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Anti-Tumor Necrosis Factor alpha

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Anti-Tumor Necrosis Factor alpha - Side Effects, Precautions, and Contraindications

What side effects can Anti-Tumor Necrosis Factor alpha cause?

Common side effects include:

  • Infection (common cold, sinusitis, urinary tract infections and skin infections)
    • If you develop a fever, sore throat, pain on urination or feel generally unwell, see a doctor immediately. Tell the doctor whom you consult that you are on anti-TNFα.
  • Injection site reactions: symptoms include bruising, redness, itching, pain and swelling
    • If you are using subcutaneous injection, rotate the injection site each time. You may also apply a cold pack to the injection site after injection.
    • These symptoms are temporary and usually go away within 3 to 5 days.
  • Infusion reactions: symptoms include flushing, chills, chest tightness, shortness of breath, hypotension or hypertension
    • Medications may be given before the infusion to prevent these reactions.
    • You will be monitored closely in the ward during and after the infusion
      • Inform the nurse immediately if you experience any of these symptoms.
      • Your infusion may be slowed down or stopped if the symptoms are severe.
  • Headache
  • Rash

It is important to monitor the effects of your new treatment, particularly during the first few months of treatment. If the symptoms persist or are severe, consult your doctor. You may need to have regular blood tests to monitor your blood counts while on this medication.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

Some rare but serious side effects include:

Severe infections such as pneumonia, fungal infection, reactivation of tuberculosis and hepatitis B

  • Combined low blood cell count (symptoms include infection, persistent fever, feeling very tired or weak, bleeding/bruising very easily, looking pale)
  • Lung inflammation
  • Severe muscle weakness/numbness/tingling sensation
  • Seizures
  • Heart problems (symptoms include shortness of breath with exertion or on lying down, swelling of feet)

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Long term use of anti-TNFα may increase the risk of lymphoma and other cancers. However, this is very rare. You may also be at higher risk if you are also taking certain medications that suppress the immune system. Your doctor will monitor/manage this risk closely.

Before taking Anti-Tumor Necrosis Factor alpha , what precautions must I follow?

Inform your healthcare professional if: 
  • You are allergic to this medication or any of the other ingredients of this medication.
  • You plan to start a family or to breastfeed. Certain biologics may be safer than others in pregnancy.
  • You are taking any other medications, including over-the-counter medicines, supplements, traditional medications and herbal remedies.  
  • You have any heart problems. Your doctor may want to monitor your heart condition more closely after starting anti-TNFα.
Avoid overcrowded places and stay away from people who are sick to prevent getting an infection.
 
Reactivation of infections such as tuberculosis (TB) and hepatitis B may happen when you are on this medication, hence, your doctor will check for such infections before starting anti-TNFα.
 

What food or medicine must I avoid when I take Anti-Tumor Necrosis Factor alpha ?

  • Avoid eating raw, undercooked or half-cooked food.
  • Live vaccines such as MMR (measles, mumps and rubella), OPV (oral polio vaccine), yellow fever or BCG (tuberculosis). Discuss with your doctor before receiving any vaccines. Also, direct contact with persons who have taken oral polio vaccine or those with infections should be avoided. However, Pneumococcal, influenza (flu) and Hepatitis B vaccinations are safe and may be given if required.
  • Updated on 10/31/2023 12:00:00 AM
  • Article contributed by PSS National Medication Information Workgroup PSS National Medication Information Workgroup
The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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