What is Certolizumab: Uses, Dosage, Side Effects and More

Certolizumab is a prescription medication that helps reduce inflammation in your body by blocking specific proteins that cause autoimmune conditions. It's given as an injection under your skin, similar to how people with diabetes give themselves insulin shots.

This medication belongs to a group called TNF blockers, which work by targeting tumor necrosis factor-alpha, a protein that triggers inflammation in conditions like rheumatoid arthritis and Crohn's disease. Your doctor might recommend certolizumab when other treatments haven't provided enough relief from your symptoms.

What is Certolizumab?

Certolizumab is a biologic medication that targets your immune system to reduce harmful inflammation. Unlike traditional pills, it's a protein-based medicine that mimics your body's natural immune responses but redirects them in a helpful way.

The medication comes as a pre-filled syringe or auto-injector pen that you use to inject the medicine under your skin. It's designed to be given at home once you and your healthcare provider feel comfortable with the injection process.

Think of certolizumab as a targeted approach to calming down your overactive immune system. While your immune system normally protects you, in autoimmune conditions it mistakenly attacks healthy tissues, causing pain and inflammation.

What is Certolizumab Used For?

Certolizumab treats several autoimmune conditions where your immune system causes inflammation in joints, intestines, or skin. Your doctor prescribes it when you need stronger treatment than what over-the-counter medications can provide.

The most common conditions treated with certolizumab include rheumatoid arthritis, where it helps reduce joint pain and swelling. It's also used for psoriatic arthritis, which affects both your skin and joints with painful, swollen areas.

For people with Crohn's disease, certolizumab can help reduce intestinal inflammation that causes abdominal pain, diarrhea, and other digestive symptoms. It's also prescribed for ankylosing spondylitis, a type of arthritis that primarily affects your spine.

Additionally, certolizumab treats plaque psoriasis, helping reduce the thick, scaly patches that appear on your skin. Your doctor will determine if it's right for your specific condition based on your symptoms and how you've responded to other treatments.

How Does Certolizumab Work?

Certolizumab works by blocking TNF-alpha, a protein that your immune system produces when it thinks it needs to fight infection or injury. In autoimmune conditions, your body makes too much of this protein, causing ongoing inflammation.

This medication is considered a strong, targeted treatment that specifically focuses on one part of your immune response. Unlike broad immune suppressants, certolizumab doesn't shut down your entire immune system, but rather fine-tunes it.

When TNF-alpha is blocked, the inflammation in your joints, intestines, or skin begins to calm down. This can lead to reduced pain, less swelling, and improved function in the affected areas of your body.

The effects aren't immediate, though. Most people start noticing improvements within 4 to 12 weeks of starting treatment, with continued benefits as long as they keep taking the medication as prescribed.

How Should I Take Certolizumab?

Certolizumab is given as an injection under your skin, usually in your thigh, abdomen, or upper arm. Your healthcare provider will teach you how to give yourself these injections safely at home.

Before each injection, take the medication out of the refrigerator and let it reach room temperature for about 30 minutes. This makes the injection more comfortable and reduces stinging at the injection site.

You don't need to take certolizumab with food since it's injected rather than swallowed. However, it's helpful to stay well-hydrated and maintain good nutrition to support your overall health while on this treatment.

Always rotate your injection sites to prevent skin irritation. Clean the injection area with an alcohol wipe and let it dry completely before injecting. Store unused medication in your refrigerator, but never freeze it.

How Long Should I Take Certolizumab For?

The length of certolizumab treatment varies depending on your condition and how well you respond to the medication. Many people take it for months or years to maintain control of their symptoms.

Your doctor will typically start you on a loading dose schedule, giving you higher or more frequent doses initially to build up therapeutic levels in your body. After this initial period, you'll likely move to a maintenance schedule.

For conditions like rheumatoid arthritis or Crohn's disease, long-term treatment is often necessary because these are chronic conditions that require ongoing management. Stopping the medication usually leads to symptoms returning.

Your healthcare provider will regularly monitor your response and may adjust your treatment plan based on how you're feeling and any side effects you experience. Never stop taking certolizumab suddenly without discussing it with your doctor first.

What Are the Side Effects of Certolizumab?

Like all medications, certolizumab can cause side effects, though not everyone experiences them. Most side effects are mild and manageable, but it's important to know what to watch for.

The most common side effects you might experience include reactions at the injection site, such as redness, swelling, or mild pain where you gave yourself the shot. These usually improve within a few days and become less noticeable as your body adjusts to the treatment.

Some people develop cold-like symptoms, including stuffy nose, sore throat, or mild headaches. You might also notice fatigue or feel slightly run down, especially when you first start the medication.

More serious but less common side effects can include increased risk of infections since certolizumab affects your immune system. Watch for signs of infection like fever, persistent cough, unusual fatigue, or any symptoms that seem more severe than a typical cold.

Very rare but serious side effects include severe allergic reactions, liver problems, or blood disorders. Your doctor will monitor you with regular blood tests to catch any potential issues early.

If you experience any side effects that concern you or interfere with your daily life, contact your healthcare provider. They can help determine if the symptoms are related to your medication and adjust your treatment if needed.

Who Should Not Take Certolizumab?

Certolizumab isn't safe for everyone, and your doctor will carefully review your medical history before prescribing it. People with active infections shouldn't start this medication since it can make infections worse.

If you have a history of tuberculosis, hepatitis B, or hepatitis C, your doctor will need to evaluate whether certolizumab is safe for you. These conditions can become active again when your immune system is suppressed.

People with certain types of cancer, particularly blood cancers like lymphoma, typically shouldn't take certolizumab. Your doctor will also be cautious if you have a history of skin cancer or other malignancies.

If you have heart failure, liver disease, or certain nervous system conditions like multiple sclerosis, your doctor will weigh the risks and benefits carefully. Pregnancy and breastfeeding also require special consideration.

Before starting certolizumab, make sure to tell your doctor about all your health conditions, including any recent infections, surgeries, or other medications you're taking. This helps ensure the treatment is safe for your specific situation.

Certolizumab Brand Names

Certolizumab is sold under the brand name Cimzia in most countries, including the United States. This is the most common name you'll see on your prescription and medication packaging.

The medication comes in different formulations under the Cimzia brand, including pre-filled syringes and auto-injector pens. Both contain the same active ingredient but offer different options for ease of use.

When talking with your pharmacist or insurance company, you can use either "certolizumab" or "Cimzia" to refer to your medication. Some insurance plans may have specific requirements about which formulation they cover.

Certolizumab Alternatives

Several other medications work similarly to certolizumab if it's not the right fit for you. These include other TNF blockers like adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade).

Your doctor might also consider different types of biologic medications that target other parts of your immune system, such as rituximab or abatacept. These work through different mechanisms but can be effective for similar conditions.

For some people, traditional medications like methotrexate or sulfasalazine might be appropriate alternatives, either alone or in combination with biologic treatments. The choice depends on your specific condition and how you've responded to other treatments.

Each alternative has its own benefits and potential side effects, so your doctor will work with you to find the best option based on your individual needs and circumstances.

Is Certolizumab Better Than Adalimumab?

Both certolizumab and adalimumab are effective TNF blockers, but they have some differences that might make one more suitable for your situation. Neither is universally "better" than the other.

Certolizumab may be preferred during pregnancy because it's less likely to cross the placenta and affect the developing baby. It also has a slightly different dosing schedule that some people find more convenient.

Adalimumab has been available longer and has been studied in more conditions, so there's more long-term data available. Some people respond better to one medication than the other for reasons we don't fully understand.

Your doctor will consider factors like your specific condition, other health issues, pregnancy plans, and insurance coverage when deciding between these medications. Both are effective options for treating autoimmune conditions.