Humira

Medicine blog #6: Humira

This will be the last in the series of medicine blogs for now.  I am also going away on vacation for two weeks, so there will be no blogs in that time.  I will be full ideas when I get back though!  Today's blog is about Humira, which is what I'm currently on.  I've been on Humira for about 7 years now, and I take it every week, which is rare, most people take it every other week.  Over the years I've been on it alone and with other medications.  I'm currently also taking Methotrexate, which was the first medicine blog I wrote.  Humira seems to work well with no reaction, but it can't work alone.  We've had a tough time finding the right combination - sometimes one combination will work for a little while, then I'll either have a bad reaction or flare up.  So far, after 10 months of slowly increasing the Methotrexate and then switching from pills to injections, I seem to be doing well.  I won't get my hopes up yet though, because you never know what can happen.  The only thing I don't like about Humira is the sting! When you inject, it stings real bad.  Even after the 7 years it still bothers me.   Let's take a closer look at Humira.

Humira is an injection that is in a class of medications known as tumor necrosis factor (TNF) inhibitors. It works by blocking the action of TNF, a substance in the body that causes inflammation.  It is used to help treat the symptoms of auto-immune diseases such as rheumatoid arthritis, crohn's disease, ankylosing spondylitis, psoriatic arthritis. 

Humira comes in a solution that is injected under the skin (subcutaneously), in either a pre-filled syringe or pen (see photo to the right).  The pen is an automatic dispenser of medication, and some people find it easier than actually injecting.  I've used the pen in the past when it first came out, but personally I prefer the injection.  The pen dispenses the medicine for you quickly and accurately, but I like to be in control of how fast or slow the medication goes in me.  It is normally injected every other week, but can vary by condition.    Humira can be injected anywhere on the front of your thighs or stomach except your belly button (navel) and the area 2 inches around it.  To prevent any bruising, redness or soreness, you should try to use a different site each time you inject.  It is also important to inject at least 1 inch away from a spot that you have already used.  Never inject into an area where the skin is tender, bruised, red, or hard or where you have scars or stretch marks. 

Common side effects that occur with Humira are: redness, itching, bruising, pain, or swelling in the place you injected Humira injection, stomach pain, nausea, headache, back pain.  I tend to get redness and bruising sometimes with my injections, and the medicine stings sometimes also.  If I take the Humira out of the fridge for about 20-30 minutes before injecting, it tends to help eliminate the sting  a bit.  More serious side effects are: numbness or tingling, problems with vision, weakness in legs, chest pain, shortness of breath, rash, especially a rash on the cheeks or arms that is sensitive to sunlight, new joint pain, hives, itching, swelling of the face, feet, ankles, or lower legs, difficulty breathing or swallowing, fever, sore throat, chills, and other signs of infection, unusual bruising or bleeding, pale skin, dizziness, red, scaly patches or pus-filled bumps on the skin.   Humira may also lower your ability to fight off infections, so if you do get sick it is important to speak to your doctor.  Sometimes when sick, you need to skip a dose or two of the Humira to help get over the infection. 

As always it is important to contact your doctor immediately if any of these, or other side effects might happen while on this or any other medication! 

Humira seems to be one medication that has sort of worked for me over the years.  I've had horrible allergic reactions with many other medications, and am at the point now where I don't have many options left.  I've never had a reaction to Humira, so my doctor keeps me on it with conjunction with another medication.  Currently, it's Methotrexate and for now it seems to be doing okay.  If this doesn't work, it will be time to stop both medications and start from scratch.  It would be great to just find that one medication that works, and works well.  There is no cure for autoimmune diseases like RA, but there are medications that can help us feel somewhat normal.  I hope that all of you fellow RAers, and others who suffer from illnesses, find medications that work for you. 

Thank you to everyone who continues reading my blogs, I truly appreciate it!  As I said in the begining, I will be taking a two- week vacation so no blogs for those two weeks. I'm going on a road-trip to visit my good RA friend, Brenna and then to visit my fiance's dad!  Brenna and I wrote a blog together back in March, so those who are interested can read that as well. :)  I will write one when I get back, and will tell you all about my fun trip! 

Have fun, be safe! xo

Rituxan

My friend Angela, getting her Rituxan!

Medicine Blog #5: Rituxan

This is the fifth medicine blog in the series!  I took Rituxan after the Remicade, and took it along with Humira.  I started it in 2006 I believe. The next medicine blog will be about Humira, and will be the last in the medicine series for now.  The Humira alone wasn't working, so my rheumatologist decided to try it with Rituxan.  The Rituxan is given the same way as Remicade, through IV.  As you can see pictured to the left is my wonderful RA friend Angela getting her Rituxan infusion, who was kind enough to let me share this photo with you!  I did really well on Rituxan, I was so nervous at first because of the reaction with the Remicade but braved it out.  I had no breathing issues and all seemed to be going really well.  About 6 months into it, I recieved a phone call from a nurse saying my white blood cell count was dangerously low and that I needed to stay in my apartment until my doctor got a hold of me.  I ended up going to see a blood specialist and had all kinds of tests to make sure I didn't have lymphoma.  They figured out that the combination of the Rituxan and Humira were killing too many of my white blood cells.  The Rituxan was stopped immediately but the Humira was continued.  Let's discuss details about Rituxan. 

Rituxan (or Rituximab, which is the scientific name it is also known for), is a medication in a class known as biologic antineoplastic agents.  It is used to treat non-Hodgkin's lymphoma (NHL) and rheumatoid arthritis (RA), it works differently with each disease.  In NHL, it works by causing the death of blood cells that have multiplied abnormally. It treats RA by causing the death of certain blood cells that may cause the immune system to attack the joints.  Rituxan is given intravenously (IV) in an infusion center, and is administered by a nurse or doctor.  It is given very slowly at first, so your first day could take up to 8 hours.  For RA it is usually given as 2 doses spaces 2 weeks apart, in NHL is is given once a week for 4-8 weeks along with chemotherapy.  Dosing will obviously vary person to person depending on severity of condition and other possible medications they are on. 

Common side effects that occur while the medication is being administered are: fever, shaking chills, tiredness, headache, or nausea.  Notify your doctor or nurse right away if you experience any or all of these side effects.   If you experience any of the following symptoms after you get home, it is highly advisable to contact your doctor as soon as possible!  The symptoms include: nausea, vomiting, diarrhea, heartburn, weight gain, muscle or back pain, flushing, night sweats, tiredness, weakness, numbness, burning or tingling in the hands or feet, runny nose.  And lastly, the following symptoms are listed under the important warnings section and as always, you must contact your doctor ASAP if you experience any of them: stomach area pain, unusual bruising or bleeding, sore throat, fever, chills, or other signs of infection, chest tightness, joint pain or soreness.

As always, I am not a medical professional and these are obviously not all the possible side effects as everyone reacts differently.  It is important that if you experience any of these or other symptoms or are considering going on this medication, to discuss it all with your doctor.

Rituxan was working well for my joints, along with the aid of Humira, but it caused me a dangerous side effect yet again.   I've known RAers who do well with Rituxan alone, mine was a rare case to try it along with something else.  As of now, I'm still on Humira to this day along with Methotrexate.  Methotrexate was my first medicine blog, and Humira will be my last for now.  Thanks for all my readers, and if you'd like to see more medicine blogs in the future, please feel free to ask!  I did blogs on just a few of the medications I have tried over the years, but can do some that I haven't because I am curious as well.  I could interview people who are on different ones and get their take on the medication.  Take care, and wishing everyone a late Happy Independence Day!!