Abatacept (Intravenous, Subcutaneous)

Administered through an injection, abatacept is used to treat forms of arthritis, including rheumatoid arthritis.

Overview

Abatacept is used to treat autoimmune disorders, usually rheumatoid arthritis, but also psoriatic arthritis and juvenile idiopathic arthritis. It's a fusion protein that interferes with the activity of T cells by scrambling the signals that direct T cells to trigger an immune response. Autoimmune disorders such as rheumatoid arthritis direct the body to attack itself, and Abatacept can help slow this unwanted immune defense reaction. This helps reduce the mechanisms and therefore the symptoms of rheumatoid arthritis.

Abatacept is administered by injection, either intravenous or subcutaneous. Intravenous injection is normally done once a month at a doctor's office, while subcutaneous injection is normally done once a week at home.

Abatacept has some mild side effects which are not a serious cause for concern and normally go away. These side effects include gastrointestinal symptoms such as stomach discomfort and indigestion, as well as rashes or pain at the injection site.

Abatacept may cause more serious side effects which require medical intervention. These include symptoms of a bladder infection, symptoms similar to a cold or flu, hypertension or hypotension, rashes, or an allergic reaction.

Conditions treated

Type of Medicine

  • Fusion protein
  • Powder for solution
  • Solution

Side Effects

Mild Side Effects

Abatacept does have a range of side effects, which many patients may experience. Some of these side effects are common and frequently go away after an initial period of discomfort, while some side effects are more serious and may need medical intervention. Always report your side effects to your doctor, even if they do not seem severe. Abatacept, like any medication, may produce side effects which are not listed.

Like many medications, Abatacept can sometimes produce mild side effects that are simply a result of your body getting used to the medication. These side effects may subside and disappear as your body adjusts to your medication, or they may persist. In any case, these mild and common side effects should not be life-threatening. Your healthcare professional should be able to work with you to reduce or prevent the impact of these side effects on your life. Always let your doctor know if your side effects become too painful or unpleasant. These mild, common side effects can include:

Gastrointestinal upset or stomach discomfort, such as, but not limited to, acid reflux, heartburn, sour stomach, or indigestion

Unusual skin appearances or unpleasant feeling at the injection site, such as burning or stinging, lumps or hives, tenderness or a feeling of pressure, coldness or numbness, itching or a tingling feeling, swelling or redness, scarring or ulceration, soreness or pain

Unusual pain in the arms or legs, regardless of injection site

Serious Side Effects

While some side effects are not cause for serious concern, some do need to be treated immediately as they may indicate or lead to more serious health problems. Some of these may be from the way your body is interacting with the drug, and some of them may be from other conditions which can be triggered by taking Abatacept. These side effects may not occur in all patients. They may be mild when they appear, but you should seek immediate medical attention for these symptoms regardless of their severity, or they may lead to more serious and lasting damage.

One common symptom is unusual pain in your back or side, especially in your lower back. This may be accompanied by pain in the bladder, as well as an unusually frequent urge to urinate. When urination occurs, it may be difficult to urinate, or accompanied by pain or a burning sensation. Your urine may become cloudy or bloody. You may experience unusual body aches or pain, as well as particularly severe or frequent headaches. This may be accompanied by a fever or chills, as well as other flu-like symptoms. Other symptoms include dizziness, unusual weakness, or frequent and unusual tiredness. You may experience symptoms of respiratory distress, such as difficult, wheezing, or labored breathing, or a tightness of the chest. Cold-like symptoms may appear, such as a sore throat, frequent coughs or coughs that produce mucus, a stuffy or running noise, or even laryngitis and loss of voice. You may also experience nausea to the point of vomiting, and pain or tenderness around your cheekbones and eyes. These symptoms may seem to be normal ailments or may be caused by a cold or flu bug, but the immunosuppressant qualities of abatacept make these health problems dangerous to you regardless of their origin. Seek medical attention immediately if you begin to experience these symptoms.

Some symptoms may be less common, and these may be caused by your body having an allergic reaction or hypersensitivity to the Abatacept. These symptoms need medical attention immediately. You may experience cold sores or painful blisters on your nose, eyes, lips, or genitals, or an unusual skin rash. This may be accompanied by or preceded by a stinging or burning sensation on your skin. Seek medical assistance if you experience blurred vision, chest pain, an unusually slow or fast heartbeat, or constant pounding in your ears. You may also feel nervous or panicky. Rarer side effects include unusual pain or tenderness in the stomach or abdominal area, as well as difficulty with swallowing and a swelling of the tongue, throat, or facial areas. You may experience flushing or redness on your skin, possibly accompanied by pain or tenderness, swelling or itching, warmth or burning, as well as welts or hives on your skin. Unusual sweating may be a side effect of Abatacept. You may also experience dizziness or lightheadedness, especially when getting up suddenly from a prone or sitting position, along with confusion that may not go away. Contact your healthcare provider immediately if you experience these symptoms.

Dosage

Abatacept is normally taken as an injection into the skin or veins. There are several ways Abatacept can be injected into the body, depending on the patient's needs, age, and level of comfort with self-injection. An intravenous or IV infusion of Abatacept can be administered at a doctor's office once per month in a procedure that takes about 30 minutes; this method is appropriate for patients six years or older. Abatacept is also available in a prefilled syringe, which provides a subcutaneous injection, or an injection under the skin. This can be administered at home and is usually done once per week. This method is ideal for patients two years of age and up. Abatacept is also available in an autoinjector, which is designed for patients who may have trouble administering a weekly dose of Abatacept in their home with a traditional syringe.

The manufacturer of Abatacept provides guidelines for dosage for adults. As with all medications, your exact dosage, preparation, and the schedule on which you take your dose will be determined by your physician according to your condition, needs, and ability to tolerate the medication. Do not take more or less of this medication than prescribed by your doctor for your particular case, regardless of dosage information provided by the manufacturer.

Abatacept is dosed according to weight for adult patients. The initial application of Abatacept is usually injected all at once and can vary between 500 mg, 750 mg, or 1000 mg, depending on the patient's weight. After this, dosage and timing will vary depending on the application method the patient selects for Abatacept. Patients who select intravenous infusion once per month will receive an additional dose two weeks after the first dose of Abatacept, and then will continue to receive similar dosage every four weeks. Patients choosing self-injection may self-administer a standard 125 mg of Abatacept one day after the initial larger dose, and then inject 125 mg weekly thereafter.

Younger patients are dosed based on their weight, with the average dosage recommended at 10 mg of Abatacept per kg of body weight. As younger patients' body weight may change when growing, the ultimate dosage is to be set by the patient's doctor and adjusted as deemed medically necessary. Subcutaneous injection is not recommended for younger patients.

This medication needs to be given on a precisely fixed schedule. If you miss a dose of your Abatacept, do not attempt to dose yourself before you call your physician or your pharmacist for instructions and assistance.

Major Drug Interactions

What does Abatacept interact with?

All drugs interact with other substances inside your body and can have unexpected or deleterious effects on other drugs that you're taking. This may cause some drugs that you're taking to stop working, not work as well, or have unexpected effects or side effects. Any patient should have a complete list of any medications or supplements they are taking, even non-prescription or over-the-counter drugs. Having this list on hand can help your doctor or pharmacist ensure that your risk of taking drugs which interact badly with each other is minimal, and that your condition is known if you do have a negative drug interaction.

While taking Abatacept, do not take any other TNF antagonists or TNF inhibitor medications. These include medications like Remicade, Humira, Cimzia, Simponi, Enbrel, Thalidomide, Pomalyst, or Imnovid. Taking Abatacept together with a TNF antagonist does not increase the effectiveness of the TNF antagonist or of Abatacept. This combination can lead to an increased risk of serious illness and infection.

Abatacept has not been sufficiently tested when taken in conjunction with biologic RA therapy. The side effects and interaction of this combination is not known, and therefore it is not advised to take Abatacept with any form of biologic RA therapy. Forms of biologic RA therapy medications include Actemra, Cimzia, Humira, Enbrel, Kineret, Remicade, Rituxan, Simponi, and Xeljanz.

Warnings

Abatacept is an immunosuppressant and can react with your body accordingly. If you have a history of recurrent or chronic infections in your body, or have an underlying condition which could cause recurrent or chronic infections in your body if aggravated, take Abatacept with extreme caution and careful monitoring. Abatacept's immunosuppressant qualities can contribute to the rise of serious infections, such as pneumonia or sepsis, which may prove fatal in some patients. This may have a higher chance of occurring while taking Abatacept if you are on other immunosuppressing medications. Check with your doctor or pharmacist to see if any other medications or therapies you are undergoing have immunosuppressant qualities before you begin taking Abatacept. Patients who contract a new infection during a course of treatment with Abatacept should be monitored carefully, as the infection may worsen. If a serious infection is contracted during a course of treatment with Abatacept, the administration of Abatacept should stop immediately and the patient should no longer take Abatacept.

Before taking Abatacept, you should be screened for the possibility of a tuberculosis infection. You may have a latent infection even if you have shown no signs or symptoms of tuberculosis. The effect of Abatacept on patients with latent or active tuberculosis infections has not been studied, and Abatacept may be dangerous to patients in conjunction with tuberculosis. If you do test positive for tuberculosis, you will need to be treated fully for the disease before you begin your regimen of Abatacept.

Abatacept and other antirheumatic therapies can sometimes lead to a reactivation of hepatitis B. It is recommended that patients get screened for viral hepatitis before beginning a regimen of Abatacept. This medication can negatively affect patients who also have COPD or chronic obstructive pulmonary disease. Patients with this condition can experience symptoms of COPD more often, such as a cough, rattling breathing, or difficult or labored breathing. COPD patients taking Abatacept should be monitored carefully to ensure that their respiratory condition does not worsen.

Abatacept has not been tested in conjunction with vaccinations, but similar medications can undermine the immunization effects of live vaccines. It is recommended that any patients who are not up to date on their immunizations receive these injections before beginning a regimen of Abatacept, and that any persons receiving Abatacept not receive any vaccinations or immunizations while taking the medication or until 3 months after its usage has been discontinued.

As with any drug, Abatacept may cause anaphylactoid reactions in patients. If you experience an allergic reaction to Abatacept, seek medical attention immediately.

Storage

Abatacept should be kept in its original packaging and out of the light until needed. Refrigerate immediately upon receipt, and keep in the refrigerator at 36°F to 46°F until it is time for dosage. Do not put Abatacept in a freezer or expose it to temperatures below freezing.

If your Abatacept is out of date, do not take it. Return it to your pharmacist or dispose of it safely.

Summary

Abatacept is a fusion protein used to treat rheumatoid arthritis. It interferes with the immune system of the body in order to dampen an overactive immune response.

Abatacept can be taken intravenously or subcutaneously. Either method involves injection. Intravenous Abatacept is taken once per month in a doctor's office, while subcutaneous Abatacept is taken once a week at home.

Abatacept, like all medications, has some side effects. It may cause mild gastrointestinal distress, as well as pain or irritation at the injection site and in some extremities. These side effects often go away and can be treated.

Abatacept, like all medications, can have more serious effects. Because it's an immunosuppressant, you may experience serious symptoms of a cold, flu, bladder infection, hypertension or hypotension, or an allergic reaction while on Abatacept. If any of these occur, seek medical attention immediately.

You should be screened for viral hepatitis and tuberculosis before starting Abatacept. You should not get any immunizations while on Abatacept.

Abatacept should be kept in its original packaging until it's ready to use, and should be stored in a refrigerator.

Resources
Last Reviewed:
December 10, 2017
Last Updated:
October 08, 2018
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