Page 45 - Naplex Q&A 2025 Version

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41. (e) Humira (Adalimumab) is a recombinant 42.(e) Tegretol (Carbamazepine) may cause bone
human IgG1 monoclonal antibody specific for marrow suppression. The whole blood counts
human tumor necrosis factor (TNF). It is supplied as should be done at regular intervals.
a sterile, preservative-free solution of Adalimumab
for subcutaneous administration. Ataxia (unsteadiness) and diplopia (double vision)
are neurotoxic side effects of Carbamazepine. It can
It is indicated for reducing signs and symptoms, be reduced by administrating the drug at night or by
inducing major clinical response, inhibiting the dividing the total daily dose into 3 to 4 intervals
progression of structural damage, and improving during the day. Patients should also be monitored
physical function in adult patients with moderately for aplastic anemia, agranulocytosis and
to severely active rheumatoid arthritis, juvenile thrombocytopenia during therapy.
idiopathic arthritis, psoriatic arthritis, ankylosing
spondylitis, plaque psoriasis, ulcerative colitis, Carbamazepine may induce the secretion of
hidradenitis suppurativa and Crohn’s disease. antidiuretic hormone which may cause sodium and
water retention and dilutional hyponatremia.
The recommended dose of Humira for adult
patients with rheumatoid arthritis, psoriatic 43.(b) Foradil (Formoterol fumarate) is classified as
arthritis, or ankylosing spondylitis is 40 mg a long-acting beta-2 receptor agonist. It is indicated
administered every other week. for treatments of COPD and exercise-induced
bronchospasm. It should not be used to treat acute
The recommended dose of Humira for patients 4 to symptoms of asthma.
17 years of age with polyarticular juvenile idiopathic
arthritis is based on weight of patients. The recommended dose of the drug is one puff
twice daily in the morning and evening.
The recommended dose of Humira for adult
patients with plaque psoriasis is an initial dose of 80 Long-acting beta2-adrenergic agonists (LABA), such
mg, followed by 40 mg given every other week as formoterol the active ingredient in Foradil
starting one week after the initial dose. Aerolizer, increase the risk of asthma-related death.

Patients treated with Humira are at increased risk Because of this risk, use of Foradil Aerolizer for the
for developing serious infections that may lead to treatment of asthma without a concomitant long-
hospitalization or death. Most patients who term asthma control medication, such as an inhaled
developed these infections were taking corticosteroid, is contraindicated. Use Foradil
concomitant immunosuppressants such as Aerolizer only as additional therapy for patients
methotrexate or corticosteroids. Humira should be with asthma who are currently taking but are
discontinued if a patient develops a serious inadequately controlled on a long-term asthma
infection or sepsis. control medication, such as an inhaled
corticosteroid.
Reported infections include:
Once asthma control is achieved and maintained,
1. Active tuberculosis, including reactivation of assess the patient at regular intervals and step
latent tuberculosis. down therapy (e.g. discontinue Foradil Aerolizer) if
2. Invasive fungal infections, including possible without loss of asthma control, and
histoplasmosis, coccidioidomycosis, candidiasis, maintain the patient on a long-term asthma control
aspergillosis, blastomycosis, and pneumocystosis. medication, such as an inhaled corticosteroid.
3. Bacterial, viral and other infections due to
opportunistic pathogens.

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