Cimzia (certolizumab) is a prescription drug that’s used to treat Crohn’s disease and other conditions. Cimzia comes as an injection given under your skin.

Cimzia is prescribed to adults to manage:

To learn more about Cimzia’s uses, see “What is Cimzia used for?” below.

Cimzia basics

Cimzia contains the active drug certolizumab, which is a tumor necrosis factor (TNF) inhibitor.

Cimzia is a biologic medication, and isn’t available in a biosimilar form. Biosimilar medications are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs. Instead, certolizumab only comes as the brand-name drug Cimzia.

Like most drugs, Cimzia may cause mild or serious side effects. The lists below describe some of the more common side effects that Cimzia may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Cimzia. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Cimzia can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Cimzia’s prescribing information.

Mild side effects of Cimzia can include:

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information on this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Cimzia can occur, but they aren’t common. If you have serious side effects from Cimzia, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects can include:

* For more information on this side effect, see the “Are there any precautions when using Cimzia?” section below.
† See the “Side effect focus” section below for more information on this side effect.

Side effect focus

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

Boxed warnings

Cimzia has boxed warnings for serious infection and cancer. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

Serious infection. Cimzia reduces the activity of your immune system, which increases your risk of getting serious infections. These infections can include:

You may have a higher risk of infection while you’re using Cimzia if you:

  • are ages 65 years or older
  • are taking other drugs that decrease your immune system activity, such as corticosteroids or methotrexate
  • have certain chronic (long-lasting) health conditions

Common symptoms of infections to watch for include:

  • fever or chills
  • sweating
  • cough
  • burning when you urinate
  • muscle aches
  • diarrhea

Cancer. Lymphoma (cancer of the lymph nodes) and other cancers have occurred in children and adolescents taking tumor necrosis factor (TNF) inhibitors. And Cimzia is a TNF inhibitor.

In addition, skin cancers have been identified in people using TNF inhibitors including Cimzia. Examples of these skin cancers include melanoma and Merkel cell carcinoma.

What might help

If you have any symptoms of infection while you’re taking Cimzia, tell your doctor right away. Your doctor may have you stop taking Cimzia. But do not stop taking Cimzia without first talking with your doctor.

Your doctor will not prescribe Cimzia for you if you have an active infection. If you have frequent or long-lasting infections, your doctor will weigh the benefits and risks of Cimzia before prescribing it for you.

While you’re taking Cimzia, your doctor will check you regularly for infection. If you travel to or live in areas with a high risk of fungal infections, you may need to take antifungal treatment to avoid a fungal infection.

Because TNF inhibitors increase the risk of cancer in children, Cimzia isn’t approved for use in people younger than 18 years of age.

During Cimzia treatment, it’s recommended that you check your skin regularly for any changes that may indicate skin cancer. If you have risk factors for skin cancer, having regular skin checks is especially important.

Be sure to talk with your doctor if you notice any changes in your skin’s appearance during or after treatment with Cimzia. These changes could include new growths or sores.

Tiredness

If you feel more tired than usual, it may be a side effect of Cimzia.

But tiredness may also be a symptom of infection. And Cimzia has a warning about the risk of infection while using the drug. For more information about this warning, see the “Boxed warnings” section above. If you think you have an infection before starting Cimzia, or think you have an infection during or after taking Cimzia, tell your doctor right away.

What might help

If you’re feeling more tired than usual while taking Cimzia, talk with your doctor. They may check whether you have an infection. If you do have an infection, your doctor will treat it.

Your doctor may also tell you to stop taking Cimzia for a short time. But do not stop taking Cimzia without first talking with your doctor.

If you don’t have an infection, your doctor may suggest ways to help boost your energy levels.

Hair loss

It’s possible to have hair loss while you’re taking Cimzia. This side effect was seen in some people who had an immune system flare-up during studies of Cimzia. The type of hair loss seen is called alopecia totalis, which is a complete loss of all the hair on your head.

Studies showed that hair loss is a rare side effect of TNF inhibitors such as Cimzia.

What might help

If you’re concerned about hair loss while you’re taking Cimzia, talk with your doctor. And check out these tips on how to help prevent hair loss.

Allergic reaction

Some people may have an allergic reaction to Cimzia.

Symptoms of a mild allergic reaction can include:

  • rash
  • itchiness
  • flushing (warmth, swelling, redness, or discoloration in your skin)
  • injection site reactions, such as bruising, pain, discoloration, or swelling

To view pictures of skin rashes, including those caused by drug allergies, see this article.

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat, which can cause trouble breathing
  • low blood pressure
  • dizziness or fainting
  • hot flashes
  • fever

Also, Cimzia prefilled syringes contain materials that are similar to latex. So, if you’re allergic to latex, you may have an allergic reaction when handling these syringes. If you’re sensitive to or allergic to latex, your doctor likely won’t prescribe Cimzia prefilled syringes to you.

Call your doctor right away if you have an allergic reaction to Cimzia. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Your doctor will recommend the dosage of Cimzia that’s right for you. Below are commonly used dosages, but always follow the dosage your doctor prescribes.

Forms and strength

Cimzia is given as an injection under your skin. The drug comes in two forms:

  • a powder inside single-dose vials that’s mixed into a solution
  • a solution inside single-dose prefilled syringes

Each form comes in a strength of 200 milligrams.

Recommended dosages

Depending on the reason you’re using Cimzia, your doctor will prescribe a specific dosage for you.

Dosage for plaque psoriasis

For plaque psoriasis treatment, you’ll have a Cimzia injection once every 2 weeks. But if you weigh less than 90 kilograms (about 198 pounds), your doctor may prescribe a first dose, followed by another 2 doses that are each taken 2 weeks apart. Then after those 3 doses, you’ll receive a dose of Cimzia once every 2 weeks.

Dosage for Crohn’s disease

For Crohn’s disease treatment, you’ll get your first injection, and then another injection 2 weeks later. Then, you’ll take the drug again 2 weeks after that. After those 3 doses, if your condition is responding to the drug, you’ll take Cimzia once every 4 weeks.

Dosage for arthritis

If you’re taking Cimzia for rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, or axial spondyloarthritis, you’ll get your first dose and a second dose 2 weeks later. Then, you’ll take another dose 2 weeks after that. After those 3 doses, your doctor may recommend a Cimzia injection once every 4 weeks or once every 2 weeks.

How to inject Cimzia

Your doctor will explain how you should use Cimzia. They’ll also explain how much to inject and how often. Be sure to follow your doctor’s instructions.

You or your doctor will inject Cimzia under your skin. If you’re giving the injections to yourself, you’ll use the prefilled syringes. A healthcare professional will show you how to administer the drug. You’ll inject Cimzia into one of these areas on your body:

  • your abdomen, staying 2 inches (5 centimeters [cm]) away from your belly button
  • the front of your thighs

Each time you inject Cimzia, you should change injection sites. And each new injection should be at least 1 inch (2.5 cm) away from the injection site you last used.

Taking Cimzia with other drugs

In some cases, your doctor may recommend that you take other medications with Cimzia. For example, if you have:

  • plaque psoriasis, your doctor may prescribe Cimzia together with methotrexate.
  • Crohn’s disease, your doctor may prescribe Cimzia together with certain other drugs. These include:
  • RA, your doctor may prescribe Cimzia together with methotrexate, if needed.
  • psoriatic arthritis, Cimzia is usually prescribed alone. Using it together with methotrexate is typically avoided. But if you have severe psoriatic arthritis, your doctor may consider prescribing Cimzia together with methotrexate.
  • stable ankylosing spondylitis or non-radiographic axial spondyloarthritis, Cimzia is usually prescribed without methotrexate. Your doctor may have you take nonsteroidal anti-inflammatory drugs (NSAIDs) with Cimzia. But you’d likely only take them together for a short time.

Also, for flare-ups of arthritis or Crohn’s disease, your doctor may have you take prednisone with Cimzia.

Questions about taking Cimzia

Below, we answer some questions related to Cimzia dosage.

  • What if I miss a dose of Cimzia? If you miss an appointment to get a Cimzia injection from your doctor, call your doctor’s office to reschedule. If you forget to inject Cimzia yourself, take the dose as soon as you remember, or call your doctor. They can tell you whether you should take the missed dose right away, or skip it and wait for your next dose. If you’re unsure when to inject your next dose after a missed dose, call your doctor to set up a new schedule for your injections.
  • Will I need to use Cimzia long term? The conditions that Cimzia treats are long lasting. So, you’ll likely take Cimzia long term. Talk with your doctor to find out how long you’ll need to take Cimzia.
  • Should I take Cimzia with food? You can inject Cimzia on an empty or a full stomach. Eating food doesn’t affect how much of the medication is absorbed by your body.
  • How long does Cimzia take to work? Everyone may have a different experience with Cimzia treatment. Depending on the reason you’re using Cimzia, you may notice the drug working at different times. For example, in studies of people with Crohn’s disease, improvements were seen after 6 weeks of Cimzia treatment. In studies of people with RA, improvements were seen after 24 weeks of Cimzia treatment. But it’s possible to have improvements within a few weeks of starting treatment. Ask your doctor how long it should take for Cimzia to work for your condition.

If you have certain conditions, your doctor may recommend that you take Cimzia. It’s prescribed to adults to treat the following long-lasting conditions:

  • Plaque psoriasis (PsO). With PsO, you have inflammation in your skin. You may have pink or dark-colored patches with scales. These may appear on your scalp, elbows, knees, and lower back. Any part of your body can be affected by PsO.
  • Crohn’s disease (CD). CD is an inflammatory bowel disease that can affect your entire digestive system. Most people with CD have inflammation in their intestines.
  • Rheumatoid arthritis (RA). With RA, you have swollen, painful joints. Usually, you’ll have swelling in the small joints of your hands and the wrist. Other joints that may be affected by RA include the knees, ankles, elbows, shoulders, and hips.
  • Psoriatic arthritis (PsA). With PsA, you have swelling in your joints and your skin. This condition shares many features of both RA and PSO.
  • Ankylosing spondylitis (AS). AS is an inflammatory disease that affects the spine. People with AS usually have long-lasting lower back pain and stiffness in their spine.
  • Non-radiographic axial spondyloarthritis. With non-radiographic axial spondyloarthritis, you have symptoms consistent with AS. But unlike AS, you don’t have inflammation on your lower spine that can be seen on radiographs (X-rays).

Cimzia works for these conditions by blocking a protein called tumor necrosis factor (TNF). By blocking the action of TNF, Cimzia helps to reduce inflammation that leads to certain immune-related conditions.

Cimzia and Humira are both used to treat some of the same conditions. They have some of the same side effects and risks. But these drugs also have some differences.

To see a breakdown of how Cimzia and Humira are alike and different, view our “Cimzia vs. Humira” article.

Find answers to some commonly asked questions about Cimzia.

Does Cimzia cause weight gain or weight loss?

No, Cimzia doesn’t affect your weight. But if you get an infection while you’re taking Cimzia, you may lose weight.

Cimzia has a warning about the risk of infection while using the drug. For more information about this warning, see the “Boxed warnings” in the “What are Cimzia’s side effects?” section above. If you think you had an infection before taking Cimzia, or you have an infection during or after taking Cimzia, tell your doctor right away.

On the other hand, if you have unexpected weight gain with Cimzia, it could indicate fluid retention in your body. And this can be a sign of heart failure. In rare cases, Cimzia has caused new or worsening heart failure.

If you’re concerned about your body weight while you’re taking Cimzia, talk with your doctor. They can recommend ways to help you manage a weight that’s healthy for you.

How does Cimzia work?

Cimzia works by affecting your immune system. It’s called a tumor necrosis factor (TNF) inhibitor. The drug works by blocking TNF, which is a protein that plays an important role in your immune system.

When TNF is overactive, it can cause conditions such as arthritis, plaque psoriasis, or Crohn’s disease. By blocking TNF, Cimzia helps to manage inflammation that occurs in diseases caused by your immune system.

Is Cimzia similar to Enbrel?

Cimzia and Enbrel are both biologic drugs. These drugs work by blocking the action of an immune system protein called tumor necrosis factor (TNF).

You’ll take either Cimzia or Enbrel as an injection under your skin.

Both Cimzia and Enbrel may be prescribed in certain people for:

In addition, Cimzia can be used for Crohn’s disease and non-radiographic spondyloarthritis. And Enbrel can be used in certain children for juvenile idiopathic arthritis and juvenile psoriatic arthritis.

It’s important to note that Cimzia has a warning about the risk of cancer, which has been found in children receiving the drug. (For more information about this, see “Boxed warnings” in the “What are Cimzia’s side effects?” section above.) Unlike Enbrel, Cimzia isn’t used in people younger than 18 years of age.

If you’d like to know more about these drugs, talk with your doctor or pharmacist.

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking Cimzia, be sure to tell your doctor about all medications you take (including prescription and OTC types). Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Cimzia.

Interactions with drugs or supplements

Cimzia can interact with several types of drugs. This includes other biologic drugs such as:

This list doesn’t contain all types of drugs that may interact with Cimzia. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Cimzia.

Other interactions

Cimzia may also interact with vaccines and affect the results of certain lab tests. Read on to learn more.

Cimzia and live vaccines

Cimzia may make some vaccines less effective than usual. This happens because Cimzia reduces the activity of your immune system. When you get a vaccine, you need your immune system to respond to the vaccine. But while you’re taking Cimzia, your immune system can’t respond like it usually would.

Also, while you’re taking Cimzia, you should not get any live vaccines. Live vaccines are made from living germs. So, with your immune system being less active than usual, if you receive a live vaccine, you may get the infection the vaccine was meant to protect you from.

Examples of live vaccines include:

Before getting any vaccines, talk with your doctor. They can make sure it’s safe for you to have the vaccine with Cimzia.

Cimzia and lab tests

Cimzia may interfere with the results of lab tests called coagulation tests. These blood tests check how well your body forms blood clots.

If you have these tests while you’re taking Cimzia, they may show abnormalities. This can happen even if you don’t have a problem with your blood’s clotting ability.

Before having any blood tests, be sure to tell your doctor that you’re taking Cimzia.

Like some other medications, Cimzia has precautions that are provided by its manufacturer. Before taking Cimzia, talk with your doctor to make sure it’s the right medication for you.

Boxed warnings

Cimzia has boxed warnings about serious infection and cancer. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Serious infections. Some people may develop serious infections while taking Cimzia. Serious infections may include tuberculosis (TB), sepsis (bacterial infection in your blood), fungal, viral, and parasitic infections, and other rare infections.

Cancer. Cimzia may raise your risk for blood cancers and skin cancer.

For more information about these warnings, see the “What are Cimzia’s side effects?” 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.

  • Reactivation of hepatitis B. Before prescribing Cimzia, your doctor will check whether you have hepatitis B. It’s possible to have hepatitis B in your body, but not have any symptoms from it. If your test is positive for hepatitis B, your doctor may prescribe medication to treat the infection before you start taking Cimzia. Your doctor will monitor you for hepatitis B while you’re taking Cimzia, and for several months after you’ve stopped taking the drug. If your hepatitis B infection comes back, your doctor will have you stop taking Cimzia. And they’ll prescribe medication to treat the infection. But do not stop taking Cimzia without first talking with your doctor.
  • Blood abnormalities. Cimzia can cause blood disorders as a side effect. If you currently have or have had abnormal blood test results, be sure to talk with your doctor about this. They can determine whether Cimzia treatment is safe for you.
  • Allergic reaction. If you’ve had an allergic reaction to Cimzia or any of its ingredients, your doctor won’t prescribe Cimzia. Ask your doctor what other medications are better options for you.
  • Heart failure. Cimzia may cause new or worsening heart failure. If you already have heart failure, your doctor will weigh the benefits and risks of prescribing Cimzia for you. If you have any problems with your heart while you’re taking Cimzia, call your doctor right away.
  • Nerve reactions. Cimzia may cause new or worsening of certain nerve diseases. These include multiple sclerosis, Guillain-Barré syndrome, seizures, optic neuritis, and peripheral neuropathy. If you have problems with your nerves, ask your doctor if Cimzia is right for you. And if you have any seizures or other symptoms related to your brain, spinal cord, or nerves, tell your doctor right away.

Some medications interact with alcohol. Although Cimzia isn’t one of them, medicines you may take with Cimzia could interact with alcohol.

For example, methotrexate is sometimes used with Cimzia. And it can injure your liver, as does drinking a lot of alcohol. Because of this, you should avoid drinking alcohol while taking methotrexate with Cimzia.

To be safe, before starting Cimzia, ask your doctor or pharmacist if it’s safe for you to drink alcohol based on your treatment plan.

It’s not known whether Cimzia is safe to use during pregnancy. Before taking this drug, let your doctor know if you’re pregnant or considering pregnancy. Your doctor can recommend appropriate treatments for your condition.

It’s thought rheumatoid arthritis (RA) that’s not well managed may be harmful to a pregnancy. And Cimzia is used for RA.

If you do use Cimzia during pregnancy, consider enrolling in the drug’s pregnancy registry. This registry collects information on the effects of Cimzia when used during pregnancy. Reporting effects of Cimzia during pregnancy helps researchers to better understand the drug’s effects if used during pregnancy. To enroll in the registry and report effects of Cimzia, call 866-626-6847 or visit the registry’s website.

Small amounts of Cimzia may pass into breast milk. But in studies, children breastfed by people taking Cimzia didn’t have side effects of the drug. Talk with your doctor about the safety of breastfeeding while taking Cimzia. Your doctor may recommend safe ways to feed your child while taking this drug.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Cimzia manufacturer’s website to see support options.

Do not take more Cimzia than your doctor prescribes. Using more than this can lead to serious side effects. If you take too much Cimzia, you doctor may closely monitor you for signs and symptoms of overdose.

What to do in case you take too much Cimzia

Call your doctor if you think you’ve taken too much Cimzia. You can also call 800-222-1222 to reach America’s Poison Centers, or use its online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

If you have questions about taking Cimzia, talk with your doctor or pharmacist. Your doctor can tell you about other treatments available for your condition.

Some questions to ask your doctor about using Cimzia may include:

  • Which creams can I use with Cimzia for my plaque psoriasis?
  • How can I boost my immune system to prevent getting a cold or flu while taking Cimzia?
  • How should I store Cimzia if I’m traveling on a plane?
  • What should I do if the solution in the Cimzia prefilled syringe is cloudy?

To learn more about Cimzia, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Q:

How should I store Cimzia prefilled syringes at home?

Anonymous

A:

If you inject Cimzia yourself, you’ll receive the drug in prefilled syringes that are packed in ice. If you need to, you can keep Cimzia syringes at room temperature (up to 77°F/25°C) for up to 7 days. Be sure to write down the date you took the syringe out of the refrigerator so you can remember when the 7 days are up.

Once you take Cimzia out of the refrigerator and bring it to room temperature, you shouldn’t put the medicine back into the fridge.

Typically, once you open and remove the outer packaging, Cimzia should be stored in the refrigerator at 36°F to 46°F (2°C to 8°C). But it should never be frozen.

Also, it’s important to protect Cimzia from light. So, leave the syringes in their original carton while storing.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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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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