Humira (Adalimumab) - Subcutaneous

Warning:

Humira (adalimumab) can increase the risk of serious infection, including tuberculosis (TB, a disease mainly affecting the lungs), bacterial sepsis (a serious, life-threatening reaction to an infection), and invasive fungal infections. Before starting Humira, your healthcare provider may test you for latent TB (this is when you have TB bacteria in your body, but it is not active) and monitor for active TB while you’re taking it.

The FDA also warns about the risk of developing lymphoma and some other cancers in children and adolescents treated with TNF blockers, such as Humira

What Is Humira?

Humira (adalimumab) is an injectable drug used to treat Crohn's disease, plaque psoriasis, ulcerative colitis, and some types of arthritis. It also treats uveitis, and a skin problem called hidradenitis suppurativa. You can get Humira in prefilled syringes, prefilled pens, and vials. 

Adalimumab is known as a monoclonal antibody. It blocks tumor necrosis factor (TNF) molecules.

The immune system produces TNF molecules, which help to fight germs. As your body fights germs, these molecules cause swelling. Sometimes, the body can make too many TNF molecules. Excess molecules cause damage and pain and lead to inflammatory diseases.

Humira binds to TNF molecules and blocks them. By blocking the TNF molecules, adalimumab lowers swelling and pain. It reduces symptoms and the damage caused by those inflammatory conditions.

Drug Facts

Generic Name: Adalimumab

Brand Name(s): Humira

Drug Availability: Prescription

Administration Route: Subcutaneous

Therapeutic Classification: Antirheumatic

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Adalimumab

Dosage Form: Solution

What Is Humira Used For?

The Food and Drug Administration (FDA) approved Humira to treat:

The FDA has a boxed warning for Humira about the increased risk of severe infections and cancers such as lymphoma, a cancer of the lymphatic system, a network that helps fight disease. A boxed warning is one of the most serious warnings from the FDA about a drug’s effects. Talk to your healthcare provider if you have any concerns before using this medication.

Humira ( Adalimumab) Drug Information - Illustration by Dennis Madamba

Verywell / Dennis Madamba

How to Take Humira

You can give yourself Humira using the prefilled pens and syringes, usually every two weeks. A healthcare provider will show you how to administer it.

Before using Humira, take it out of the fridge and leave it at room temperature for 15–30 minutes. This helps make the injection less painful. Do not heat it up or remove the cap or cover while waiting for your medication to reach room temperature. The needle cover for the pen and the cap of the prefilled syringe may contain latex.

Check the appearance of the medication before administering: If the liquid is cloudy, colored, or leaking, do not use it. Wash your hands before and after use.

To administer: 

  • Inject the medication under your skin (subcutaneously) as directed by your healthcare provider. 
  • Inject into the fatty part of the skin on top of your lower stomach or thigh, at least 2 inches from your naval. 
  • Make sure that you rotate injection sites. 

Do not inject into hard, bruised, red, or tender skin. Also, do not inject in areas of the skin that have stretch marks, psoriasis plaques, or scars.

Humira vials are supposed to be for institutional use only. They do not have preservatives. After using it, throw away any leftovers. 

Do not reuse needles or syringes. Instead, throw used needles or syringes in a sharps (needle) container and get rid of full containers based on your local guidelines. If you have any questions, ask your healthcare provider or pharmacist.

Storage

Store Humira in the refrigerator, but do not freeze it. If the medication freezes, do not use it even when it thaws. You can store adalimumab at room temperature. 

Make sure to write down the date after removing it from the refrigerator. After 14 days from taking it out of the fridge, toss it. Do not use it after 14 days. 

Be sure to protect Humira from heat and away from light, and keep it out of the reach of children and pets. Discard the leftover portion.

Do not pour your medicine down the drain or toilet. Learn where your local drug take-back programs are. You can find programs in your area on the FDA website. If you have any questions, contact your pharmacist, who can advise you of proper disposal.

Off-Label Uses

Healthcare providers sometimes prescribe Humira for other purposes not indicated by the FDA. This is known as off-label use. Although not approved for these conditions, Humira can still be beneficial in treating them under your physician’s care. 

Off-label use for Humira are:

  • ​Management of Crohn's disease after removing all or some part of the affected organ
  • ​Management of an aggressive type of Crohn’s disease called perianal/fistulizing disease
  • Pyoderma gangrenosum (large painful sores on the skin)

Alopecia areata (sudden hair loss with overlapping bald patches)

How Long Does Humira Take to Work?

You may not feel the effects of Humira right away. It takes about three to four months to evaluate the response to adalimumab.

What Are the Side Effects of Humira?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on all side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

As with other medications, Humira can cause side effects. Tell your healthcare provider about any symptoms you experience while using this medication.

Common Side Effects

Some of the common side effects of adalimumab include:

  • Back pain
  • Headache
  • Nausea
  • Stomach pain
  • Irritation where the shot is given
  • Signs of a common cold

Contact your healthcare provider if any of these side effects worsen or do not go away.

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency. Serious side effects and their symptoms can include the following:

Signs of a urinary tract infection (UTI):

  • Fever
  • Blood in the urine
  • Lower belly pain
  • Feeling the need to pass urine many times or right away
  • Burning or pain when passing urine

Signs of high blood pressure:

  • Dizziness
  • Terrible headache
  • Change in vision
  • Passing out

Signs of an allergic reaction: 

  • Hives
  • Rash
  • Wheezing
  • Itching
  • Peeling skin, with or without fever
  • Tightness in the chest 
  • Trouble breathing, swallowing, or talking
  • Swelling of the tongue, face, throat, mouth, or lips

Signs of lupus (autoimmune condition causing inflammation of the joints, skin, and other organs)

  • Muscle pain
  • Joint pain
  • Sunburn easily
  • Rash on the cheek
  • Swelling in the arms or legs

Signs of infection:

  • Cough
  • Mouth sores
  • Fever
  • Ear pain
  • Wounds that will not heal
  • Change in color of sputum
  • Pain with urinating

Signs of liver problems: 

  • Dark urine
  • Pale skin
  • Fever 
  • Easy bruising

Other severe side effects:

  • A growth or lump on the skin
  • Red bumps and patches filled with pus
  • Weight loss without trying
  • Night sweats (extreme perspiration as you sleep)

Humira carries a boxed warning highlighting the increased risk of serious infection, including tuberculosis (TB, a disease mainly affecting the lungs), bacterial sepsis (a serious, life-threatening reaction to an infection), and invasive fungal infections. Your healthcare provider may test you for latent TB (this is when you have TB bacteria in your body, but it is not active) before starting Humira and monitor for active TB while you’re taking it.

The FDA also warns about the risk of developing lymphoma and some other cancers in children and adolescents treated with TNF blockers, such as Humira.

Report Side Effects

Humira may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).

Dosage: How Much Humira Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage forms (pen or prefilled syringe):
    • For Crohn's disease:
      • Adults and children 6 years of age and older weighing 40 kilograms (kg) or more—At first (week 0), 160 milligrams (mg) injected under the skin in divided doses. This may be given as four shots in 1 day or as two shots per day for 2 days. Then 2 weeks later, a dose of 80 mg is given. A maintenance dose of 40 mg is given at week 4 and every other week thereafter.
      • Children 6 years of age and older weighing 17 kg and less than 40 kg—At first (week 0), 80 mg injected under the skin in divided doses. This may be given as two shots in 1 day. Then 2 weeks later, a dose of 40 mg is given. A maintenance dose of 20 mg is given at week 4 and every other week thereafter.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.
    • For hidradenitis suppurativa:
      • Adults—At first (week 0), 160 milligrams (mg) injected under the skin in divided doses. This may be given as four shots in 1 day or as two shots per day for 2 days. Then 2 weeks later, a dose of 80 mg is given. A maintenance dose of 40 mg every week or 80 mg every other week is given starting at week 4.
      • Children 12 years of age and older weighing 60 kilograms (kg) or more—Dose is based on body weight and must be given by your doctor. At first (week 0), 160 mg injected under the skin in divided doses. This may be given as four shots in 1 day or as two shots per day for 2 days. Then 2 weeks later, a dose of 80 mg is given. A maintenance dose of 40 mg every week or 80 mg every other week is given starting at week 4.
      • Children 12 years of age and older weighing 30 kg to 59 kg—Dose is based on body weight and must be given by your doctor. At first (Day 1), 80 mg injected under the skin, then 40 mg on Day 8. A maintenance dose of 40 mg is given every other week.
      • Children younger than 12 years of age or weighing less than 30 kg—Use and dose must be determined by your doctor.
    • For juvenile idiopathic arthritis:
      • Children 2 to 17 years of age weighing 30 kilograms (kg) or more—40 milligrams (mg) injected under the skin every other week.
      • Children 2 to 17 years of age weighing 15 to less than 30 kg—20 mg injected under the skin every other week.
      • Children 2 to 17 years of age weighing 10 to less than 15 kg—10 mg injected under the skin every other week.
      • Children younger than 2 years of age or weighing less than 10 kg—Use and dose must be determined by your doctor.
    • For plaque psoriasis:
      • Adults—At first, 80 milligrams (mg) injected under the skin, then 40 mg 1 week after the initial dose and every other week thereafter.
      • Children—Use and dose must be determined by your doctor.
    • For psoriatic arthritis, rheumatoid arthritis, or ankylosing spondylitis:
      • Adults—40 milligrams (mg) injected under the skin every other week. Your doctor may adjust your dose as needed. Some patients with rheumatoid arthritis who are not taking methotrexate may use 40 mg every week or 80 mg every other week.
      • Children—Use and dose must be determined by your doctor.
    • For ulcerative colitis:
      • Adults—At first (week 0), 160 milligrams (mg) injected under the skin in divided doses. This may be given as four shots in 1 day or as two shots per day for 2 days. Then 2 weeks later, a dose of 80 mg is given. A maintenance dose of 40 mg is given at week 4 and every other week thereafter.
      • Children 5 years of age and older weighing 40 kilograms (kg) or more—At first (Day 1), 160 mg injected under the skin as a single dose in 1 day or in divided doses. This may be given as four shots in 1 day or as two shots per day for 2 days. Then 80 mg is given on Day 8 and Day 15. A maintenance dose of 80 mg every other week or 40 mg every week is given starting at week 4 (Day 29).
      • Children 5 years of age and older weighing 20 to less than 40 kg—At first (Day 1), 80 mg injected under the skin, then 40 mg on Day 8 and Day 15. A maintenance dose of 40 mg every other week or 20 mg every week is given starting at week 4 (Day 29).
      • Children younger than 5 years of age—Use and dose must be determined by your doctor.
    • For uveitis:
      • Adults—At first, 80 milligrams (mg) injected under the skin, then 40 mg 1 week after the initial dose and every other week thereafter.
      • Children 2 to 17 years of age weighing 30 kilograms (kg) or more—40 milligrams (mg) injected under the skin every other week.
      • Children 2 to 17 years of age weighing 15 to less than 30 kg—20 mg injected under the skin every other week.
      • Children 2 to 17 years of age weighing 10 to less than 15 kg—10 mg injected under the skin every other week.
      • Children younger than 2 years of age or weighing less than 10 kg—Use and dose must be determined by your doctor.

Modifications

The prefilled pens or syringes have citrate-free formulations. Citrate-free formulations may cause less pain on injection.

Missed Dose

If you miss a dose, take it as soon as you can. Skip the missed dose if it is too close to your next dose. Return to your regular time. Do not inject two doses at a time or use extra amounts.

Overdose: What Happens If I Take Too Much Humira?

Do not use more than the recommended dosage of Humira. In the case of an overdose, you may need to be monitored for symptoms of adverse reactions or side effects.

What Happens If I Overdose on Humira?

If you think you or someone else may have overdosed on Humira, call a healthcare provider or the Poison Control Center (1-800-222-1222).

If someone collapses or isn't breathing after taking Humira, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

If you will be using this medicine for a long time, it is very important that your doctor check your or your child's progress at regular visits. This will allow your doctor to see if this medicine is working properly and to decide whether you should continue to use it. Blood and urine tests may be needed to check for unwanted effects.

You or your child will need to have a skin test for tuberculosis before using this medicine. Tell your doctor if you or anyone in your home has ever had a positive reaction to a tuberculosis skin test.

Adalimumab can temporarily lower the number of white blood cells in your blood, which may increase the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor right away if you or your child think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor right away if you or your child notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

Do not take other medicines unless they have been discussed with your doctor. Using abatacept (Orencia®) or anakinra (Kineret®) together with this medicine may increase your risk of having serious side effects.

This medicine may cause other unwanted effects that may not occur until months or years after this medicine is used. A small number of people (including children and teenagers) who have used this type of medicine have developed certain types of cancer (eg, leukemia). Some patients also developed a rare type of cancer called lymphoma. Talk with your doctor if you or your child have unusual bleeding, bruising, or weakness, swollen lymph nodes in the neck, underarms, or groin, or unexplained weight loss. Also, check with your doctor right away if your or your child's skin has red, scaly patches, or raised bumps that are filled with pus.

Adalimumab may cause serious allergic reactions (eg, anaphylaxis and angioneurotic edema), which can be life-threatening and requires immediate medical attention. Check with your doctor right away if you or your child have a cough, difficulty swallowing, dizziness, fast heartbeat, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs, rash, itching, trouble breathing, or unusual tiredness or weakness after you receive the medicine.

Check with your doctor right away if you or your child has swelling of the face, fingers, feet, or lower legs, or sudden weight gain. These may be signs of a heart condition called congestive heart failure (CHF).

Some people who have used this medicine developed lupus-like symptoms during treatment and got better after the medicine was stopped. Check with your doctor right away if you or your child start having chest pains, joint pain, or a rash on the cheeks or arms that is sensitive to the sun.

Do not have any live vaccines (immunizations) while you or your child are being treated with adalimumab. Your child's vaccines need to be current before using adalimumab. Be sure to ask your child's doctor if you have any questions about this.

The needle cover of some prefilled syringes and pens contain dry natural rubber (a derivative of latex), which may cause allergic reactions in people who are sensitive to latex. Tell your doctor if you or your child have a latex allergy before using this medicine.

Serious skin reactions can occur during treatment with this medicine. Check with your doctor right away if you or your child has blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Humira?

Humira is safe to use in most cases. However, there are instances in which your healthcare provider may not prescribe Humira for you. 

Humira can worsen conditions like heart failure. Therefore, if you have heart failure, you may not be able to use this medication. It can also increase your chances of developing severe infections, like TB, leading to hospitalization or death. 

You should also avoid Humira if you have:

  • Liver problems
  • An allergy or hypersensitivity to it

As a precaution, children younger than 4 years old and weighing less than 11 pounds are not prescribed Humira. There is not enough data in this group.

What Other Medications Interact With Humira?

Some medications may interact with Humira. These interactions can increase side effects or lower the effects of your treatment.

Humira can interact with the following:

  • Echinacea
  • Live vaccines
  • Arava (leflunomide)

Echinacea

Echinacea is an over-the-counter (OTC) supplement product. It has many health benefits, but it may lower the effect of adalimumab. Do not take echinacea without consulting your healthcare provider first.

Live Vaccines

Humira can increase the side effects of live vaccines. It may also affect how well a live vaccine works. If you are on adalimumab, do not get live vaccines. Wait at least three months after taking Humira before getting immunized. Examples of live vaccines include MMR (measles, mumps, rubella), varicella (chickenpox), rotavirus (which results in severe diarrhea), and the intranasal flu vaccine. 

Arava (Leflunomide) 

Arava
treats conditions like rheumatoid arthritis. Humira may increase the side effects of Arava when taken together. 

This combination can raise blood concerns like:

  • Pancytopenia (low red and white blood cells and low platelet count)
  • Agranulocytosis (the body does not make white blood cells)
  • Thrombocytopenia (low platelet level). 

Your healthcare provider should monitor your bone marrow at least monthly if you are on both drugs.

What Medications Are Similar?

Biologic disease-modifying antirheumatic drugs (DMARDs) are similar to Humira.

These drugs affect the immune system. Using DMARDs with Humira will lower your immune system function even further. You should avoid these drugs with adalimumab. 

Examples of DMARDs include:

Frequently Asked Questions

  • Where should I store Humira?

    Store Humira in the refrigerator. Be careful not to freeze it. 

  • How do I take Humira?

    Inject Humira under your skin. To administer, inject it into the fatty part of the skin on top of your lower stomach or thigh.

  • How long does it take to see results with Humira?

    You can expect to see results within three to four months from starting the medication. However, this may vary from person to person.

  • How long is the drug good for after removing it from the fridge?

    Humira is only good for 14 days after removing it from the fridge. Throw away any leftover portion after this time.

How Can I Stay Healthy While Taking Humira?

Humira suppresses your immune system. Be aware of this and be proactive about protecting yourself from germs. Make sure you wash your hands before and after you take your medication.

Always check with your healthcare provider before taking another OTC drug, supplement, or herb. Do not start, stop, or adjust your medicine without telling your provider first. Humira may make you bleed easier. Try to avoid any injury while you’re on this medication. To prevent your gums and skin from bleeding, use a soft toothbrush and electric razor.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. LaMattina KC, Goldstein DA. Adalimumab for the treatment of uveitis. Expert Rev Clin Immunol. 2017;13(3):181-188. doi:10.1080/1744666X.2017.1288097

  2. Ellis CR, Azmat CE. Adalimumab. In: StatPearls. StatPearls Publishing; 2021.

  3. Food and Drug Administration. Humira label.

  4. Benjamin O, Bansal P, Goyal A, Lappin SL. Disease modifying anti-rheumatic drugs (DMARD). In: StatPearls. StatPearls Publishing; 2021.

By Queen Buyalos, PharmD
Queen Buyalos is a pharmacist and freelance medical writer. She takes pride in advocating for cancer prevention, overall health, and mental health education. Queen enjoys counseling and educating patients about drug therapy and translating complex ideas into simple language.