Golimumab (Intravenous subcutaneous)

Overview

Golimumab is a drug that is given via an injection to treat arthritis in the backbone or spine (known as ankylosing spondylitis), or for symptoms of moderate-to-severe rheumatoid arthritis. It may be administered on its own, or it may be given alongside other medicines, such as methotrexate. It may also be given to patients who are suffering from psoriatic arthritis. This is where the arthritis is causing swelling and pain in a patient's joints, along with leaving areas of scaly skin on certain parts of the body.

Finally, it is used on patients who are suffering from moderate-to-severe ulcerative colitis. It is given when other drugs have been administered, but have remained ineffective. You can only obtain Golimumab following a doctor's prescription, and should not try and access it on your own.

Condition(s) treated

  • Ankylosing spondylitis

Type of medicine

  • Human monoclonal antibody

Side Effects

As well as helping to treat the conditions listed above, it is possible that Golimumab can cause a number of different side effects to arise. Directly below is a list of the more serious side effects that may occur. If you experience any of the following then you should notify your doctor immediately.

  • More common
  • Muscle aches
  • Less common
  • Wheezing or tightness of the chest
  • Rare
  • Inflammation and pain at the joints
  • Incidence not known
  • Swelling of the throat, tongue, or face

As well as these more serious side effects, it may be that you experience other side effects that do not require such immediate attention. Instead, you may find that they pass as times goes on and your body adjusts to the medicine. However, if any of the following are bothersome or lingering, then you can still contact your doctor. They may be able to advise on ways to help reduce the effects or make them more manageable.

  • Less common
  • Stinging or burning of the skin

Though these lists are extensive, they are not necessarily complete. If you experience any side effects not listed here, and if they are worrying you, then you can still contact your doctor for advice.

Dosage

Below you can find the average doses for patients suffering from ankylosing spondylitis, rheumatoid arthritis, or psoriatic arthritis. Do be aware that the exact doses you have been prescribed may differ greatly from those below. That is because each prescription is based on the exact needs of each patient and takes into account many other factors, such as other drugs they are currently taking. You should not adjust your doses in any way unless told to do so by your doctor.

  • Adults: Take 50mg injected under the skin once each month.

Here is the average dose given to patients suffering from ulcerative colitis.

  • Adults: To start, take 200 mg injected under the skin.'œ weeks later, you will receive a dose of 100mg. After that, you will receive 100mg every 4 weeks.

It is important that you do not miss any doses, as doing so will affect the overall benefits you receive from treatment. However, if you do miss a dose it is possible you can still receive it as long as it is not too close to your next scheduled dose. You should contact your doctor for advice under such circumstances.

You will receive this medicine from a trained nurse or doctor. They will administer it in a hospital and will inject it at the same time as methotrexate. It is given via a needle that is placed into one of your veins. The IV tube will need to remain in place for 30 minutes whilst the medicine is slowly infused.

Your doctor may also provide you with a Medication Guide. You should read this and address any questions to your doctor.

If you do not need to be in a clinic or hospital, then a medical professional may be able to give you this medicine from home. Alternatively, it is possible you can self-administer it. If this is the case, then make sure you fully understand how to inject it and that you receive proper training on doing so. The medicine has a brand name of Simponi®.

If you are allowed to self-administer Simponi®, then the nurse or doctor will show you which spots on your body you can inject. Every time you give yourself a shot, use a different body area and then keep track of each place you have previously used. This will help prevent the chance of experiencing skin problems.

Simponi® will come in either one of two forms. Either as a prefilled SmartJect® autoinjector or a prefilled syringe.

You will find that the needle covers of the autoinjector and the prefilled syringe both contain a dry natural rubber which is a derivative of latex. This may, therefore, cause an allergic reaction for people who are sensitive to latex. Before receiving the medicine, inform your doctor if you are allergic to latex at all.

  • Here is a guide to using the Simponi® injection:
  • First of all, place all the necessary equipment on a flat, clean surface using a towel or cloth in an area with good lighting.
  • If you are using the SmartJect® autoinjector:
  • Hold it in your hand and push the open end against your skin. Do so at a 90-degree angle.
  • If you are using the prefilled syringe:
  • You should hold the syringe in one hand and between the index fingers and thumb.
  • For either method, you may find that there is a small amount of liquid or blood at the site of injection. If so, press and hold a clean and dry cotton ball on the injection site for 10 seconds. Do not rub it.

Interactions

It is possible that Golimumab will interact with other drugs you are currently taking. In many cases, it is advisable that these interactions are avoided, but in other cases, they may be necessary. Either way, inform your doctor of any and all drugs you are currently using as well as this one. Directly below is a list of drugs with which it is usually not recommended you use at the same time as Golimumab. However, if necessary, then your doctor may wish to change the dose or how frequently you receive one or both medicines.

  • Typhoid Vaccine

As well as drugs, it is possible that Golimumab will interact with certain parts of your typical daily diet. Your doctor may request you to alter certain aspects of what you eat, drink, or smoke. For example, it may be advisable that you consume less alcohol or tobacco whilst receiving Golimumab.

Finally, other medical problems which you currently suffer from may interact with this drug. If you have any of the following, make your doctor well aware of this.

  • A history of Guillain-Barré syndrome (a nervous system disorder)

Warnings

Before being prescribed the medicine, your doctor will need to consult with you fully to understand the extent of your condition and decide whether this is indeed a suitable drug to take. As a part of this, they will need to know about any and all allergies you suffer from. This includes those to foods, animals, dyes, or preservatives.

As of writing, there have not been suitable studies performed on pediatric patients receiving this medicine. As such, no safety and efficacy have been established in determining whether this is still safe and suitable to use. Your doctor is best placed to decide whether this is a suitable drug for your child.

The studies that have been performed on geriatric patients have not highlighted any problems that would make this any less useful for older patients. However, do be aware that the Golimumab Injection has been known to cause more unwanted side effects and infections in elderly patients. This means that greater caution should be exercised by elderly patients receiving this medicine.

As of writing, it appears that some studies have been carried out on either pregnant animals for pregnant women using this drug. However, it is unclear as to whether or not these have demonstrated any notably increased risk to the fetus. Your doctor is best placed to inform you of any increased risk to infants if pregnant and using Golimumab. If you do fall pregnant whilst using this drug, then you should inform your doctor right away.

There are no adequate studies that have yet been performed on breastfeeding women using this medicine. In order to decide whether this drug is suitable, you will need to weigh any risks and benefits with your doctor.

If you are going to be using this medicine over an extended period your doctor will need to schedule regular appointments to see you and track your condition. This allows them to check if the medicine is working alright or is causing any unwanted effects. They may want to use blood tests to check for such effects, and then make any necessary adjustments to your prescription.

It is possible that Golimumab will cause a serious allergic reaction to occur. One such reaction is called anaphylaxis which is life-threatening and means seeking immediate medical attention. You should stop using this medicine and contact your doctor right away if you notice any of the following.

  • Itching

Before you start using Golimumab you will first need to have a skin test for tuberculosis. If you, or anyone in your home, has ever had a positive reaction to this test, inform your doctor.

Whilst taking Golimumab, you may find that the number of white blood cells in your blood becomes lower. This increases your risk of getting an infection and lowering your number of platelets (these are necessary for blood clotting). In order to reduce the risk of bleeding or of infection, there are certain precautions you can take.

  • Avoid people with infections wherever possible. If you think you are getting an infection, or are experiencing lower back or side pain, difficult or painful urination, chills, a fever, hoarseness, or a cough, inform your doctor immediately.

Before having any other vaccines first check with your doctor. But do not have any live vaccines (immunizations) at all whilst taking Golimumab.

  • Unless first cleared by your doctor, do not take any other arthritis medicines. Doing so could increase the chance of experiencing serious side effects. This includes the following drugs.
  • Infliximab (Remicade®)

If you display more than one of the following symptoms, you should tell your doctor straight away. They could be signs of a serious liver problem.

  • Yellow skin or eyes

If you have more than one of the following symptoms, then tell your doctor immediately. They could be signs of a serious heart condition called congestive heart failure.

  • Swelling of the feet, lower legs, face, or fingers

If you have more than one of the following symptoms, inform your doctor immediately. They could be signs of multiple sclerosis, which is a serious nervous system disease.

  • Difficulty controlling your bowels or bladder

Do be aware that a small number of people who have used medicines of this type (including teenagers and children) have developed certain types of cancer, such as lymphoma or leukemia. If you experience any of the following symptoms, inform your doctor immediately.

  • Red, scaly patches on your skin or raised bumps filled with pus

Storage

You should store this medicine in a refrigerator, but never allow it to freeze. Keep it safely away from children, as it can be dangerous. Once you no longer need the medicine, you should dispose of any that are remaining, in a safe and sensible manner as advised by your doctor. Do the same if you find any medicine that is out of date. You should store the medicine in the original package until it is time to use, and you should never expose the medicine to direct light.

Summary

If you suffer from certain arthritic problems, or others similar conditions, then Golimumab can be a very useful drug in helping to treat the symptoms and improve your condition. However, it is a drug that is only suitable for certain patients, and should only be used if it has been prescribed. Your doctor will first need to understand the extent of your condition, and also be familiar with all other drugs you are currently taking.

Your doctor may also offer certain changes you should make to your lifestyle or diet. You should follow these closely as it will best improve your condition. Above, you can find details regarding the different side effects that may occur whilst taking Golimumab. If you are experiencing any of the more serious ones, or have questions regarding your side effects, then discuss these with your doctor. They may be able to adjust your dosage or offer other means to reduce the unwanted effects. If you have any other questions regarding this medicine or your condition, then these should be addressed to your doctor.