Side Effects of Cimzia: What You Need to Know


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Introduction

If you have an autoimmune or inflammatory condition, such as a type of arthritis, your doctor may prescribe Cimzia (certolizumab) for you.

Cimzia is a prescription drug. It’s used to treat the following conditions in adults:

  • an active* form of arthritis, such as:
    • moderate-to-severe rheumatoid arthritis
    • psoriatic arthritis (arthritis that affects your skin and joints)
    • ankylosing spondylitis (arthritis that mostly affects your spine)
    • non-radiographic axial spondyloarthritis with inflammation that can be measured with certain tests
  • moderate-to-severe Crohn’s disease (inflammation in your digestive tract), when other treatments haven’t been effective enough
  • moderate-to-severe plaque psoriasis that may benefit from phototherapy (light treatment) or systemic treatment (medication that works throughout your body)

Cimzia is a biologic drug. (Biologics are medications made from living cells.) It’s given by subcutaneous injection (an injection given under the skin).

Cimzia is a long-term treatment that you may use alone or with other drugs. To learn more about Cimzia, see this in-depth article.

Like all drugs, Cimzia may cause side effects in some people. Keep reading to learn more.

* “Active” means that your condition is causing symptoms.

What are the more common side effects of Cimzia

Some people may experience mild or serious side effects during their Cimzia treatment. Side effects of Cimzia may vary depending on the condition it’s being used to treat.

In general, Cimzia’s common side effects may include:

  • injection site reactions, such as bruising, pain, redness, or swelling
  • rash
  • upper respiratory infections, such as the common cold
  • urinary tract infections, such as a bladder infection

Cimzia may cause other side effects, too. Talk with your doctor about your specific risk for side effects while using this drug.

Learn more about Cimzia’s side effects in the next sections.

What are the mild side effects of Cimzia?

Cimzia may cause mild side effects in some people. Side effects may vary depending on the condition the drug’s being used to treat.

Mild side effects may include:

  • injection site reactions, such as bruising, pain, redness, or swelling
  • rash
  • upper respiratory infections, such as the common cold
  • urinary tract infections, such as a bladder infection
  • cough
  • headache, in people with psoriasis or arthritis
  • herpes infections (such as cold sores, genital herpes, or chickenpox) in people with psoriasis who’ve been exposed to the herpes virus
  • fatigue (lack of energy), when used with methotrexate (Trexall, Rasuvo, RediTrex, Otrexup) to treat rheumatoid arthritis
  • painful joints (in people with Crohn’s disease)

Cimzia may cause other mild side effects, too. See the drug’s medication guide for more details.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop using Cimzia unless your doctor tells you to.

What are the serious side effects of Cimzia?

Cimzia may cause serious side effects. In general, these side effects are rare. But some people may have a higher risk for certain serious side effects. Before starting treatment, talk with your doctor about your risk for serious side effects from this drug.

Serious side effects of Cimzia can include:

  • immune system reactions, such as lupus-like syndrome (which can cause joint pain or a cheek rash that worsens with sun exposure)
  • blood disorders, such as leukopenia (low white blood cell levels) or thrombocytopenia (low platelet levels in the blood)
  • nervous system disorders, such as seizure disorder and optic neuritis (inflammation of the nerves in your eyes)
  • heart failure
  • hepatitis B reactivation, if you carry the virus*
  • serious or fatal infection*†
  • risk for certain cancers*†
  • allergic reaction*

Call your doctor right away if you’re having any new or worsening symptoms. If your symptoms feel life threatening, call 911 or your local emergency phone number to get medical care right away.

* To learn more about this side effect, see the “Side effects explained” section below.
† Cimzia has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

What are the side effects of stopping Cimzia?

Cimzia helps treat certain autoimmune and inflammatory conditions. The goal of treatment is to reach remission. (Remission means that your condition isn’t causing symptoms.)

When you stop using Cimzia, your condition may become active again and cause symptoms. This is called a flare-up.

And if you stop your Cimzia treatment, there’s a chance it won’t work as well if you start using it again. This happens because your body may think that Cimzia is a foreign object and make antibodies against it. The antibodies work in different ways to neutralize Cimzia, making it less effective.

In clinical studies of people taking Cimzia, those who developed antibodies against the drug had much lower blood concentrations of Cimzia than those who did not. This made the drug less effective. In rare cases, this process may raise your risk for other serious side effects, such as lupus-like syndrome.

You shouldn’t stop or change your Cimzia treatment without your doctor telling you to. If you have questions about how long you should expect to take Cimzia, talk with your doctor.

FAQs about Cimzia’s side effects

Get answers to some frequently asked questions about Cimzia’s side effects.

Can Cimzia affect my eyes or eyesight?

It’s possible. In rare cases, Cimzia has caused eye disorders. These may include:

  • optic neuritis (inflammation in the nerves of your eyes)
  • retinal hemorrhage (bleeding in the back of the eye)
  • uveitis (inflammation of the middle layer of your eye)

Talk with your doctor if you’re concerned about your eye health while using Cimzia. And call them right away if you have eye redness, pain, blurred vision, or other vision changes.

Does Cimzia cause weight gain or weight loss?

No, Cimzia isn’t known to cause weight changes. Weight loss or weight gain weren’t seen in clinical studies of Cimzia. But these may be symptoms of other serious side effects of Cimzia.

Weight gain due to fluid retention could be a sign of heart failure. In rare cases, Cimzia has caused heart failure or made existing heart failure worse.

Weight loss can be a symptom of a serious infection caused by Cimzia, such as hepatitis B or tuberculosis.

Lastly, weight changes can be caused by the autoimmune or inflammatory condition you’re using Cimzia to treat. For example, many people with rheumatoid arthritis or Crohn’s disease experience unintentional weight loss.

If you have unexplained weight changes during your Cimzia treatment, talk with your doctor right away.

Does Cimzia cause itching?

Yes, itching can occur with Cimzia. Itching is a symptom of various side effects of Cimzia, such as:

  • dermatitis (skin irritation), rash, or hives
  • allergic reaction
  • latex allergy

It’s important to note that rash and hives could also be symptoms of an allergic reaction. Allergic reactions may be mild, or, in rare cases, serious.

Also, Cimzia comes as prefilled syringe with a cap that contains latex. If you have a latex allergy, you may be sensitive to this form of the drug. In rare cases, allergic reactions have been seen with Cimzia, but it’s unclear if any of these reactions were due to a latex allergy.

While using Cimzia, if you have an itchy rash, hives, or irritated skin that bothers you or gets worse, call your doctor. If you experience side effects that feel serious or life threatening, call 911 or your local emergency phone number to get emergency medical care.

Can Cimzia cause other side effects that affect the skin?

Yes. Severe skin reactions have been seen with Cimzia. Examples of these reactions include new or worsening psoriasis, Stevens-Johnson syndrome, and toxic epidermal necrolysis.

But it’s important to note that these skin reactions weren’t seen in clinical studies of Cimzia. There have been reports of severe skin reactions in people using this drug, but it’s unclear how often this has happened or if Cimzia was the cause.

In rare cases, Cimzia may also cause an inflammatory skin disorder called erythema nodosum. This condition causes painful lumps to form in the fatty layer under your skin.

To learn more about itchy skin with Cimzia, see “Does Cimzia cause itching?” directly above. And talk with your doctor if you have questions or concerns about side effects that may affect your skin.

Is eye twitching a side effect of Cimzia?

No, using Cimzia shouldn’t cause eye twitching. This side effect wasn’t seen in clinical studies of Cimzia.

But Cimzia can cause rare but serious nervous system problems. These problems may include new or worsening multiple sclerosis (MS). And eye twitching is a common MS symptom.

In rare cases, Cimzia has caused other eye problems. See “Can Cimzia affect my eyes or eyesight?” above for more information.

If you have new or worsening eye twitching or other vision concerns, visit your eye doctor.

Side effects explained

Learn more about some of the side effects that Cimzia may cause.

Upper respiratory infections

Upper respiratory infections are a common side effect of Cimzia. These are bacterial or viral infections that affect your upper airways (the sinuses, nose, back of the throat, throat, and lungs). Examples include:

  • the common cold
  • sinus infections
  • strep throat

What might help

While using Cimzia, take steps to avoid germs that can cause upper respiratory infections. For example:

  • Wash or sanitize your hands often.
  • Avoid crowds and people who are sick during cold and flu season.
  • Stay up to date on vaccines (see note below for details).
  • Eat a balanced diet and drink enough water to stay hydrated.
  • Keep all doctor and lab appointments.
  • Contact your doctor if you feel sick.
  • Finish antibiotics as prescribed by your doctor.

Call your doctor if you have any symptoms of an infection, even if they seem mild. Examples of infection symptoms include fever, cough, sore throat, and congestion.

Your doctor will check for infection and, if needed, prescribe treatment to clear it. In some cases, they may stop your Cimzia treatment until your infection has cleared. But don’t stop or change your Cimzia treatment unless your doctor tells you to.

Note: Because Cimzia may weaken your immune system, you shouldn’t get live vaccines during your treatment. Live vaccines contain a weakened form of a virus or bacterium, and they could cause infection in someone with a weakened immune system. Examples of live vaccines include those for smallpox, chickenpox, and measles, mumps, and rubella (MMR). Before starting Cimzia, talk with your doctor about any vaccines you may need.

Urinary tract infection

Urinary tract infection (UTI) is a common side effect of Cimzia. A UTI is a bacterial infection that affects your ureters, urethra, bladder, or kidneys.

What might help

If you have a UTI, you’ll need antibiotics to clear the infection. Without treatment, a UTI can become serious. So, contact your doctor right away if you have any symptoms, such as:

  • pain or burning while urinating
  • bloody, cloudy, or smelly urine
  • an urgent or frequent need to urinate
  • pain in your lower abdomen (belly) or back
  • fever or chills

Hepatitis B reactivation

Hepatitis B is a serious liver infection. If you have a chronic (ongoing) hepatitis B infection or have had hepatitis B in the past, Cimzia could reactivate the virus in your body. This could cause severe illness or even lead to death.

In rare cases, Cimzia has caused raised liver enzymes (which can be a sign of liver damage and hepatitis B).

What might help

Tell your doctor about any liver problems you’ve had, including a current or past hepatitis B infection. Your doctor will test you for hepatitis B before starting Cimzia and during your treatment. If you test positive, they’ll decide if Cimzia is right for you.

While using Cimzia, watch for any symptoms of liver damage. Call your doctor if you notice any new or worsening symptoms, such as:

  • jaundice (yellowing skin or whites of your eyes)
  • weight loss or low appetite
  • pain in your upper-right abdomen
  • nausea or vomiting
  • weakness or extreme fatigue (lack of energy)
  • itching
  • dark urine or light-colored stools
  • joint pain

Other serious infections

Cimzia has a boxed warning for the risk of serious infection. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Cimzia can make it harder for your immune system to protect against germs. So, you may have a higher risk for serious or fatal infections. These infections may be bacterial, such as tuberculosis (TB), or they may be fungal, parasitic, or viral.

Your risk for a serious infection with Cimzia may be higher if you:

  • live in or travel to places where these infections are common
  • use Cimzia with drugs that suppress the immune system
  • have certain other conditions, such as diabetes or HIV
  • are over the age of 65 years

What might help

Before starting Cimzia, your doctor will test you for TB and other infections, especially if you live in or have traveled to certain places.

Tell your doctor if you’re sick, get infections often, or get infections that keep returning. Before starting Cimzia, you’ll need to receive treatment to clear any infections.

And while using Cimzia, tell your doctor about any infection symptoms you have, such as:

  • fever or chills
  • lasting fatigue (lack of energy)
  • cough
  • unexplained weight loss
  • body aches or malaise (an overall feeling of discomfort)

Talk with your doctor about your risk for serious infections while using Cimzia.

Certain cancers

Cimzia has a boxed warning for the possible risk of certain cancers. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

In rare cases, drugs such as Cimzia have been linked with certain cancers. These cancers may include:

  • skin cancers
  • leukemia (cancer that usually affects white blood cells)
  • lymphomas (cancers of the lymphatic system and immune cells)

Rare cancers and lymphoma have occurred in children and teens using tumor necrosis factor (TNF) blocker drugs. Cimzia is a TNF blocker and shouldn’t be used by anyone younger than 18 years old.

What might help

Talk with your doctor about your cancer risk with Cimzia. Tell them if you’ve had cancer in the past or if you’re currently undergoing cancer treatment.

While taking Cimzia, tell your doctor right away about any new or worsening symptoms, such as:

  • changes in your skin, including new or growing marks, moles, or lesions
  • swollen glands
  • fever or chills
  • lasting fatigue
  • unexplained weight loss
  • bruising or bleeding

These symptoms could indicate cancer. If you experience any of them, call your doctor right away.

Allergic reaction

Like most drugs, Cimzia can cause an allergic reaction in some people. Symptoms can be mild or serious and can include:

  • rash or hives
  • itchiness
  • flushing (warmth, swelling, or redness in your skin)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine, such as diphenhydramine (Benadryl), or a topical product, like hydrocortisone cream, to manage your symptoms.

If your doctor confirms that you had a mild allergic reaction to Cimzia, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

Keeping track of side effects

During your Cimzia treatment, consider keeping notes about any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things like:

  • what dosage of drug you were taking when you had the side effect
  • how soon after starting that dosage you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • which other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Cimzia affects you. And your doctor can use this information to adjust your treatment plan, if needed.

Warnings for Cimzia

Cimzia has several warnings that may affect whether or not you can safely use this drug.

Boxed warnings

Cimzia has boxed warnings about serious or fatal infections, certain cancers, and usage in children. These are serious warnings from the Food and Drug Administration (FDA).

Serious or fatal infections

Cimzia can make it harder for your immune system to protect against germs. So, you may have a higher risk for serious or fatal infections. If you develop an infection, you may need to stop using Cimzia and receive treatment in a hospital.

For more details, see the “Side effects explained” section above.

Possible risk of certain cancers

Cimzia may raise your risk for certain cancers, such as lymphoma, leukemia, and skin cancer. Rare cancers and lymphoma have occurred in children and teens using tumor necrosis factor (TNF) blocker drugs. Cimzia is a TNF blocker and shouldn’t be used by anyone younger than 18 years old. To learn more, see the “Side effects explained” section above.

Other warnings

Cimzia may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Cimzia. Factors to consider include those in the list below.

Current or past hepatitis B infection. If you have a chronic (ongoing) hepatitis B infection or have had hepatitis B in the past, Cimzia could reactivate the virus in your body. This could cause severe illness or even lead to death. Your doctor will check you for the hepatitis B virus before starting your Cimzia treatment. If you test positive, they’ll decide if Cimzia is right for you. You’ll also be monitored for infection during treatment with Cimzia.

Heart failure. Cimzia can cause heart failure or make the condition worse. If you have heart failure, your doctor will monitor you closely while using Cimzia.

Nervous system disorders. Cimzia can cause nervous system disorders, including multiple sclerosis, seizure disorder, optic neuritis, and peripheral neuropathy. Or, it could make symptoms worse if you already have one of these conditions. If you have a nervous system disorder, talk with your doctor before using Cimzia.

Blood disorders. Cimzia may lower your levels of certain blood cells, such as your white blood cells or platelets. If you’ve ever had blood cell disorders or blood cancer, your doctor will monitor you closely and check your blood counts during your Cimzia treatment.

Allergy to Cimzia or another TNF blocker. Don’t take Cimzia if you’ve had an allergic reaction to it or any of its ingredients. Cimzia is a type of TNF blocker drug. If you’ve had an allergic reaction to another TNF blocker, such as adalimumab (Humira) or etanercept (Enbrel), your doctor will decide if Cimzia is right for you.

Latex allergy. The Cimzia prefilled syringe has a cap that contains latex. If you have a latex allergy, talk with your doctor before using this form of the drug. They may suggest that you use the other form of Cimzia (single-dose vial) instead.

Alcohol use and Cimzia

Cimzia should be safe to use if you drink alcohol.

But alcohol can damage your liver. And other drugs that are used with Cimzia, such as methotrexate (Trexall, Rasuvo, RediTrex, Otrexup), can also harm your liver. Drinking alcohol with methotrexate may raise your risk for liver problems. Because of this, you shouldn’t drink alcohol if you use methotrexate. In addition, alcohol could also make your autoimmune or inflammatory condition worse.

If you’ve had a hepatitis B infection in the past and are using Cimzia, it may not be safe for you to drink alcohol.

If you drink alcohol, ask your doctor how much may be safe for you to drink with your condition and treatment plan.

Pregnancy and breastfeeding while taking Cimzia

It’s unknown if Cimzia is safe to use during pregnancy or while breastfeeding. If you’re pregnant, planning to become pregnant, or would like to breastfeed your child, talk with your doctor before using Cimzia.

If you decide to use Cimzia during pregnancy, consider joining the pregnancy registry. The registry gathers details about how Cimzia may affect pregnancy.

What to ask your doctor

Cimzia may improve your rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, or other condition. But it may cause mild side effects in some people. In rare cases, it could also cause an infection or other serious side effects.

If you have questions about Cimzia’s side effects, talk with your doctor or pharmacist. For example, you may wonder:

  • Which serious fungal infections can occur with Cimzia, and am I at risk?
  • Which symptoms of heart failure should I watch for?
  • What is my risk for infection if I’m older than age 65 years and have lung disease?
  • If I’ve had low white blood cell levels in the past, can I still use Cimzia?
  • What can I do to help prevent infection while using Cimzia?

If you’re using Cimzia for psoriasis, subscribe to our online newsletter for helpful information on treatment options, dealing with flare-ups, and more.

Ask a pharmacist

Q:

My doctor told me I shouldn’t get certain vaccines while using Cimzia. Which ones should I avoid?

Anonymous patient

A:

During your Cimzia treatment, you should avoid getting any live vaccines. Live vaccines contain a weakened form of a virus or bacterium. In some cases, they could cause infection in people with weakened immune systems, such as someone using Cimzia.

Examples of live vaccines include those for yellow fever, chickenpox, and measles, mumps, and rubella (MMR), as well as the intranasal (nasal spray) form of the flu vaccine.

Before starting Cimzia, talk with your doctor about any vaccines you may need or are scheduled to receive. If you recently received a live vaccine, your doctor will wait a few weeks to start your Cimzia treatment. And your doctor won’t give you a live vaccine during your Cimzia treatment.

Purva Singla, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Healthline

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.


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