Cimzia Injection

What are Cimzia’s side effects?

Like most drugs, Cimzia may cause mild to serious side effects. The following lists contain some of the more common side effects the drug may cause, but don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Cimzia. They can also suggest ways to help reduce or manage them.

Mild side effects

Here’s a short list of some of the mild side effects Cimzia can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the drug’s prescribing information.

Mild side effects of Cimzia can include:

• skin rash
• urinary tract infection (UTI)
• respiratory infection
• hair loss*
• headache
• tiredness*

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information on this side effect, see the “Side effect focus” section.

Serious side effects

Serious side effects from Cimzia can occur, but they aren’t common. If you have serious side effects with this medication, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Serious side effects can include:

• reactivation of hepatitis B, if you already have the virus
• immune system reactions, such as lupus-like syndrome
• new or worsening heart failure*
• new or worsening nerve problems*
• kidney failure
• blood disorders
• boxed warnings: serious infection and cancer†
• allergic reaction†

* For more information on this side effect, see the “Are there any precautions when using Cimzia?” section.
† See the following “Side effect focus” section for more information.

Side effect focus

Learn more about some of the side effects Cimzia may cause.

Boxed warnings

Cimzia has boxed warnings for serious infection and cancer. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). They alert doctors and patients about drug effects that may be dangerous.

Serious infection: Cimzia reduces the activity of your immune system, which increases your risk of getting serious infections. These can include:

• tuberculosis (TB)
• sepsis (bacterial infection in your blood)
• fungal infections
• other rare infections

You may have a higher risk of infection during Cimzia treatment if you:

• are age 65 years or older
• are taking other drugs that decrease your immune system activity, such as corticosteroids or methotrexate
• have certain chronic (long-lasting) health conditions

Common symptoms of infections to watch for include:

• fever or chills
• sweating
• cough
• burning when you urinate
• muscle aches
• diarrhea

Cancer: Lymphoma (cancer of the lymph nodes) and other cancers have occurred in children and adolescents taking tumor necrosis factor (TNF) inhibitors, the group of drug Cimzia belongs to.

In addition, skin cancers have been identified in people using TNF inhibitors including Cimzia. Examples of these skin cancers include melanoma and Merkel cell carcinoma.

What might help

If you have any symptoms of infection during treatment with Cimzia, tell your doctor right away. They may have you stop treatment. But do not stop taking this medication without first talking with your doctor.

Your doctor will not prescribe Cimzia for you if you have an active infection. If you have frequent or long-lasting infections, your doctor will weigh the benefits and risks of Cimzia before prescribing it for you.

Throughout your Cimzia treatment, your doctor will check you regularly for infection. If you travel to or live in areas with a high risk of fungal infections, you may need to take an antifungal treatment to avoid a fungal infection.

Because TNF inhibitors increase the risk of cancer in children, Cimzia isn’t approved for use in people younger than 18 years of age, except for the treatment of active polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older.

During Cimzia treatment, it’s recommended that you check your skin regularly for any changes that may indicate skin cancer. If you have risk factors for skin cancer, having regular skin checks is especially important.

Be sure to talk with your doctor if you notice any changes in your skin’s appearance during or after treatment with Cimzia. These changes could include new growths or sores.

Tiredness

If you feel more tired than usual, it may be a side effect of Cimzia. But tiredness may also be a symptom of infection, and Cimzia has a warning about the risk of infection while receiving treatment. (For more information about this warning, see the “Boxed warnings” section.)

If you think you have an infection before, during, or after Cimzia treatment, tell your doctor right away.

What might help

Talk with your doctor if you’re feeling more tired than usual during Cimzia treatment. They may check whether you have an infection. If you do have an infection, they’ll prescribe medication to treat it. They may also have you temporarily stop Cimzia for a short time. But do not stop Cimzia treatment without first talking with your doctor.

If you don’t have an infection, your doctor may suggest ways to help boost your energy levels.

Hair loss

It’s possible to have hair loss with Cimzia. This side effect was seen in some people who had an immune system flare-up during studies of the drug. The type of hair loss seen is called alopecia totalis, which is a complete loss of all the hair on your head.

Studies show that hair loss is a rare side effect of TNF inhibitors such as Cimzia.

What might help

If you’re concerned about hair loss with Cimzia, talk with your doctor. And check out these tips on how to help prevent hair loss.

Allergic reaction

Some people may have an allergic reaction to Cimzia.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (temporary warmth, swelling, and redness or other skin discoloration)
• injection site reactions, such as bruising, pain, discoloration, and swelling

To view pictures of skin rashes, including those caused by drug allergies, see this article.

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin — typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat, which can make it difficult to breathe
• low blood pressure
• dizziness or fainting
• hot flashes
• fever

Also, Cimzia prefilled syringes contain materials that are similar to latex. So, if you’re allergic to latex, you may have an allergic reaction when handling these syringes. If you’re sensitive to latex, your doctor likely won’t prescribe Cimzia prefilled syringes for you.

Call your doctor right away if you have an allergic reaction to Cimzia. But if you think you’re having a medical emergency, call 911 or your local emergency number.

What is Cimzia’s dosage?

The following are commonly used dosages of Cimzia, but always follow the dosage your doctor prescribes. They’ll determine the dosage that’s right for you.

Forms and strength

Cimzia is given as an injection under your skin. The drug comes in two forms:

• a powder inside single-dose vials that’s mixed into a liquid solution
• a solution inside single-dose prefilled syringes

Each form comes in one strength of 200 milligrams (mg).

Recommended dosages

The dosage your doctor prescribes will depend on the condition you’re using Cimzia to treat.

Note: Certain Cimzia dosing schedules are determined based on body weight in kilograms (kg). For reference, 1 kg equals approximately 2.2 pounds (lb).

Dosage for plaque psoriasis

The recommended dosage of Cimzia for adults with moderate to severe plaque psoriasis is one 400-mg dose (2 subcutaneous injections of 200 mg each) every other week.

People with a body weight less than or equal to 90 kg (about 198 lb) may receive Cimzia 400 mg (2 subcutaneous injections of 200 mg each) at weeks 0, 2, and 4, followed by 200 mg every other week.

Dosage for Crohn’s disease

The recommended dosage of Cimzia for Crohn’s disease is one 400-mg dose (2 subcutaneous injections of 200 mg each) at weeks 0, 2, and 4. After those three doses, if your condition is responding to the drug, you’ll likely receive one 400-mg dose every 4 weeks.

Dosage for arthritis

The recommended dosage of Cimzia for rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, or axial spondyloarthritis, is 400 mg (2 subcutaneous injections of 200 mg each) at weeks 0, 2, and 4. This will be followed by either 200 mg every 2 weeks or 400 mg every 4 weeks.

Dosage for polyarticular juvenile idiopathic arthritis

The dosage of Cimzia for polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older is based on body weight in kg.

How to use Cimzia

You or your doctor will inject Cimzia under your skin.

If you’re giving the injections to yourself, you’ll use the prefilled syringes and a healthcare professional will show you how to administer the drug.

You’ll inject Cimzia into one of these areas on your body:

• your abdomen, 2 inches (5 centimeters [cm]) away from your belly button
• the front of your thigh

Each time you inject Cimzia, you should change the injection site, and each site should be at least 1 inch (2.5 cm) from the site you last used.

Taking Cimzia with other drugs

In some cases, your doctor may recommend that you take other medications with Cimzia. For example, if you have:

• plaque psoriasis, your doctor may prescribe Cimzia together with methotrexate.
• Crohn’s disease, your doctor may prescribe Cimzia together with certain other drugs. These include:
  • azathioprine
  • 6-mercaptopurine
  • methotrexate
• rheumatoid arthritis (RA), your doctor may prescribe Cimzia together with methotrexate if needed.
• psoriatic arthritis, Cimzia is usually prescribed alone. Using it with methotrexate is typically avoided unless you have severe psoriatic arthritis, in which case your doctor may consider prescribing these drugs together.
• stable ankylosing spondylitis or non-radiographic axial spondyloarthritis, Cimzia is usually prescribed without methotrexate. Your doctor may have you take nonsteroidal anti-inflammatory drugs (NSAIDs) with Cimzia, but you’d likely only take them together for a short time.
• polyarticular juvenile idiopathic arthritis (pJIA), Cimzia may be prescribed with methotrexate, glucocorticoids, and/or NSAIDs.

Also, for flare-ups of arthritis or Crohn’s disease, your doctor may have you take prednisone with Cimzia.

Questions about taking Cimzia

Here are answers to some questions related to Cimzia’s dosage.

• What if I miss a dose of Cimzia? If you miss an appointment to get a Cimzia injection from your doctor, call their office to reschedule. If you forget to inject Cimzia yourself, take the dose as soon as you remember, or call your doctor. They can tell you whether you should take the missed dose right away, or skip it and wait for your next dose. If you’re unsure when to inject your next dose after a missed dose, call your doctor to set up a new schedule for your injections.
• Will I need to use Cimzia long term? The conditions Cimzia treats are long lasting so you’ll likely use Cimzia long term. Talk with your doctor to find out how long you’ll need Cimzia treatment.
• Should I take Cimzia with food? You can inject Cimzia on an empty or a full stomach. Eating food doesn’t affect how much of the medication is absorbed by your body.
• How long does Cimzia take to work? Everyone may have a different experience with Cimzia treatment. Depending on the reason you’re using Cimzia, you may notice the drug working at different times. For example, in studies of people with Crohn’s disease, improvements were seen after 6 weeks of Cimzia treatment. In studies of people with RA, improvements were seen after 24 weeks of Cimzia treatment. But it’s possible to have improvements within a few weeks of starting treatment. Ask your doctor how long it should take Cimzia to work for your condition.

What is Cimzia used for?

Cimzia is prescribed to treat a number of long-term conditions. These include:

• Plaque psoriasis (PsO): With PsO, you have inflammation in your skin. You may have pink or dark-colored patches with scales. These may appear on your scalp, elbows, knees, and lower back. Any part of your body can be affected by PsO.
• Crohn’s disease (CD): CD is an inflammatory bowel disease (IBD) that can affect your entire digestive system. Most people with CD have inflammation in their intestines.
• Rheumatoid arthritis (RA): With RA, you have swollen, painful joints. Usually, you’ll have swelling in the small joints of your hands and the wrist. Other joints that may be affected by RA include the knees, ankles, elbows, shoulders, and hips.
• Psoriatic arthritis (PsA): With PsA, you have swelling in your joints and your skin. This condition shares many features of both RA and PSO.
• Ankylosing spondylitis (AS): AS is an inflammatory disease that affects the spine. People with AS usually have long-lasting lower back pain and stiffness in their spine.
• Non-radiographic axial spondyloarthritis: With nonradiographic axial spondyloarthritis, you have symptoms consistent with AS. But unlike AS, you don’t have inflammation on your lower spine that can be seen on radiographs (X-rays).
• Polyarticular juvenile idiopathic arthritis (pJIA): pJIA occurs when children under the age of 16 years develop arthritis in five or more joints, occurring most often in the hands and wrists.

Cimzia works for these conditions by blocking a protein called tumor necrosis factor (TNF). By blocking the action of TNF, this medication helps to reduce inflammation that leads to certain immune-related conditions.

What should I know about Cimzia vs. Humira?

Cimzia and Humira are both used to treat some of the same conditions. They have some of the same side effects and risks. But these drugs also have some differences.

To see a breakdown of how Cimzia and Humira are alike and different, view our “Cimzia vs. Humira” article.

What are some frequently asked questions about Cimzia?

Find answers to some commonly asked questions about Cimzia.

Does Cimzia cause weight gain or weight loss?

No, Cimzia doesn’t affect your weight. But if you get an infection during Cimzia treatment, you may lose weight.

Cimzia has a boxed warning about the risk of infection during treatment. (For more information about this warning, see “Boxed warnings” in the “What are Cimzia’s side effects?” section.) If you think you’ve had an infection before, during, or after receiving Cimzia, tell your doctor right away.

On the other hand, if you have unexpected weight gain with Cimzia, it could indicate fluid retention which can be a sign of heart failure. In rare cases, Cimzia has caused new or worsening heart failure.

If you’re concerned about your weight during Cimzia treatment, talk with your doctor. They can recommend ways to help you reach or maintain a moderate weight.

How does Cimzia work?

Cimzia works by affecting your immune system. It’s called a tumor necrosis factor (TNF) inhibitor. The drug works by blocking TNF, which is a protein that plays an important role in your immune system.

When TNF is overactive, it can cause conditions such as arthritis, plaque psoriasis, or Crohn’s disease. By blocking TNF, Cimzia helps to manage inflammation that occurs in diseases caused by your immune system.

How long does Cimzia stay in your system?

Cimzia typically stays in your body for about 10 weeks (70 days) after your most recent dose. This is based on the drug’s half-life, which is the time it takes for half of a dose to be cleared from your system. Cimzia’s half-life is approximately 14 days, and it takes about 5 half-lives for a drug to be fully cleared from your body.

Talk with your doctor or a pharmacist if you have more questions about how long Cimzia stays in your system.

Is Cimzia similar to Enbrel?

Cimzia and Enbrel are both biologic drugs. These drugs work by blocking the action of an immune system protein called TNF.

You’ll receive either Cimzia or Enbrel as an injection under your skin.

Both Cimzia and Enbrel may be prescribed in certain people for:

• plaque psoriasis
• rheumatoid arthritis
• psoriatic arthritis
• ankylosing spondylitis
• polyarticular juvenile idiopathic arthritis

In addition, Cimzia can be used for Crohn’s disease and non-radiographic spondyloarthritis. And Enbrel can be used in certain children for juvenile psoriatic arthritis.

It’s important to note that Cimzia has a warning about the risk of cancer, which has been found in children receiving the drug. (For more information, see “Boxed warnings” in the “What are Cimzia’s side effects?” section.)

If you’d like to know more about these drugs, talk with your doctor or pharmacist.

What are Cimzia’s interactions?

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before starting Cimzia, tell your doctor about all medications you take, including prescription and over-the-counter (OTC) types. Also describe any herbs, vitamins, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Cimzia.

Interactions with drugs or supplements

Cimzia can interact with several types of drugs. This includes other biologic drugs such as:

• anakinra (Kineret)
• abatacept (Orencia)
• rituximab (Rituxan)
• natalizumab (Tysabri)

This list does not contain all types of drugs that may interact with Cimzia. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Cimzia.

Other interactions

Cimzia may also interact with vaccines and affect the results of certain lab tests. Read on to learn more.

Cimzia and live vaccines

Cimzia may make some vaccines less effective than usual. This happens because Cimzia reduces the activity of your immune system. When you get a vaccine, you need your immune system to respond to it. But during Cimzia treatment, your immune system can’t respond like it usually would.

You should also not get any live vaccines during Cimzia treatment. Live vaccines are made from living germs and with your immune system being less active than usual, a live vaccine could cause you to get the infection the vaccine was meant to protect you from.

Examples of live vaccines include:

• yellow fever
• chickenpox
• measles, mumps, rubella (MMR)
• intranasal (nasal spray) form of the flu vaccine

Before getting any vaccines, talk with your doctor. They can make sure it’s safe for you to have the vaccine with Cimzia.

Cimzia and lab tests

Cimzia may interfere with the results of lab tests called coagulation tests. These blood tests check how well your body forms blood clots.

If you have these tests while receiving Cimzia treatment, they may show abnormalities. This can happen even if you don’t have a problem with your blood’s clotting ability.

Before having any blood tests, be sure to tell your doctor that you’re receiving Cimzia treatment.

Are there any precautions when using Cimzia?

Like many other medications, Cimzia has precautions provided by its manufacturer. Before starting this medication, talk with your doctor to make sure it’s the right treatment for you.

Boxed warnings

Cimzia has boxed warnings about serious infection and cancer. A boxed warning is the most serious warning from the FDA.

Serious infection: Some people may develop a serious infection during Cimzia treatment. Serious infections may include tuberculosis (TB), sepsis (bacterial infection in your blood), fungal, viral, and parasitic infections, and other rare infections. Be sure to tell your doctor if you have a current infection or history of infections.

Cancer: Cimzia may increase your risk of blood cancers and skin cancer. Tell your doctor if you currently have or have a history of lymphoma or other cancer.

For more information about these warnings, see “Boxed warnings” in the “What are Cimzia’s side effects?” section.

Other warnings

Cimzia may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting this medication. Factors to consider include those listed here.

• Reactivation of hepatitis B: Before prescribing Cimzia, your doctor will check whether you have hepatitis B. (It’s possible to have hepatitis B without any symptoms.) If you test positive for this infection, your doctor may prescribe medication to treat it before having you start Cimzia. They’ll monitor you for hepatitis B throughout your Cimzia treatment, and for several months after you’ve stopped treatment. If your hepatitis B infection comes back, your doctor will have you stop Cimzia and prescribe medication to treat the infection. But do not stop Cimzia treatment without first talking with your doctor.
• Blood abnormalities: Cimzia can cause blood disorders as a side effect. If you currently have or have had abnormal blood test results, be sure to talk with your doctor about this. They can determine whether Cimzia treatment is safe for you.
• Allergic reaction: If you’ve had an allergic reaction to Cimzia or any of its ingredients, your doctor won’t prescribe this medication for you. Ask them about other treatments that may be better options for you.
• Heart failure: Cimzia may cause new or worsening heart failure. If you already have heart failure, your doctor will weigh the benefits and risks of prescribing Cimzia for you. If you have any problems with your heart during Cimzia treatment, call your doctor right away.
• Nerve reactions: Cimzia may cause certain nerve diseases or worsen existing ones. These include multiple sclerosis, Guillain-Barré syndrome, seizures, optic neuritis, and peripheral neuropathy. If you have problems with your nerves, ask your doctor if Cimzia is right for you. And if you have any seizures or other symptoms related to your brain, spinal cord, or nerves, tell your doctor right away.
• Rubber or latex allergies: Part of the single-dose prefilled syringe is made of a material similar to natural rubber latex. Handling the syringe could cause an allergic reaction if you are sensitive to latex. Tell your doctor if you have a latex allergy.
• Recent or upcoming vaccines: Getting a live vaccine right before or during Cimzia treatment can cause serious infection. Live vaccines contain a weakened form of the virus or bacteria they’re meant to protect against. Cimzia weakens your immune system which means it may not be able to fight the virus or bacteria effectively. Tell your doctor if you’ve recently had a live vaccine or have one scheduled.

Can I consume alcohol during Cimzia treatment?

Some medications interact with alcohol. Although Cimzia isn’t one of them, medicines you may take with Cimzia could interact with alcohol.

For example, methotrexate is sometimes prescribed with Cimzia and can injure your liver — as does drinking a lot of alcohol. Because of this, if you drink alcohol, you should avoid it while taking methotrexate with Cimzia.

To be safe, before starting Cimzia, ask your doctor or pharmacist if it’s safe for you to drink alcohol based on your treatment plan.

Cimzia and pregnancy and breastfeeding

If you can become pregnant or are breastfeeding, it’s important to consider whether Cimzia is a safe choice for you.

You can refer to this article for more information. If you have other questions, talk with your doctor.

What does Cimzia cost?

Costs of prescription drugs can vary depending on many factors, including what your insurance plan covers and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Cimzia manufacturer’s website to see support options.

What should be done in case of overdose?

Do not inject more Cimzia than your doctor prescribes, as this can lead to serious side effects. If you inject too much Cimzia, you doctor may closely monitor you for signs and symptoms of overdose.

What to do in case you inject too much Cimzia

Call your doctor if you think you’ve injected too much Cimzia. You can also call 800-222-1222 to reach America’s Poison Centers, or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

What to ask your doctor

If you have questions about taking Cimzia, talk with your doctor or pharmacist. Your doctor can tell you about other treatments available for your condition.

Some questions to ask your doctor about using Cimzia may include:

• Which creams can I use with Cimzia for my plaque psoriasis?
• How can I boost my immune system to prevent getting a cold or flu while taking Cimzia?
• How should I store Cimzia if I’m traveling on a plane?
• What should I do if the solution in the Cimzia prefilled syringe is cloudy?

To learn more about Cimzia, see these articles:

• Cimzia and Cost: What You Need to Know
• Cimzia Interactions: Alcohol, Medications, and Others
• Dosage Details for Cimzia
• Side Effects of Cimzia: What You Need to Know

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.