This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.
- Very bad and sometimes deadly infections have happened in patients who take this drug. Most people who had these infections were taking other drugs to lower the immune system like methotrexate or steroid drugs. If you have any infection, are taking antibiotics now or in the recent past, or have had many infections, talk with your doctor.
- TB (tuberculosis) has been seen in patients started on this drug. These patients were exposed to TB in the past, but never got the infection. You will be tested to see if you have been exposed to TB before starting this drug.
- Lymphoma and other cancers have happened in people who take this drug or drugs like it. This has been deadly in some cases. Talk with the doctor.
- Heart attack, stroke, and blood clots have happened with this drug. These effects have also been seen in a study of a drug like this one. Sometimes these were severe and even deadly. People in the study had rheumatoid arthritis (RA), were at least 50 years of age, and had at least 1 heart disease risk factor. This drug is not approved to treat RA. Call your doctor right away if you have signs of a heart attack, stroke, or blood clot.
- Tell your doctor if you smoke, have smoked in the past, or have ever had a heart attack, other heart problems, stroke, or blood clot.
- It is used to treat eczema.
- If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you have kidney disease.
- If you have liver disease or if you have had hepatitis B or hepatitis C infections.
- If you have any of these health problems: Low white blood cell count, low platelet count, or low red blood cell count.
- If you are using another drug like this one. If you are not sure, ask your doctor or pharmacist.
- If you are taking any drugs used to suppress your immune system like azathioprine or cyclosporine. There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.
- If you are taking aspirin (more than 81 mg), clopidogrel, or other drugs that affect platelets. There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.
- If you are breast-feeding. Do not breast-feed while you take this drug and for 1 day after your last dose.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
- Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
- Have your blood work and other lab tests checked as you have been told by your doctor.
- You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
- If you have had hepatitis B before or carry the virus, talk with your doctor. Drugs like this one can cause the virus to become active. This can lead to very bad and sometimes deadly liver problems.
- Hepatitis B testing needs to be done as you were told by the doctor. Talk with the doctor.
- Some viral infections like herpes zoster (shingles) and herpes simplex have become active again with this drug. Tell your doctor if you have ever had a viral infection like herpes zoster or herpes simplex. Talk with your doctor.
- Make sure you are up to date with all your vaccines before treatment with this drug.
- Talk with your doctor before getting any vaccines right before you start this drug, while you take it, and right after you stop taking it. Vaccine use with this drug may either raise the chance of an infection or make the vaccine not work as well.
- Do not get a weakened bacteria like BCG for bladder cancer while you use this drug. Talk with your doctor.
- High cholesterol has happened with this drug. If you have questions, talk with the doctor.
- The chance of skin cancer may be raised. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
- Have your skin checked. Tell your doctor if you have any skin changes like a new wart, skin sore or reddish bump that bleeds or does not heal, or a change in the color or size of a mole.
- If you are 65 or older, use this drug with care. You could have more side effects.
- Talk with the doctor about how this drug may affect being able to get pregnant.
- Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this drug while you are pregnant.
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
- Signs of a urinary tract infection (UTI) like blood in the urine, burning or pain when passing urine, feeling the need to pass urine often or right away, fever, lower stomach pain, or pelvic pain.
- Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
- Warm, red, or painful skin or sores on the body.
- A skin lump or growth.
- Any unexplained bruising or bleeding.
- Change in eyesight.
- Cold sweats.
- Severe upset stomach or throwing up.
- Call your doctor right away if you have a swollen gland, night sweats, shortness of breath, or weight loss without trying.
- Rarely, severe eye problems (retinal tear or detachment) have happened with this drug. Call your doctor or get medical help right away if you start to see flashing lights, floaters, a curtain-like shadow coming across your eye, or have sudden eyesight loss.
- Blood clots may happen with this drug. These may include heart attack, stroke, and clots in the legs or lungs. Call your doctor right away if you have chest, arm, back, neck, or jaw pain or pressure. Call your doctor if you cough up blood or have dizziness; numbness or weakness on 1 side of your body; trouble speaking or thinking; change in balance; change in eyesight; shortness of breath; or swelling, warmth, or pain in the leg or arm.
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Upset stomach or throwing up.
- Dizziness or headache.
- Nose irritation.
- Signs of a common cold.
- Flu-like signs.
- Feeling tired or weak.
- Pimples (acne).
- Mouth or throat pain or irritation.
- Stomach pain.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- Take with or without food.
- Take this drug at the same time of day.
- Swallow whole with a drink of water.
- Do not chew, break, or crush.
- Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
- Take a missed dose as soon as you think about it.
- If it is less than 12 hours until the next dose, skip the missed dose and go back to your normal time.
- Do not take 2 doses within 12 hours of each other.
- Store in the original container at room temperature.
- Store in a dry place. Do not store in a bathroom.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else’s drugs.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
- If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
© 2023 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.