Cimzia (Certolizumab)

Cimzia is a biologic medication that is approved to treat adults with moderately to severely active RA. The medication is an engineered version of an antibody that acts against tumor necrosis factor alpha, a normal chemical in the immune system that causes swelling, pain, and redness.1

All biologic medicines approved for use against RA improve the symptoms of arthritis, reduce joint damage, improve functional ability, and increase the quality of life patients with RA.1

Certolizumab is not available in generic forms.

What are the ingredients in Cimzia?

The active ingredient in Cimzia is certolizumab pegol.2

How does Cimzia work?

Cimzia is a medication that is engineered to block TNF-α. TNF-α is an important immune system signaling factor (called a cytokine) that plays a key role in swelling and inflammation. It is found in higher levels in the synovial fluid in the joints of patients with RA, and it is connected to inflammation as well as bone and cartilage damage. Blocking TNF-α helps tamp down the damage caused by the dysfunction of the immune system that is characteristic of RA.1

In Cimzia, the TNF blocker is joined with a polyethylene glycol (pegol) molecule that increases the length of time the medication is active in the body. It also helps the medicine penetrate inflamed tissues more effectively than normal tissues.1

What are the possible side effects of Cimzia?

Common side effects with Cimzia include3,4:

  • headache
  • redness, itching, pain, or swelling at the site of injection
  • back pain
  • urinary tract infection
  • upper respiratory infection
    • In some patients, Cimzia can cause more harmful side effects. Patients who take Cimzia are at increased risk for serious infections, including tuberculosis, invasive fungal infections, viral infections, bacterial infections, and other opportunistic infections (infection caused by a microorganism that does not normally cause infection in humans, typically due to an abnormally functioning immune system).3

      Children and adolescents taking Cimzia are also at slightly higher risk for lymphoma and other cancers. Other rare but serious side effects include heart failure, Hepatitis B reactivation, nerve diseases like multiple sclerosis, and certain blood disorders.4

      This is not an exhaustive list of all potential side effects of Cimzia. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects, contact your doctor or healthcare provider immediately.

      Things to note about Cimzia

      Before taking Cimzia, tell your doctor if you2:

      • Have a current infection or are prone to recurring infections
      • Have or have had cancer of any type
      • Have congestive heart failure
      • Have seizures, numbness or tingling, or any disease that affects your nervous system
      • Are scheduled to receive a vaccine
      • Have HIV, diabetes, or a weak immune system
      • Have tested positive for TB or have been in close contact with someone who has TB
      • Have or have had Hepatitis B
      • Live in areas of the US known for fungal infections, including the Ohio and Mississippi Valley and the southwest
      • Have a burning sensation when you urinate
      • Are pregnant or plan to become pregnant or are breastfeeding

      There is an increased risk for serious infections with Cimzia. This is because Cimzia can decrease the ability of the immune system to fight infections. Most patients who developed serious infections while taking Cimzia were also receiving immunosuppressant treatments, including methotrexate or corticosteroids.4 If you are taking Cimzia and develop any symptoms of an infection, contact your doctor immediately.

      Cimzia should not be used by patients diagnosed with multiple sclerosis or other demyelinating disease. Patients taking this medication should not receive live vaccines. It is important for doctors to test you for TB before you take Cimzia and to monitor for heart problems, infection, and nerve damage while you are on the medication.5

      Dosing information

      Cimzia is taken by subcutaneous (under the skin) injection and requires an initial loading dose of 400 mg (given as two injections of 200 mg each) every 2 weeks for 6 weeks, followed by a maintenance dose of 200 mg every other week. A dose of 400 mg every 4 weeks can also be considered as a maintenance dose.1

      Certolizumab comes in a formula that can be injected by a doctor or nurse in a medical office and as a pre-filled syringe that you can inject yourself at home. It is safe to inject Cimzia anywhere in the stomach or thighs, except near the belly button. You should vary the location of the injection site. Do not inject the medication into skin that is tender, bruised, red, or hard, or that has scars or stretch marks.3

Written by: Sara Finkelstein | Last reviewed: June 2018.
View References
  1. Carolina Negrei, Violeta Bojinca, Andra Balanescu, et. al., Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches. Exp Ther Med. 2016 Apr; 11(4): 1177–1183. Published online 2016 Feb 2. doi: 10.3892/etm.2016.3045 Accessed May 26, 2018.
  2. Medication Guide Cimzia. UCB, Inc., Smyrna, GA. Revised March 2018. https://www.cimzia.com/sites/default/files/docs/MedicationGuide_2018.pdf Accessed May 26, 2018.
  3. Certolizumab Injection. MedlinePlus. US National Library of Medicine. Bethesda, MD. Revised December 15, 2015. https://medlineplus.gov/druginfo/meds/a608041.html Accessed May 26, 2018.
  4. Prescribing Information. Cimzia. UCB, Inc., Smyrna, GA. Revised November 2012. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/125160s189lbl.pdf Accessed May 26, 2018.
  5. Certolizumab Pegol (Cimzia). American College of Rheumatology. Revised March 2018. https://www.rheumatology.org/Learning-Center/Medication-Guides/Medication-Guide-Certolizumab-Cimzia Accessed May 26, 2018.