Arthritis Treatment Biologics Orencia (Abatacept) Side Effects By Angelica Bottaro facebook linkedin Angelica Bottaro is a writer with expertise in many facets of health including chronic disease, Lyme disease, nutrition as medicine, and supplementation. Learn about our editorial process Angelica Bottaro Published on January 21, 2021 Print Table of Contents View All Table of Contents Common Side Effects Serious Side Effects Warnings Orencia (abatacept) is used to treat autoimmune diseases, mainly it reduces pain and symptoms of rheumatoid arthritis. It's also used for psoriatic arthritis and juvenile idiopathic arthritis. Orencia is available in powder form, which can be taken intravenously when mixed with a solution, and in liquid form, which is also taken intravenously or given through an injection under the skin (subcutaneous injection). The medication works by preventing antigen-presenting cells from binding to T-cells, inhibiting the overactivity of the immune system. Step-by-Step Guide to Injecting Biologic Drugs for Psoriasis Kmatta / Getty Images Common Side Effects Those taking Orencia may experience mild side effects. Mild side effects typically disappear within days of the first dose and don’t cause any serious issues. Some of the most common side effects include: The common cold, a sinus infection, or other types of upper respiratory infectionsHeadachesNauseaSore throat In children and adolescents taking Orencia, the common side effects are different and include: Abdominal painDiarrheaCoughFever Mild Allergic Reactions Orencia can also cause a mild allergic reaction, possibly with a skin rash. Typically, these were found in less than 5% of participants in the clinical study and went away in days. Symptoms of a mild allergic reaction to Orencia include: Skin rash that may occur on any part of the bodySkin rash that occurs at the injection siteItchinessWarm and redness of the skinRunny noseDizzinessHeartburnBack, leg, or arm pain Serious Side Effects Although rare, some people who take Orencia can experience serious side effects, which could potentially result in permanent damage, the need for emergency medical treatment and hospitalization, or death in some cases. Infections The use of Orencia can increase someone's chances of getting infections, or it may worsen current infections. During clinical trials, infections were reported in 54% of participants being treated with the medication vs. 48% of people treated with placebo, with 3% being serious infections in the Orencia group and 1% in the placebo group. In very rare cases, these infections can be fatal. The most common organs affected are the lungs, kidneys, colon, urinary tract, and skin. Symptoms of infection that could occur as a serious side effect of the medication include: Fever or chillsCoughSkin that is red, warm, or painful to touchFatigueFlu-like symptoms Hepatitis B For those with chronic infections such as hepatitis B, the risk for reactivation of their chronic liver disease is higher while taking Orencia. If Orencia does cause a dormant hepatitis B infection to flare up, symptoms could come back and the infection could become more serious. Typical symptoms of a flare-up of hepatitis B include: General fatigueLoss of appetiteWeaknessJoint and muscle painDark-colored urineYellowing of the skin or whites of the eyes, otherwise known as jaundiceFeverAbdominal discomfort COPD Those with chronic obstructive pulmonary disease (COPD) should be cautious when taking Orencia because the medication can worsen difficulties with breathing and worsen the condition over time. Symptoms to look out include: Difficulty breathingShortness of breathUnintentional weight lossNight sweatsThe sudden need to urinate or frequent urinationA burning sensation while urinatingA red, hot, swollen area on the skin (cellulitis) Severe Allergic Reactions Orencia was found to cause severe allergic reactions in 1% of people in clinical studies. Symptoms of a severe allergic reaction include hives, swelling that occurs in the eyelids, lips, hands, feet, tongue, mouth, or throat, and difficulty breathing. A severe allergic reaction can be life-threatening. If you notice any of the signs of a severe allergic reaction, call 911 for medical help immediately. Cancer Taking Orencia can increase your risk of developing cancer over time because of the effects it has on cell growth and multiplication. The most common types of cancer that occurred because of Orencia are lung cancer and blood cancer. When To Call Your Doctor The mild side effects of Orencia will typically go away in a few days once the body adjusts to the medication, but if they persist or become worse, talk to your doctor.You should seek emergency medical help if you experience the following symptoms:Trouble breathingStabbing chest pain, wheezing, cough with yellow or green mucusPain or burning when you urinateSigns of skin infection such as itching, swelling, warmth, redness, or oozing Warnings Orencia comes with several warnings, including hypersensitivity and anaphylaxis, serious infections like pneumonia and sepsis, and adverse events in COPD patients (rhonchi, shortness of breath, and worsening symptoms). People who are taking Orencia should not receive live vaccines while taking the medication or within three months of stopping the drug. There is also a warning regarding immunosuppression to Orencia use because it inhibits the body's T-cell response and lower the body's defense against infections. For people who are pregnant, Orencia should be used only when it is prescribed. It is unclear if Orencia passes into breast milk or if it would harm a nursing baby. Breastfeeding is therefore not recommended while using this drug. Interactions The main drug interaction one should be concerned about while using Orencia is with anti-TNFs (tumor necrosis factor inhibitors) or TNF antagonists. This type of medication is also used to treat arthritic autoimmune disorders, and includes Humira, Enbrel, and Remicade. People receiving IV Orencia and TNF antagonist therapy experienced more infections (63%) and serious infections (4.4%) compared with those who were only on TNF antagonists. While transitioning from anti-TNFs to Orencia, people should therefore monitor for signs of infections. A Word From Verywell Dealing with an arthritic autoimmune disorder can be tough. The right medication can ease symptoms and help slow the progression of the disease, but it often comes with its own set of side effects. If you are thinking about taking Orencia or are already taking the medication, it’s important to talk with your doctor about possible side effects and how best to minimize them. If you experience any of the side effects mentioned above and they become bothersome, there may be another medication that works better for you. Was this page helpful? Thanks for your feedback! Dealing with chronic inflammation? An anti-inflammatory diet can help. Our free recipe guide shows you the best foods to fight inflammation. Get yours today! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. DailyMed. ORENCIA- abatacept injection, powder, lyophilized, for solution ORENCIA- abatacept injection, solution. Updated June 17, 2020. MedlinePlus. Abatacept Injection. Updated August 15, 2020. Montastruc F, Renoux C, Dell'Aniello S, Simon TA, Azoulay L, Hudson M, Suissa S. Abatacept initiation in rheumatoid arthritis and the risk of cancer: a population-based comparative cohort study. Rheumatology (Oxford). 2019 Apr 1;58(4):683-691. doi: 10.1093/rheumatology/key352 U.S. Food and Drug Administration. Orencia (abatacept) Label. U.S. Food and Drug Administration. Orencia (abatacept).