Abatacept Injection (patient information)

# Why this medication is prescribed
Abatacept is used alone or in combination with other medications to reduce the pain, swelling, difficulty with daily activities, and joint damage caused by rheumatoid arthritis (a condition in which the body attacks its own joints causing pain, swelling, and loss of function) in patients who have not been helped by other medications. Abatacept is in a class of medications called selective costimulation modulators (immunomodulators). It works by blocking the activity of T-cells, a type of immune cell in the body that causes swelling and joint damage in people who have arthritis.

# How this medication should be used
Abatacept comes as a powder to be mixed with sterile water and infused (injected slowly) intravenously (into a vein) by a doctor or nurse. It is usually given in a doctor's office every 2 weeks for the first three doses and then every 4 weeks. It will take about 30 minutes for you to receive your entire dose of abatacept.
Your doctor will give you the manufacturer's patient information sheet to read before you receive each dose of abatacept. Read the information carefully and ask your doctor any questions you have.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before using abatacept:
- tell your doctor and pharmacist if you are allergic to abatacept or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anakinra (Kineret), adalimumab (Humira), etanercept (Enbrel),and infliximab (Remicade). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have an infection anywhere in the body, including infections that come and go, such as cold sores, and chronic infections that do not go away, or if you often get any type of infection such as bladder infections. Also tell your doctor if you have or have ever had chronic obstructive pulmonary disease (COPD; a group of lung diseases that includes chronic bronchitis and emphysema); any disease that affects your nervous system, such as multiple sclerosis; any disease that affects your immune system, such as cancer, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), or severe combined immunodeficiency syndrome (SCID). Also tell your doctor if you have or have ever had tuberculosis (TB; a lung infection that may not cause symptoms for many years and that may spread to other parts of the body) or if you have been around someone who has or has had tuberculosis. Your doctor may give you a skin test to see whether you are infected with tuberculosis. Tell your doctor if you have ever had a positive skin test for tuberculosis in the past.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using abatacept, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are using abatacept.
- tell your doctor if you have recently received or are scheduled to receive any vaccines. You should not have any vaccinations while you are using abatacept or for 3 months after you stop using abatacept without talking to your doctor.

# Special dietary instructions
Unless your doctor tells you otherwise, continue your normal diet.

# What to do if you forget a dose
If you miss an appointment to receive an abatacept infusion, call your doctor as soon as possible.

# Side Effects

## Minor Side Effects
Abatacept may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- headache
- runny nose
- sore throat
- nausea
- dizziness
- heartburn
- back pain
- arm or leg pain

## Severe Side Effects
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
- hives
- skin rash
- itching
- swelling of the eyes, face, lips, tongue, or throat
- difficulty breathing or swallowing
- shortness of breath
- fever, chills, and other signs of infection
- dry cough that doesn't go away
- weight loss
- night sweats
- frequent urination or sudden need to urinate right away
- burning during urination
- cellulitis (red, hot, swollen area on the skin)
Abatacept may increase the risk of developing certain types of cancer including lymphoma (cancer that begins in the cells that fight infection). People who have had severe rheumatoid arthritis for a long time may have a greater than normal risk of developing these cancers even if they do not use abatacept. Talk to your doctor about the risks of using this medication.
Abatacept may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

# Storage conditions needed for this medication
Your doctor will store the medication in his or her office.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Other information
Be sure to schedule appointments with your doctor well in advance so that you will be able to receive abatacept on schedule and at times that are convenient for you.

# Brand names
- Orencia