Cimzia (certolizumab) is a biologic medicine that helps the pain and swelling of arthritis. It works by blocking TNF (Tumor Necrosis Factor), a type of signalling protein (called a cytokine), that is involved in systemic inflammation.
Cimzia belongs to a class of similar medications called “Anti-TNF” agents.
Cimzia is used to treat Rheumatoid Arthritis and Crohn’s Disease.
Cimzia is available in pre-filled syringes that are usually taken once every 2 weeks. The normal dose is 400 mg every 2 weeks for the first 3 doses, then 200 mg every 2 weeks after that.
Although some patients can feel better quite quickly in others it can take a little longer. Patients starting Cimizia should continue taking the medication as prescribed.
To learn how take Cimzia at home, watch our video: Learn how to inject: subcutaneous injections. Subcutaneous injections are easy to do compared to other types of injections. A small needle pokes just under the skin to deliver medicine into the “fatty tissue” below.
Important Tests and Risks
Cimzia can make it a bit harder for people to fight off infections. Patients taking this medicine should call their doctor they have a fever, think they have an infection, or have been prescribed antibiotics to treat an infection.
Patients should coordinate with their doctor to stop treatment before any surgery. It can be re-started once things have healed and there’s no sign of infection.
Patients should discuss all vaccinations with their doctor because some are not advisable to get while taking Cimzia.
It is important to get a TB (tuberculosis) skin test and a chest x-ray before starting Cimzia.
Drug Identification Number (DIN): 02331675 (SC)
How Cimzia Works
In some people with arthritis, a signalling protein (cytokine) called Tumour Necrosis Factor (TNF) is present in the blood and joints in excessive amounts where it increases inflammation (pain and swelling).
Cimzia is another type of protein called a monoclonal antibody that works as a TNF blocker. It binds to TNF and prevents it from working. Normally TNF would bind to TNF receptors in the body and cause inflammation.
In blocking TNF, Cimzia suppresses the body’s immune system. Though this suppression can make it slightly harder for patients to fight off infections, it also helps to stabilize an overactive immune system and control arthritis.
Side Effects of Cimzia
MORE COMMON side-effects include:
- Mild skin reaction at the injection site (itchiness, redness, and mild swelling).
- Nausea, abdominal pain
- Upper respiratory tract infections (such as sinusitis).
RARE side-effects include:
- Infection – There is an increased risk of serious infections associated with the use of Certolizumab. Any infections or fevers should be taken very seriously and reviewed by a doctor.
- Nervous System – There have been rare reports of some patients developing disorders that affect the nervous system (multiple sclerosis, seizures, or inflammation of the nerves of the eye) while taking medications like Certolizumab. Fortunately, these reports are exceedingly rare.
- Heart – Patients should inform their doctor if they have congestive heart failure as Certolizumab may make it worse.
- Blood Counts – Certolizumab can cause a drop in the numbers of white blood cells (which are needed to fight infection) or red blood cells (which carry oxygen). This is very rare and it is unusual for this to be a serious problem.
- Malignancy – Certolizumab may be associated with a very small increased risk of developing cancer (<1%).
How to minimize the side-effects of Cimzia:
- Take Cimzia as prescribed by a doctor
Who Should NOT Take Cimzia
Patients who should NOT be taking Cimzia (certolizumab) include:
- Patients who have had a previous serious allergic reaction to Cimzia
- Women who are pregnant, planning on becoming pregnant in the near future, or currently breast feeding
- Possibly patients who have cancer or have had a past history of certain cancers
- Patients who have severe or uncontrolled congestive heart failure
- Patients who have multiple sclerosis
- Patients with active infections (such as tuberculosis)
Anyone who becomes pregnant while taking Cimzia should notify their doctor immediately.
When to Call a Doctor
People taking Cimzia should call their doctor if they feel sick and want to stop, or if they are concerned about any side effects.
Other reasons to call a doctor while taking Cimzia include:
- Fever or possible infection
- If another doctor has prescribed antibiotics to fight an infection
- Before having surgery
- Planning to get any vaccinations
Watch Dr. Andy Thompson, a Canadian rheumatologist, introduce Cimzia.