Precautions and warnings with adalimumab relate to things such as the risk of dangerously low blood counts, the danger of developing certain nervous system conditions, and the potential for allergic reactions. People who have medical conditions such as congestive heart failure, multiple sclerosis, or any kind of infection should not take the drug. Precautions and warnings with adalimumab also extend to those who are allergic to rats, mice, or any ingredient used to make the medication.

• Congestive heart failure (CHF)
• A history of cancer of any type
• Multiple sclerosis
• Any disease that affects the immune system, such as diabetes, cancer, HIV, or AIDS
• Any conditions that affect the blood, including blood clotting disorders
• Any current infection
• Infections that come and go (such as cold sores)
• Plans to receive vaccinations
• A history of hepatitis B infection or tuberculosis
• Any other allergies, including allergies to foods, dyes, preservatives, rats, or mice.

 

• Pregnant or thinking of becoming pregnant
• Breastfeeding.

 

• Adalimumab can increase your chance of infections, including serious infections. You should not start adalimumab if you have an infection (even a skin infection). While taking adalimumab, tell your healthcare provider right away if you think you may have any kind of infection. Adalimumab may not be the best choice for people who get frequent infections.

 

• In rare cases, adalimumab has been reported to cause certain nervous system conditions, including multiple sclerosis (MS). Adalimumab may also make these conditions worse. Talk to your healthcare provider before taking adalimumab if you have MS or any other nervous system condition.

 

• In rare cases, adalimumab has caused dangerously low blood counts (including aplastic anemia). You should tell your healthcare provider about any unusual bruising, bleeding, or paleness while taking adalimumab.
   
• There have been reports of lymphoma (a certain type of cancer) and skin cancer in people taking adalimumab. It is not yet known if adalimumab caused these cancers or not.
   
• Adalimumab can cause certain infections (such as hepatitis B or tuberculosis) that were inactive in the body to become active again. Tell your healthcare provider if you have ever had hepatitis B or tuberculosis before starting adalimumab.
   
• Allergic reactions can occur with adalimumab. These reactions include rashes, hives, itching, wheezing, difficulty breathing, and unusual swelling. Let your healthcare provider know right away if you think you are having an allergic reaction to adalimumab.
   
• In studies, people with congestive heart failure (CHF) who took medications like adalimumab had an increased risk of death. Also, worsening of heart failure and new cases of heart failure (in people who did not already have CHF) have been reported in people taking similar medications. Talk to your healthcare provider about adalimumab and congestive heart failure before starting adalimumab.
   
• You should not receive live vaccines while taking adalimumab. Talk to your healthcare provider before receiving any vaccines while on adalimumab.
   
• Rarely, adalimumab has caused lupus-like conditions. Symptoms of a lupus-like condition may include an unexplained rash across the nose and checks (known as a butterfly rash) or ulcers in the mouth or nose.
   
• Adalimumab can cause liver problems, including liver failure and hepatitis. Let your healthcare provider know if you have any signs of liver damage, such as yellowing of the whites of the eyes or skin, dark urine, and upper abdominal (or stomach) pain.
   
• Adalimumab can interact with certain medications (see Drug Interactions With Adalimumab).
   
• Adalimumab is considered a pregnancy Category B medication. This means that adalimumab is unlikely to harm an unborn baby. However, the full risks of using adalimumab while pregnant are not known. Be sure to talk to your healthcare provider about the risks and benefits of using adalimumab during pregnancy (see Humira and Pregnancy).
   
• It is not known if adalimumab passes through breast milk. Therefore, if you are breastfeeding or plan to start, be sure to talk with your healthcare provider about using adalimumab (see Humira and Breastfeeding).