What Is adalimumab?

Adalimumab is a biologic medication classified as a TNF (tumor necrosis factor) inhibitor. Originally marketed as Humira by AbbVie, it is now available as multiple biosimilar products including Amjevita, Cyltezo, Hadlima, Hyrimoz, Hulio, Yusimry, Yuflyma, and others.

Adalimumab is FDA-approved to treat a wide range of autoimmune and inflammatory conditions, including:

• Rheumatoid arthritis (RA)
• Psoriatic arthritis (PsA)
• Ankylosing spondylitis (AS)
• Crohn's disease (adults and children 6+)
• Ulcerative colitis (adults and children 5+)
• Plaque psoriasis (adults)
• Hidradenitis suppurativa (adults and adolescents 12+)
• Uveitis (adults and children 2+)
• Juvenile idiopathic arthritis (ages 2+)

It is self-administered as a subcutaneous injection, typically every other week, using a prefilled pen or syringe at home.

How does adalimumab work?

Adalimumab is a recombinant human IgG1 monoclonal antibody that works by specifically binding to tumor necrosis factor-alpha (TNF-α), a key protein in the inflammatory process. By blocking TNF-α from attaching to its receptors (p55 and p75) on cell surfaces, adalimumab reduces the inflammatory cascade that drives autoimmune conditions.

In diseases like rheumatoid arthritis, Crohn's disease, and psoriasis, the immune system overproduces TNF-α, causing chronic inflammation, tissue damage, and symptoms like joint pain, digestive problems, or skin lesions. Adalimumab helps control these symptoms by neutralizing the excess TNF-α.

The medication is injected subcutaneously (under the skin) and must be refrigerated at 36–46°F. Allow it to reach room temperature for 15–30 minutes before injecting. Inject into the thigh or abdomen, rotating injection sites each time.

What doses are available for adalimumab?

• 10 mg/0.1 mL — prefilled syringe (pediatric)
• 20 mg/0.2 mL — prefilled syringe (pediatric)
• 40 mg/0.4 mL — prefilled pen or syringe (citrate-free, high concentration)
• 40 mg/0.8 mL — prefilled pen or syringe (original formulation)
• 80 mg/0.8 mL — prefilled pen or syringe (higher dose for loading)
• Single-dose vial — for institutional use

How hard is it to find adalimumab in stock?

Adalimumab (Humira and its biosimilars) scores a 60 out of 100 on our findability scale, meaning it's moderately easy to find but may require some effort. Adalimumab is not currently on the FDA or ASHP drug shortage lists, and supply is generally stable.

However, because adalimumab is a specialty biologic that requires cold-chain storage (refrigeration at 36–46°F), it's not stocked at every pharmacy. Most patients fill their prescriptions through a specialty pharmacy rather than a standard retail pharmacy. With 10+ biosimilars now on the market, individual pharmacies may carry only one or two specific products, making it harder to find your exact prescribed version.

Use Medfinder to quickly locate which pharmacies near you have your specific adalimumab product in stock.

Who Can Prescribe adalimumab?

Adalimumab is typically prescribed by specialists who treat autoimmune and inflammatory conditions:

• Rheumatologists — for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis
• Gastroenterologists — for Crohn's disease and ulcerative colitis
• Dermatologists — for plaque psoriasis and hidradenitis suppurativa
• Ophthalmologists — for uveitis
• Internal medicine physicians — may initiate or co-manage therapy

Telehealth consultations are available for ongoing management. However, initial prescriptions often require in-person evaluation, lab work (including tuberculosis testing and hepatitis B screening), and a detailed medical history review.

Is adalimumab a controlled substance?

No. Adalimumab is not a controlled substance and does not have a DEA schedule. It is a prescription biologic medication but does not carry the restrictions or monitoring requirements associated with controlled substances.

However, adalimumab does carry a boxed warning (the FDA's most serious warning) regarding increased risk of serious infections (including tuberculosis and invasive fungal infections) and malignancies (including lymphoma in children and adolescents). Patients require regular monitoring and must be screened for latent TB before starting treatment.

Common Side Effects of adalimumab

The most frequently reported side effects include:

• Injection site reactions — redness, swelling, itching, or pain at the injection site (most common)
• Upper respiratory infections — cold-like symptoms, sore throat
• Headache
• Rash
• Nausea
• Back pain
• Urinary tract infections
• Abdominal pain
• Flu-like symptoms
• Sinusitis

Serious side effects (seek medical attention immediately):

• Serious infections including tuberculosis, invasive fungal infections, and sepsis
• Signs of lymphoma or other cancers
• New or worsening heart failure
• Liver problems (jaundice, fatigue, dark urine)
• Lupus-like syndrome (joint pain, rash on cheeks or arms)
• Nervous system problems (numbness, tingling, vision changes)
• Severe allergic reactions

Alternative Medications to adalimumab

If adalimumab is not right for you, several other TNF inhibitors and biologic medications may be considered:

• Etanercept (Enbrel) — Another TNF inhibitor given as a weekly subcutaneous injection. Treats RA, PsA, AS, and psoriasis but not inflammatory bowel disease.
• Infliximab (Remicade) — A TNF inhibitor given as an IV infusion every 6–8 weeks. Treats similar conditions including Crohn's disease and ulcerative colitis. Multiple biosimilars available.
• Certolizumab pegol (Cimzia) — A PEGylated TNF inhibitor given subcutaneously every 2–4 weeks. Does not cross the placenta, making it a preferred option during pregnancy.
• Golimumab (Simponi) — A TNF inhibitor available as a monthly subcutaneous injection or IV infusion every 8 weeks. Treats RA, PsA, AS, and ulcerative colitis.

Non-TNF biologics like ustekinumab (Stelara), vedolizumab (Entyvio), secukinumab (Cosentyx), and JAK inhibitors like tofacitinib (Xeljanz) may also be options depending on your condition. Talk to your doctor about which alternative is best for you.

Drug Interactions with adalimumab

Adalimumab can interact with several other medications. Inform your doctor about all medications you are taking:

• Other biologic DMARDs (anakinra, abatacept) — Do not combine. Significantly increases the risk of serious infections.
• Other TNF blockers (etanercept, infliximab, certolizumab, golimumab) — Never use two TNF blockers together.
• Rituximab (Rituxan) — Using a TNF blocker after rituximab increases infection risk.
• Live vaccines (MMR, varicella, yellow fever, live flu) — Avoid during adalimumab treatment. Inactivated vaccines are safe.
• Methotrexate — Commonly used together but monitor for additive immunosuppression.
• Azathioprine / 6-mercaptopurine — Increased risk of hepatosplenic T-cell lymphoma when combined, especially in younger patients with IBD.
• Corticosteroids — Additive immunosuppression; use the lowest effective dose.
• CYP450 substrates (warfarin, cyclosporine, theophylline) — TNF blockade may normalize CYP450 enzyme activity; monitor drug levels.

No significant food interactions. No dietary restrictions are required while taking adalimumab.

Final Thoughts on adalimumab

Adalimumab remains one of the most widely prescribed biologic medications in the world, treating a broad range of autoimmune and inflammatory conditions. The arrival of 10+ biosimilar options since 2023 has been a game-changer for patients, dramatically lowering costs from over $7,000/month down to as low as $1,300–$1,900/month for biosimilar versions.

While adalimumab is generally available, finding your specific product in stock can require working with a specialty pharmacy. Use Medfinder to locate pharmacies that have your prescribed adalimumab product in stock near you.

If cost is a concern, explore manufacturer savings programs (as low as $5/month with the HUMIRA Savings Card), biosimilar alternatives, coupon platforms like GoodRx and SingleCare, and patient assistance programs from AbbVie and other manufacturers. Your specialist and specialty pharmacy can help navigate insurance requirements and find the most affordable option for your situation.