Exemptia has 40mg of Adalimumab which is human IgG1monoclonal antibody especially for tumor necrosis factor TNF Exemptia 40mg/0.8ml containing an active ingredient Adalimumab is a FDA product involved in the therapy of rheumatoid arthritis, chronic plaque psoriasis, crohn’s disease, Ankylosing spondylitis, psoriatic arthritis &polyarticular juvenile idiopathic arthritis. Exemptia is available in the form of injection, package containing a prefilled syringe. Adalimumab is belongs to the class of tumor necrosis factor inhibitor, anti-inflammatory, or biologic drug.
Exemptia consist of Adalimumab, exist as anti-inflammatory agent.
Exemptia categorized as;
Immuno suppressive agent
Exemptia is involved in the treatment of auto immune disease like rheumatoid arthritis.
In rheumatoid arthritis RA
Exemptia is used to diminish the manifestation related to rheumatoid arthritis in adults, it also exhibits effect in serious polyarticular juvenile idiopathic arthritis with the age of 4 years or older. In this condition, Exemptia is used in combination with methotrexate.
In psoriasis arthritis PA
Exemptia is used in psoriasis arthritis
In Ankylosing spondylitis AS
Exemptia is used to reduce the syndrome of AS Various conditions like crohn’s disease, ulcerative colitis, plaque psoriasis, hidradenitis suppurativa and juvenile idiopathic arthritis.
MECHANISM OF Exemptia
Tumor necrosis factor is a naturally arising cytokine, which involved in natural inflammatory and immune reaction.
Increased level of tumor necrosis factor which is occurs in synovial fluid of rheumatoid arthritis patients. This elevation level leads to cause pathological inflammation and joint eradication.
Exemptia contains Adalimumab exhibits action by definitely binds to TNF-alpha and involved in blockade of inter communication of TNF alpha with its receptors like p55 & p75 cell surface receptors. Exemptia also sophisticated in lyses of surface TNF disclose cells in vitro in the presence of completion.
The peak plasma concentration time of Exemptia is occurs at 131 ± 56 hours and maximum serum concentration is 4.7 ± 1.6mcg/ml The mean bioavailability of Exemptia is reaches at 64%
The volume of distribution is 4.7 to 6.0L
The systemic clearance of Adalimumab is relatively occurs as 12ml/hr The mean terminal half life period of Adalimumab is relatively occurs as 2 weeks ranging from 10 to 20 days
Dosage & Administration
Exemptia is a prefilled syringe, single use. Exemptia is administered through subcutaneous; with maintenance therapy at every week
In RA, PA, & AS:
The usual recommended dosage of Exemptia in these conditions, 40mg should be administered for every other week through subcutaneously. Other medicines like methotrexate, NSAIDS, glucocorticoid, salicylates, analgesics, or DMARDs may be carrying out during the therapy with Exemptia. In some patients, methotrexate is not used for combination. In this condition the dosage frequency of Exemptia is elevates to 40mg for every week.
In juvenile idiopathic arthritis:
The usual dose of Exemptia is recommended for the age of 4 to 17 years with polyarticular JIA is calculated on the basis of body weight of the patients. Methotrexate, NSAIDS, glucocorticoid, salicylates or analgesics may be used in combination. In 10kg to less than 15kg: 10mg dose should be used In 15 kg to <30kg: 20mg of dose for every other week ≥30kg: 40mg of dose for every other week
In adult crohn’s:
In this conditions, the recommended dosage of Exemptia is 160mg starting at day 1 (administered as four 40mg in a day or two 40mg per day for two successive days) proceeding with 80mg two weeks later (day 15). After two weeks, day 29 starts with continuance dose of 40mg every other week. Aminosalicylates, corticosteroids, or Immuno modulatory agents may be used during the therapy.
6 years & older
17kg to less than 40kg: The initial dose is 80mg given subcutaneous on day 1 followed by 40mg two weeks later, then 20mg SC every other week 40kg or greater: 160mg of Exemptia given subcutaneous on day 1, respectively 80mg SC for two weeks later, then 40mg SC every other week.
In ulcerative colitis
The recommended dosage of Exemptia is 160mg starting at day 1 (administered as four 40mg in a day or two 40mg per day for two successive days) proceeding with 80mg two weeks later (day 15). After two weeks, day 29 starts with continuance dose of 40mg every other week.
The recommended dosage of Exemptia is starting with 80mg, which is followed by 40mg for every other week, initiate one week after the initial dose
Exemptia SIDE EFFECTS
Severe infections, Malignancies, Erythema, Itching, Hemorrhage, Pain, swelling, Rash, Pneumonia, Tuberculosis, Lupus like syndrome, Sinusitis, Flu like syndrome, Respiratory tract infection, Abdominal pain, Nausea, Hypercholesterolemia, Hyperlipidaemia, Hematuria, Elevation of alkaline phosphatase, Injection site pain, Headache, Back pain, Hypertension, Thrombocytopenia, Anaphylaxis, Angioneurotic edema, Interstitial lung disease like pulmonary fibrosis, Cutaneous vasculitis, psoriasis, Erythema multiforme, Systemic vasculitis
Warning & precautions
To reduce the serious infections, avoid concomitant use of Exemptia with methotrexate, Anakinraetc
Before starting the therapy, patient should be examine whether presence or absence of tuberculosis in active or latent stage.
Exemptia therapy should not be recommended for the patients who are infected with active tuberculosis.
Risk takes into consideration while starting the therapy:
1. Severe or frequent infection
2. Patient exposed to tuberculosis
3. With the history of an opportunistic infection
4. With viral, fungal or bacterial infections
Patients should be frequently monitored, the signs and manifestation of tuberculosis The exposure and advantages of TNF-inhibitor therapy including Exemptia should be taken into consideration, before initiation of therapy. To reduce the risk of non-melanoma skin cancer or other malignancy In pediatric patients, Hepatosplenic T-cell lymphoma occurs during the TNF blocking therapy, this may occur due to combination of TNF blocker with other immunosuppressant Post marketing hypersensitivity reactions occurs like anaphylaxis, angioneurotic edema and other allergic conditions may occur. In this condition Exemptia should be discontinue and provide alternative medicine.
HBV reactivation occurs
While using with anakinra causes severe adverse reaction related to anakinra, avoid this concomitant Autoimmunity occurs during the therapy with Exemptia , lupus like syndrome occurs Immunizations, concurrent usage of Exemptia with live vaccine should be avoided While using abatacept with Exemptia causes serious infections, use Exemptia alone.
If Adalimumab combines with anakinra (interleukin 1 antagonist), or other TNF blocking agents may have increased the risk of adverse effects like neutropenia. Avoid the combination of Exemptia with Anakinra.
Exemptia increase the adverse effects of Anakinra
Live vaccines should not be concomitant during the therapy using with Exemptia In rheumatoid arthritis, Exemptia is combined with methotrexate causes depleting the apparent clearance of Exemptia