
- 15 kg to <30 kg: 20 mg every other week
- >30 kg: 40 mg every other week
Adults:
-Rheumatoid arthritis:
- 40 mg every other week; may be administered with other DMARDs; patients not taking methotrexate may increase dose to 40 mg every week
-Ankylosing spondylitis, psoriatic arthritis:
- 40 mg every other week
-Crohn's disease:
- Initial: 160 mg given as 4 injections on day 1 or over 2 days, then 80 mg 2 weeks later (day 15); Maintenance: 40 mg every other week beginning day 29
Potential hazards of parenteral administration:
- Local reactions: erythema, itching, hemorrhage, pain, swelling
- Headache, nausea, abdominal pain, flu-like symptoms
- Allergic reactions: rash , anaphylaxis (rare) -medications for treatment of hypersensitivity reactions should be available for immediate use
- Increased susceptibility to infections including tuberculosis, invasive fungal infections, & other opportunistic infections (Histoplasma, Aspergillus, & Nocardia)
- Rare cases of autoimmune disorder, including lupus-like syndrome reported
Notes:
- Perform tuberculin skin test prior to initiating therapy
- DO NOT administer live vaccines concurrently - bring immunizations up to date before initiating therapy
- Use with caution in patients with chronic infection, history of recurrent infection or predisposition to infection. DO NOT give to patients with active chronic or localized infection, monitor closely if a new infection develops while on treatment, and discontinue treatment if a serious infection or lupus-like syndrome develops