Cimzia (Certolizumab Pegol)
Complete patient guide for uses, dosage, side effects, and safety information
Quick Facts
What Is Cimzia Used For?
Cimzia contains certolizumab pegol, a human antibody fragment that targets and blocks a protein called tumor necrosis factor alpha (TNFα). By blocking TNFα, Cimzia helps reduce inflammation and the painful symptoms it causes.
Primary Uses
Cimzia is used to treat several inflammatory conditions including: rheumatoid arthritis (joint pain, tenderness, swelling and stiffness), plaque psoriasis (red, itchy and inflamed skin), psoriatic arthritis (similar symptoms to rheumatoid arthritis and plaque psoriasis), and ankylosing spondylitis and non-radiographic axial spondyloarthritis (back pain and morning stiffness). It may be used together with methotrexate for rheumatoid arthritis.
How It Works
Cimzia is a human antibody fragment that specifically recognizes and binds to tumor necrosis factor α (TNFα). By blocking the activity of TNFα, Cimzia can prevent the harmful effects of this protein, thereby reducing the signs and symptoms of inflammatory diseases such as joint pain, tenderness, swelling and stiffness.
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How to Take Cimzia
Cimzia is given as an injection under the skin (subcutaneous injection). You can learn to inject it yourself, or have a family member or friend give you the injection after proper training from your healthcare provider.
Dosage Instructions
The starting dose is 400 mg (given as 2 injections in one day) at weeks 0, 2 and 4. This is followed by a maintenance dose of 200 mg every other week starting at week 6. Alternatively, your doctor may decide you should receive a monthly dose of 400 mg. The maintenance dose may be adjusted based on your response to treatment. Allow the medication to reach room temperature before injecting (about 30 minutes for pre-filled syringe, 30-45 minutes for pre-filled pen). Choose injection sites on your thigh or stomach, rotating locations for each injection.
What If You Miss a Dose?
If you miss your dose at the usual time, inject the next dose as soon as you remember. Then inject your next dose as you would have on your originally scheduled day. If it's almost time for your next dose, skip the missed dose and take your next dose when scheduled. Never take a double dose to make up for a missed dose.
Important: Do not attempt to self-inject until you are sure you understand how to prepare and give the injection. Get proper training from your healthcare provider first.
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Lower respiratory tract infections (bronchitis, pneumonia)
- Upper respiratory infections (cold, runny nose, sinus infections)
- Bacterial infections including abscesses or urinary tract infections
- Viral infections (cold sores, shingles, influenza)
- Fever
- High blood pressure
- Rash or itching
- Abdominal symptoms (pain, nausea, vomiting, diarrhea, constipation, heartburn, indigestion)
- Injection site reactions (pain, swelling, redness, itching)
- Feeling weak and generally unwell
- Headache
- Dizziness
Seek immediate medical attention if you experience:
- Persistent cough, weight loss, listlessness, fever
- Signs of nervous system disorders (numbness or tingling, arm or leg weakness, double vision)
- A bump or open sore that doesn't heal
- Severe rash, hives, or other signs of allergic reactions
- Swollen face, hands, feet
- Trouble breathing or swallowing
- Shortness of breath with exertion or when lying down
- Swelling of the feet
- Persistent fever, bruising, bleeding, paleness
Important Warnings
Cimzia can affect your immune system and increase your risk of serious infections. It's important to understand all the risks before starting treatment.
Who Should Not Take Cimzia
Do not use Cimzia if you are allergic to certolizumab pegol or any ingredients, have a severe infection including tuberculosis or ongoing/recurring infections, have moderate to severe heart failure, are already using anakinra (another rheumatoid arthritis medicine), or if the packaging is damaged or past its expiry date.
Medical Conditions to Discuss
Tell your doctor if you have: any symptoms of infection (fever, cough, flu-like symptoms, open cuts or sores), history of recurrent infections, nervous system disorders like multiple sclerosis, congestive heart failure, cancer (such as lymphoma and skin cancer), symptoms of lupus (persistent rash, fever, joint pain, tiredness), allergic reactions, airway disease like emphysema or COPD, blood disorders, tuberculosis or close contact with someone who has had it, scheduled vaccines, or planned surgery or dental procedures.
Pregnancy and Breastfeeding
Check with your doctor if you are pregnant or intend to become pregnant. Cimzia can be used during breastfeeding, but discuss this with your doctor first.
Infection Risk: Cimzia may increase your risk of developing serious infections that could lead to hospitalization or death. Watch for signs of infection and contact your doctor immediately if you develop fever, flu-like symptoms, or other signs of infection.
Drug Interactions
Some medicines may interfere with Cimzia and affect how it works. Always tell your healthcare providers about all medications you're taking.
- Anakinra (increases infection risk)
- Abatacept (should not be used together)
- Other biologic medicines (may increase infection risk when used with anti-TNF therapy)
Alcohol & Driving
Be cautious with activities that require alertness until you know how Cimzia affects you.
Alcohol
Tell your doctor if you drink alcohol. Discuss any concerns about alcohol consumption while using Cimzia.
Driving and Operating Machinery
Be careful before you drive or use any machines or tools until you know how Cimzia affects you. The medication may cause dizziness or other side effects that could impair your ability to drive safely.
Storage
Store Cimzia in a refrigerator between 2°C and 8°C. Do not freeze. Keep the pre-filled syringe or pen in the outer carton to protect from light. If needed, Cimzia may be stored at room temperature up to a maximum of 25°C for a single period of up to 10 days with protection from light. Once stored at room temperature, it should not be placed back in the refrigerator and should be discarded if not used within 10 days. Keep out of reach of children.
Overdose Information
If you think you have used too much Cimzia, seek urgent medical attention immediately. Phone the Poisons Information Centre (13 11 26), contact your doctor, or go to the Emergency Department at your nearest hospital. Do this even if there are no signs of discomfort or poisoning.
Frequently Asked Questions
The initial dosing schedule involves injections at weeks 0, 2, and 4, followed by maintenance dosing every 2 weeks or monthly starting at week 6. Your doctor will monitor your response to determine if the treatment is working effectively.
Yes, you can learn to self-inject Cimzia, but only after receiving proper training from your healthcare provider. The injection can also be given by a family member or friend who has been trained in the injection technique.
Contact your doctor immediately if you develop signs of infection such as fever, cough, flu-like symptoms, or open cuts and sores. Cimzia can increase your risk of serious infections, so prompt medical attention is important.
Tell your doctor if you are scheduled for any vaccines. Because Cimzia affects your immune system, your doctor will need to advise you about the safety and timing of vaccinations.
Do not stop using Cimzia unless your doctor tells you to. Follow the instructions provided and use Cimzia until your doctor tells you to stop to ensure the best treatment outcome.
Tell your doctor if you drink alcohol. While the medication information doesn't specify restrictions, it's important to discuss alcohol consumption with your healthcare provider.
Check with your doctor if you are pregnant or intend to become pregnant. Cimzia can be used during breastfeeding, but you should discuss this with your doctor first to ensure it's appropriate for your situation.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.