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Cimzia Side Effects

Generic name: certolizumab

Medically reviewed by Philip Thornton, DipPharm. Last updated on Apr 6, 2023.

Note: This document contains side effect information about certolizumab. Some dosage forms listed on this page may not apply to the brand name Cimzia.

Applies to certolizumab: subcutaneous powder for solution, subcutaneous solution.


Subcutaneous route (Powder for Solution; Solution)

Serious Infections-Patients treated with certolizumab pegol are at increased risk for developing serious infections that may lead to hospitalization or death. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids.Certolizumab pegol should be discontinued if a patient develops a serious infection or sepsis.Reported infections include:Active tuberculosis, including reactivation of latent tuberculosis. Patients with tuberculosis have frequently presented with disseminated or extrapulmonary disease. Patients should be tested for latent tuberculosis before certolizumab pegol use and during therapy. Treatment for latent infection should be initiated prior to certolizumab pegol use.Invasive fungal infections, including histoplasmosis, coccidioidomycosis, candidiasis, aspergillosis, blastomycosis, and pneumocystosis. Patients with histoplasmosis or other invasive fungal infections may present with disseminated, rather than localized disease. Antigen and antibody testing for histoplasmosis may be negative in some patients with active infection. Empiric anti-fungal therapy should be considered in patients at risk for invasive fungal infections who develop severe systemic illness.Bacterial, viral and other infections due to opportunistic pathogens, including Legionella and Listeria.The risks and benefits of treatment with certolizumab pegol should be carefully considered prior to initiating therapy in patients with chronic or recurrent infection.Patients should be closely monitored for the development of signs and symptoms of infection during and after treatment with certolizumab pegol, including the possible development of tuberculosis in patients who tested negative for latent tuberculosis infection prior to initiating therapy.Malignancy-Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with TNF blockers, of which certolizumab pegol is a member. certolizumab pegol is not indicated for use in pediatric patients.

Serious side effects of Cimzia

Along with its needed effects, certolizumab (the active ingredient contained in Cimzia) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking certolizumab:

More common

  • Bladder pain
  • bloody or cloudy urine
  • body aches or pain
  • chills
  • cough
  • difficult, burning, or painful urination
  • difficulty with breathing
  • ear congestion
  • fever
  • frequent urge to urinate
  • headache
  • hoarseness
  • loss of voice
  • lower back or side pain
  • nasal congestion
  • runny nose
  • sneezing
  • sore throat
  • unusual tiredness or weakness

Less common

  • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • chest pain
  • frequent urination
  • pain in the arms, ankles, knees, or legs
  • painful, red lumps under the skin, mostly on the legs
  • rapid weight gain
  • stomach pain
  • tingling of the hands or feet
  • tightness in the chest
  • unusual weight gain or loss


  • Blurred vision
  • confusion
  • coughing or spitting up blood
  • diarrhea
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fainting
  • feeling of warmth
  • general feeling of discomfort, illness, or weakness
  • itching, skin rash
  • joint pain or swelling
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • loss of appetite
  • muscle aches
  • nausea
  • night sweats
  • redness of the face, neck, arms, and occasionally, upper chest
  • sudden high fever or low-grade fever for months
  • sweating
  • swelling of the lymph glands
  • weakness

Incidence not known

  • Blistering, peeling, or loosening of the skin
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • red, scaling, or crusted skin
  • sores, ulcers, or white spots in the mouth or on the lips

Other side effects of Cimzia

Some side effects of certolizumab may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Difficulty with moving
  • muscle pain or stiffness

Less common

  • Vomiting

For Healthcare Professionals

Applies to certolizumab: subcutaneous kit.


Uncommon (0.1% to 1%): Vasculitides, lupus erythematosus

Rare (less than 0.1%): Angioneurotic edema, sarcoidosis, serum sickness, panniculitis (including erythema nodosum)

Rare (less than 0.1%): Opportunistic infections, sepsis, tuberculosis, and fungal infections (candidiasis, histoplasmosis, pneumocystosis)

Frequency not reported: Viral infections (herpes, papillomavirus, influenza), pneumonia, tuberculosis, cellulitis, pyelonephritis bacterial and viral infections, positive ANA titers[Ref]


Common (1% to 10%): Hypertension

Uncommon (0.1% to 1%): Cardiomyopathies (including heart failure), ischemic coronary artery disorders, arrhythmias (including atrial fibrillation), palpitations, hypercoagulation (including thrombophlebitis, pulmonary embolism), edema (including peripheral, facial), ecchymoses (including hematoma, petechiae)

Frequency not reported: Angina pectoris, myocardial infarction, pericardial effusion, stroke

Rare (less than 0.1%): Pericarditis, atrioventricular block, cerebrovascular accident, arteriosclerosis, Raynaud's phenomenon, livedo reticularis, telangiectasia

Postmarketing reports: Systemic vasculitis[Ref]


Common (1% to 10%): Upper respiratory tract infection, nasopharyngitis, pharyngitis, acute bronchitis, pneumonia, inflammation

Uncommon (0.1% to 1%): Asthma, pleural effusion, respiratory tract congestion, lower respiratory tract infection, oropharyngeal dryness, cough

Rare (less than 0.1%): Interstitial lung disease, pneumonitis[Ref]


Common (1% to 10%): Rash

Uncommon (0.1% to 1%): Alopecia, new onset or worsening of psoriasis (including palmoplantar pustular psoriasis) and related conditions, dermatitis and eczema, sweat gland disorder, skin ulcer, photosensitivity, acne, skin discoloration, dry skin, nail and nail bed disorders skin injuries

Rare (less than 0.1%): Skin exfoliation and desquamation, bullous conditions, hair texture disorder

Frequency not reported: Cellulitis, erythema nodosum, urticaria, pruritus

Postmarketing reports: Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme[Ref]


Common (1% to 10%): Urinary tract infections, pyelonephritis

Uncommon (0.1% to 1%): Menstrual cycle and uterine bleeding disorders (including amenorrhea), breast disorders, hematuria, bladder symptoms, urethral symptoms

Rare (less than 0.1%): Sexual dysfunction[Ref]


Common (1% to 10%): Eosinophilic disorders, leukopenia (including neutropenia, lymphopenia)

Uncommon (0.1% to 1%): Anemia, lymphadenopathy, thrombocytopenia, thrombocytosis, blood alkaline phosphatase increased, coagulation time prolonged

Rare (less than 0.1%): Pancytopenia, splenomegaly, erythrocytosis, white blood cell morphology abnormal, ancytopenia (including aplastic anemia), erythrocytosis

Frequency not reported: Thrombophilia, hemorrhage, hypercoagulation, hematoma, blood uric acid increased, blood bilirubin increased[Ref]


Common (1% to 10%): Hepatitis (including hepatic enzyme increased)

Uncommon (0.1% to 1%): Hepatopathy (including cirrhosis), cholestasis

Rare (less than 0.1%): Reactivation of hepatitis B virus (HBV), including fatalities

Frequency not reported: Elevated liver enzymes[Ref]


Uncommon (0.1% to 1%): Drug hypersensitivity (including anaphylactic shock), allergic disorders, auto-antibody positive, angioedema, allergic dermatitis, dizziness (postural), dyspnea, hot flush, hypotension, (vasovagal) syncope, autoantibody positive[Ref]


Common (1% to 10%): Conjunctivitis

Uncommon (0.1% to 1%): Visual disorder (including decreased vision), eye and eyelid inflammation, lacrimation disorder, optic neuritis

Frequency not reported: Retinal hemorrhage, uveitis[Ref]


Uncommon (0.1% to 1%): Blood and lymphatic system malignancies (including lymphoma and leukemia), solid organ tumors, non-melanoma skin cancers, pre-cancerous lesions (including oral leukoplakia, melanocytic nevus), benign tumors, cysts (including skin papilloma)

Rare (less than 0.1%): Gastrointestinal tumors, melanoma

Frequency not reported: Merkel cell carcinoma[Ref]


Uncommon (0.1% to 1%): Anxiety, mood disorders (including associated symptoms), restlessness

Rare (less than 0.1%): Suicide attempt, delirium, mental impairment, bipolar disorder[Ref]


Uncommon (0.1% to 1%): Renal impairment

Rare (less than 0.1%): Nephropathy (including nephritis)[Ref]


Common (1% to 10%): Back pain, arthralgia, muscle spasms, pain in extremity

Uncommon (0.1% to 1%): Muscle disorders, blood creatine phosphokinase increased[Ref]


Common (1% to 10%): Abdominal pain (including upper abdominal pain), diarrhea, dyspepsia, gastritis, nausea

Uncommon (0.1% to 1%): Ascites, gastrointestinal infections, abdominal distension, gastrointestinal fistula, odynophagia, oropharyngeal dryness, hypermotility, splenomegaly, pancreatitis, dental infections, gastrointestinal ulceration and perforation, gastrointestinal tract inflammation (any site), stomatitis

Rare (less than 0.1%): Gastrointestinal stenosis, gastrointestinal obstruction[Ref]

Nervous system

Common (1% to 10%): Headaches (including migraine), sensory abnormalities

Uncommon (0.1% to 1%): Peripheral neuropathies, dizziness, tremor, vertigo, acoustic neuritis, trigeminal neuralgia, Raynaud's phenomenon, cranial nerve inflammation, cranial nerve impairment, dysesthesia, paresthesia

Rare (less than 0.1%): Seizure, exacerbation of clinical symptoms and/or radiographic evidence of central nervous system demyelinating disease, including multiple sclerosis, and with peripheral demyelinating disease, including Guillain-Barre syndrome[Ref]


Common (1% to 10%): Pyrexia, fatigue, pain (any site), asthenia, pruritus (any site)

Uncommon (0.1% to 1%): Tinnitus, vertigo, chills, altered temperature perception, night sweats, flushing, impaired healing, malaise, ear infections

Rare (less than 0.1%): Fistula (any site)[Ref]


Uncommon (0.1% to 1%): Injection site reactions (erythema, itching, hematoma, pain, swelling, bruising)[Ref]


Uncommon (0.1% to 1%): Electrolyte imbalance, dyslipidemia, appetite disorders, weight change, electrolyte imbalance, increased alkaline phosphatase levels

Rare (less than 0.1%): Hemosiderosis[Ref]


Rare (less than 0.1%): Thyroid disorders[Ref]


The most commonly reported side effects were upper respiratory infection (18%), urinary tract infection (18%), and rash (9%)[Ref]

Frequently asked questions


1. Cerner Multum, Inc. UK Summary of Product Characteristics.

2. Cerner Multum, Inc. Australian Product Information.

3. Product Information. Cimzia (certolizumab). UCB Pharma Inc. 2008.

4. Certolizumab (Cimzia) for Crohn's disease. Med Lett Drugs Ther. 2008;50:81-2.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.