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Humira (adalimumab) Disease Interactions

There are 8 disease interactions with Humira (adalimumab):

Major

Tnf Blocking Agents (Includes Humira) ↔ Malignancies

Severe Potential Hazard, Moderate plausibility

Applies to: Skin Cancer, History - Skin Cancer, Lymphoma

In clinical trials malignancies have been observed in patients receiving TNF-blockers agents. Psoriasis patients should be monitored for nonmelanoma skin cancers (NMSCs), particularly those patients who have had prior prolonged phototherapy treatment. Melanoma and Merkel cell carcinoma have been reported in patients treated with TNF blocker therapy. Periodic skin examination is recommended for all patients, particularly those with risk factors for skin cancer. Postmarketing cases of fatal hepatosplenic T-cell lymphoma (HSTCL) have been reported in patients treated with TNF blockers. Caution should be exercised in considering these agents in the treatment of patients with a history of malignancy or in continuing treatment in patients who develop malignancy while receiving these agents.

Major

Tnf Blocking Agents (Includes Humira) ↔ Neurologic Reactions

Severe Potential Hazard, Moderate plausibility

Applies to: Optic Nerve Disorder, Multiple Sclerosis, Seizures, Vasculitis, Guillain-Barre Syndrome, CNS Disorder

The use of TNF blocking agents has been associated with rare cases of CNS manifestations of systemic vasculitis, seizure and new onset or exacerbation of clinical symptoms and/or radiographic evidence of central nervous system demyelinating disorders, including multiple sclerosis and optic neuritis, and peripheral demyelinating disorders, including Guillain-Barré syndrome. Care should be exercised when considering the use of these agents in patients with neurologic disorders and discontinuing the agent is recommended if these disorders develop during therapy.

Major

Tnf Blocking Agents (Includes Humira) ↔ Tuberculosis

Severe Potential Hazard, Moderate plausibility

Applies to: Tuberculosis -- Active, Tuberculosis -- Latent

Cases of reactivation of tuberculosis or new tuberculosis infections have been observed in patients receiving TNF blocking agents, including patients who have previously received treatment for latent or active tuberculosis. Cases of active tuberculosis have also occurred in patients being treated with these agents during treatment for latent tuberculosis. Prior to initiating TNF blocking agents, patients should be screened for latent tuberculosis infection with a tuberculin skin test and periodically during therapy. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy with TNF blocking agents. Anti-tuberculosis therapy should also be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection. Tuberculosis should be strongly considered in patients who develop a new infection during infliximab treatment, especially in patients who have previously or recently traveled to countries with a high prevalence of tuberculosis, or who have had close contact with a person with active tuberculosis.

Moderate

Adalimumab (Includes Humira) ↔ Chf

Moderate Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure

Cases of worsening congestive heart failure (CHF) and new onset CHF have been reported with TNF blockers. Cases of worsening CHF have also been observed with adalimumab. Adalimumab has not been formally studied in patients with CHF; however, in clinical trials of another TNF blocker, a higher rate of serious CHF-related adverse reactions was observed. Exercise caution when using adalimumab in patients who have heart failure and monitor them carefully.

Moderate

Adalimumab (Includes Humira) ↔ Copd

Moderate Potential Hazard, Moderate plausibility

Applies to: Chronic Obstructive Pulmonary Disease

In controlled trials of other TNF blockers, other than adalimumab, in adult patients at higher risk for malignancies (i.e., patients with COPD with a significant smoking history and cyclophosphamide-treated patients with Wegener's granulomatosis), a greater portion of malignancies occurred in the TNF blocker group compared to the control group.

Moderate

Adalimumab (Includes Humira) ↔ Hepatitis B

Moderate Potential Hazard, Moderate plausibility

Applies to: Infectious Hepatitis

Adalimumab , has been associated with reactivation of hepatitis B, in some cases fatal, in patients who were previously infected with the hepatitis B virus (HBV) and had received concomitant TNF-blocking agents. Therefore, screening for viral hepatitis should be performed in accordance with published guidelines before starting therapy with adalimumab. Monitor patients at risk or with evidence of current or prior HBV infection for clinical and laboratory signs of hepatitis or HBV reactivation. Prescribers should exercise caution in prescribing TNF blockers in patients previously infected with HBV. Monitor patients with evidence of current or prior HBV infection for clinical and laboratory signs of hepatitis or HBV reactivation during and for several months following adalimumab therapy. In patients who develop HBV reactivation, stop adalimumab and initiate anti-viral therapy with appropriate supportive treatment. The safety of resuming adalimumab therapy after HBV reactivation is controlled is not known. Therefore, prescribers should weigh the risks and benefits when considering resumption of therapy.

Moderate

Tnf Blocking Agents (Includes Humira) ↔ Hematologic Abnormalities

Moderate Potential Hazard, Moderate plausibility

Applies to: Anemia, Neutropenia, Thrombocytopenia, Bone Marrow Depression/Low Blood Counts, History - Blood Dyscrasias, Pancytopenia

Cases of leukopenia, neutropenia, thrombocytopenia, and pancytopenia, some with a fatal outcome, have been reported in patients treated with TNF blocking agents. Caution should be exercised when treating patients who have ongoing or a history of significant hematologic abnormalities. Discontinuation of therapy should be considered in patients with confirmed significant hematologic abnormalities.

Moderate

Adalimumab (Includes Humira) ↔ Infections

Minor Potential Hazard, Moderate plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral, Sepsis

There have been reports of serious infections, including sepsis and opportunistic infections due to bacterial, mycobacterial, invasive fungal, viral, parasitic, or other opportunistic pathogens including aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, histoplasmosis, legionellosis, listeriosis, pneumocystosis and tuberculosis with TNF blockers. Treatment with adalimumab should not be initiated in patients with an active infection, including clinically important localized infections. Caution and close monitoring is recommended when considering the use of adalimumab in patients with a history of recurrent infections, underlying conditions which may predispose them to infections, or chronic, latent, or localized infections. Administration of adalimumab should be discontinued if a patient develops a serious infection or sepsis.

Humira (adalimumab) drug Interactions

There are 459 drug interactions with Humira (adalimumab)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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