"Rheumatoid arthritis overview
Rheumatoid arthritis (RA) is a disease in which the body's immune system attacks its own joints. This results in pain, swelling and potentially permanent damage. About 1.5 million people in the United State"...
CIMZIA is indicated for reducing signs and symptoms of Crohn's disease and maintaining clinical response in adult patients with moderately to severely active disease who have had an inadequate response to conventional therapy.
CIMZIA is indicated for the treatment of adults with moderately to severely active rheumatoid arthritis (RA).
CIMZIA is indicated for the treatment of adult patients with active psoriatic arthritis (PsA).
DOSAGE AND ADMINISTRATION
CIMZIA is administered by subcutaneous injection. Injection sites should be rotated and injections should not be given into areas where the skin is tender, bruised, red or hard. When a 400 mg dose is needed (given as two subcutaneous injections of 200 mg), injections should occur at separate sites in the thigh or abdomen.
The solution should be carefully inspected visually for particulate matter and discoloration prior to administration. The solution should be a clear colorless to yellow liquid, essentially free from particulates and should not be used if cloudy or if foreign particulate matter is present. CIMZIA does not contain preservatives; therefore, unused portions of drug remaining in the syringe or vial should be discarded.
The recommended initial adult dose of CIMZIA is 400 mg (given as two subcutaneous injections of 200 mg) initially, and at Weeks 2 and 4. In patients who obtain a clinical response, the recommended maintenance regimen is 400 mg every four weeks.
The recommended dose of CIMZIA for adult patients with rheumatoid arthritis is 400 mg (given as two subcutaneous injections of 200 mg) initially and at Weeks 2 and 4, followed by 200 mg every other week. For maintenance dosing, CIMZIA 400 mg every 4 weeks can be considered [see Clinical Studies].
The recommended dose of CIMZIA for adult patients with psoriatic arthritis is 400 mg (given as 2 subcutaneous injections of 200 mg each) initially and at week 2 and 4, followed by 200 mg every other week. For maintenance dosing, CIMZIA 400 mg every 4 weeks can be considered [see Clinical Studies].
Preparation and Administration of CIMZIA Using the Lyophilized Powder for Injection
CIMZIA Lyophilized powder should be prepared and administered by a health care professional. CIMZIA is provided in a package that contains everything required to reconstitute and inject the drug [see HOW SUPPLIED/Storage and Handling]. Step-by-step preparation and administration instructions are provided below.
Preparation and Storage
- CIMZIA should be brought to room temperature before reconstituting.
- Use appropriate aseptic technique when preparing and administering CIMZIA.
- Reconstitute the vial(s) of CIMZIA with 1 mL of Sterile Water for Injection, USP using the 20-gauge needle provided.
- Gently swirl each vial of CIMZIA without shaking, assuring that all of the powder comes in contact with the Sterile Water for Injection.
- Leave the vial(s) undisturbed to fully reconstitute, which may take approximately 30 minutes.
- The final reconstituted solution contains 200 mg/mL and should be clear to opalescent, colorless to pale yellow liquid essentially free from particulates.
- Once reconstituted, CIMZIA can be stored in the vials for up to 24 hours between 2° to 8° C (36° to 46° F) prior to injection. Do not freeze.
- Prior to injecting, reconstituted CIMZIA should be at room temperature but do not leave reconstituted CIMZIA at room temperature for more than two hours prior to administration.
- Withdraw the reconstituted solution into a separate syringe for each vial using a new 20gauge needle for each vial so that each syringe contains 1 mL of CIMZIA (200 mg of certolizumab pegol).
- Replace the 20-gauge needle(s) on the syringes with a 23-gauge(s) for administration.
- Inject the full contents of the syringe(s) subcutaneously into thigh or abdomen. Where a 400 mg dose is required, two injections are required, therefore, separate sites should be used for each 200 mg injection.
Preparation and Administration of CIMZIA Using the Prefilled Syringe
After proper training in subcutaneous injection technique, a patient may self-inject with the CIMZIA Prefilled Syringe if a physician determines that it is appropriate.
Patients using the CIMZIA Prefilled Syringe should be instructed to inject the full amount in the syringe (1 mL), according to the directions provided in the Instructions for Use booklet.
Monitoring to Assess Safety
Before initiation of therapy with CIMZIA, all patients must be evaluated for both active and inactive (latent) tuberculosis infection. The possibility of undetected latent tuberculosis should be considered in patients who have immigrated from or traveled to countries with a high prevalence of tuberculosis or had close contact with a person with active tuberculosis. Appropriate screening tests (e.g. tuberculin skin test and chest x-ray) should be performed in all patients.
CIMZIA may be used as monotherapy or concomitantly with non-biological disease modifying anti-rheumatic drugs (DMARDs). In rheumatoid arthritis clinical studies, patients on CIMZIA therapy also took concomitant methotrexate (MTX) with the recommended CIMZIA dose of 200 mg every other week.
In the psoriatic arthritis clinical study, oral corticosteroids, DMARDs (methotrexate, leflunomide, sulfasalazine,) and NSAIDs were permitted as concomitant therapy. CIMZIA should not be used in combination with biological DMARDs or other tumor necrosis factor (TNF) blocker therapy.
Dosage Forms And Strengths
- Lyophilized Powder for Reconstitution
Sterile, white, lyophilized powder for reconstitution and then subcutaneous administration. Each single-use vial provides approximately 200 mg of CIMZIA.
- Prefilled Syringe
A single-use, 1 mL prefilled glass syringe with a fixed 25 gauge ½ inch thin wall needle, providing 200 mg per 1 mL of CIMZIA.
Storage And Handling
Storage and Stability
Refrigerate intact carton between 2 to 8 °C (36 to 46 °F). Do not freeze. Do not separate contents of carton prior to use. Do not use beyond expiration date, which is located on the drug label and carton. Protect solution from light.
Lyophilized Powder for Reconstitution
|2||Type I glass vials with rubber stopper and overseals each containing 200 mg of lyophilized CIMZIA for reconstitution.|
|2||2 mL Type I glass vials containing 1 mL sterile Water for Injection|
|2||3 mL plastic syringes|
|4||20 gauge luer-lock needles (1 inch)|
|2||23 gauge luer-lock needles (1 inch)|
2 alcohol swabs and 2 single use prefilled glass syringes with a fixed 25 ½ gauge thin-wall needle, each containing 200 mg (1 mL) of CIMZIA.
Prefilled Syringe Starter Kit
6 alcohol swabs and 6 single use prefilled glass syringes with a fixed 25 ½ gauge thin-wall needle. The Starter Kit contains 3 sets of 2 prefilled syringes to provide sufficient drug supply for the initial 3 induction doses at the start of treatment. Each prefilled syringe contains 200 mg (1 mL) of CIMZIA.
Product manufactured by: UCB, Inc. 1950 Lake Park Drive Smyrna, GA 30080. Revised: 09/2013
Last reviewed on RxList: 10/14/2013
This monograph has been modified to include the generic and brand name in many instances.
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