Live Vaccines
Contraindicated
Database
Immunosuppression — disseminated vaccine infection
Update/avoid live vaccines; delay infant live vaccines if 3rd-trimester exposure
Source: Kimi deep-research + Cla
Drug reference
Adalimumab
Anti-TNF-alpha fully human monoclonal antibody · Immunosuppressant, Anti-inflammatory, Disease-modifying antirheumatic drug (DMARD)
Also known as Humira, Exemptia, Adfrar, Cipmuri, Hulio, Hadlima
START
Screen TB/HBV/HCV first; RA 40 mg SC every other week (IBD: 160→80→40 mg EOW)
TYPICAL MAX
Indication-defined (RA up to 40 mg weekly)
STOP IF
Serious infection, malignancy, demyelination, significant heart failure, HBV reactivation
WATCH
TB/HBV screening pre-treatment, infection vigilance, avoid live vaccines, infant live-vaccine delay if 3rd-trimester exposure
CDSCO approvedSchedule HATC L04AB04
KDIGO 2024 + manufacturer label
- ONSET
- 5d · SC absorption (Tmax ~5 d)
- PEAK
- 5d · Cmax (~5 d)
- t½
- 2w · terminal t½ (~14 d)
- DURATION
- 2w · every-other-week interval
EXCRETION
Proteolytic catabolism; not renal
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
May be continued if clearly needed (low placental transfer 1st/2nd trimester; transfers 3rd trimester — avoid infant live vaccines ≥6 months)
FDA category + note
Top interactionssee all 12 →
- Live VaccinesContraindicatedDatabaseKimi deep-research + Cla
- AbataceptSevereDatabaseDDInter
- AbemaciclibSevereDatabaseDDInter
- AcalabrutinibSevereDatabaseDDInter
Available in India
15 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Binds soluble and transmembrane tumour necrosis factor-alpha, neutralising TNF–receptor interaction → reduced inflammatory cytokine cascade, leukocyte trafficking and tissue damage in immune-mediated diseases.
Indications
Rheumatoid, psoriatic and juvenile idiopathic arthritis; ankylosing spondylitisCrohn disease and ulcerative colitisPlaque psoriasis; hidradenitis suppurativaNon-infectious uveitis
Dosing
- Adult
- RA/PsA/AS: 40 mg SC every other week (weekly if no methotrexate, RA). Crohn/UC: 160 mg → 80 mg → then 40 mg every other week. Psoriasis: 80 mg → 40 mg EOW from week 1.
- Pediatric
- Weight-based (JIA, paediatric Crohn) per label.
- Renal adjustment
- No adjustment (antibody).
- Hepatic adjustment
- No specific adjustment; screen/monitor HBV.
- Geriatric
- Higher infection/malignancy risk; monitor.
- Max dose
- Indication-defined (e.g. 40 mg weekly RA; induction higher in IBD)
Pharmacokinetics
Onset
Clinical response 2–12 weeks
Peak effect
SC Tmax ~5 days
Duration
Every-other-week dosing
Half-life
~10–20 days (~2 weeks)
Bioavailability
SC ~64%
Protein binding
Not applicable (antibody)
Metabolism
Proteolytic catabolism
Excretion
Not renally excreted
Contraindications
- Active serious infection (incl. active TB, sepsis)
- Moderate–severe heart failure (NYHA III/IV — higher dose contraindicated)
- Hypersensitivity to adalimumab
- Live vaccines during therapy
Side effects
Common
Injection-site reactionsUpper respiratory/other infectionsHeadacheRash
Serious
- Serious/opportunistic infections incl. reactivation TB, invasive fungal (boxed)
- Malignancy incl. lymphoma (esp. hepatosplenic T-cell in young IBD on thiopurines) (boxed)
- Demyelinating disease; new/worsening heart failure
- Hepatitis B reactivation; drug-induced lupus; severe cytopenias; hypersensitivity
Pregnancy & lactation
Pregnancy
May be continued if clearly needed (low placental transfer 1st/2nd trimester; transfers 3rd trimester — avoid infant live vaccines ≥6 months)
Lactation
Compatible — minimal infant exposure (large IgG, gut-degraded)
Drug interactions
Abatacept
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Abemaciclib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Acalabrutinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Aflibercept
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Aldesleukin
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Altretamine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anakinra
Severe
Database
Markedly increased serious infection, no added benefit
Do not combine biologic DMARDs
Source: Kimi deep-research + Cla
Antithymocyte Immunoglobulin (rabbit)
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Asparaginase Escherichia Coli
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Atezolizumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Avapritinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Ask House about Adalimumab
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19