Orencia (abatacept) is an injectable biologic medication used for different types of autoimmune arthritis (joint inflammation), including rheumatoid arthritis (RA) and psoriatic arthritis (PsA). It's given as an injection under the skin once a week or as an infusion through the veins (IV) in the clinic once a month. Common side effects include infection, headache, and dizziness.
Orencia (abatacept) is a biologic disease-modifying anti-rheumatic drug (DMARD). It blocks certain proteins and processes in cells, which lowers inflammation. This prevents specific types of arthritis from getting worse.
| Common Brands | Orencia |
|---|---|
| Drug Class | Biologic DMARD |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Please note: The side effects above were reported by adults who received Orencia (abatacept) for rheumatoid arthritis. The side effects you experience might be different if you're taking Orencia (abatacept) for a different condition or if you're injecting it under the skin.
Contact your healthcare provider immediately if you experience any of the following.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Back pain
bladder pain
bloody or cloudy urine
body aches or pain
chills
cough producing mucus
difficult, burning, or painful urination
difficult or labored breathing
dizziness
ear congestion
frequent urge to urinate
headache
loss of voice
lower back or side pain
nausea or vomiting
noisy breathing
pain or tenderness around the eyes and cheekbones
stuffy or runny nose
tightness of the chest
trouble breathing
unusual tiredness or weakness
Less common
Blurred vision
burning or stinging of the skin
nervousness
painful cold sores or blisters on the lips, nose, eyes, or genitals
pounding in the ears
skin rash
slow or fast heartbeat
Rare
Confusion
difficulty with swallowing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
flushing
hives or welts
itching, pain, redness, swelling, tenderness, or warmth on the skin
stomach pain or tenderness
sweating
swelling of the face, throat, or tongue
Incidence not known
Redness, soreness, or itching of the skin
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
sores, welts, blisters
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Belching
bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
indigestion
stomach discomfort or upset
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Tips for using the Orencia (abatacept) prefilled syringes or autoinjectors at home:
Orencia (abatacept) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Orencia (abatacept) can make it more difficult for your body to fight off infections. This raises your risk of bacterial, viral, or fungal infections. The risk is higher for people who are taking or have recently taken other medications that weaken the immune system. Additionally, Orencia (abatacept) might reactivate (wake up) certain viruses that are already in your body, such as tuberculosis (TB) or hepatitis B. If you develop an infection, your provider will likely ask you to stop taking Orencia (abatacept) until your body fights off the infection. Let your provider know if you experience symptoms of these infections, such as fever, cough, difficulty breathing, or weakness.
Severe allergic reactions to Orencia (abatacept) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). If you notice dizziness, a choking sensation, nausea, swelling around your eyes, swelling of the lips or tongue, or difficulty breathing after using Orencia (abatacept), get medical attention right away.
There's limited information available on the effects of Orencia (abatacept) on your body's response to vaccines, including live vaccines. Make sure your shots are up-to-date before starting Orencia (abatacept). Talk with your prescriber before you receive any vaccines while receiving Orencia (abatacept) treatment. Avoid getting live vaccines while you're taking Orencia (abatacept), and for at least 3 months after the last dose, because there's a risk that you can get sick from them.
In clinical trials, adults with chronic obstructive pulmonary disease (COPD) who were treated with Orencia (abatacept) had more COPD-related side effects. If you have COPD, make sure you monitor your symptoms, such as shortness of breath and cough. Let your provider know if they get worse while taking Orencia (abatacept).
The Orencia (abatacept) IV infusion contains maltose, which is a type of sugar that can cause your blood sugar readings to be falsely high if you use certain blood sugar monitors that use a substance called GDH-PQQ to detect blood sugar. This raises your risk for low blood sugar (hypoglycemia) if you give yourself insulin to correct this falsely high blood sugar. Contact your local pharmacist or the manufacturer of the glucose monitor test you use if you're not sure if it can be used with products that have maltose in them.
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 4 syringes of 125mg/ml | 1 carton | $5,545.82 | $5,545.82 |
| 4 syringes of 87.5mg/0.7ml | 1 carton | $6,317.54 | $6,317.54 |
| 4 syringes of 50mg/0.4ml | 1 carton | $14,945.64 | $14,945.64 |
| 4 clickject autoinjectors of 125mg/ml | 1 carton | $5,539.00 | $5,539.00 |
Vial| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 250mg | 3 vials | $4,747.75 | $1,582.58 |
Rheumatoid arthritis and psoriatic arthritis in adults
Juvenile idiopathic arthritis
Prevention graft-versus-host disease
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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In clinical studies of people with RA, those who received IV Orencia, sometimes along with other RA medications, typically started to feel better in about 3 to 6 months. But everyone responds differently to medications, so it's possible Orencia might work slower or faster for you. Contact your provider if you're not sure if Orencia is helping your symptoms.
If you've been taking Orencia for RA, it might take anywhere between over a month to close to 5 months for most of this medication to leave your body after you stop treatment. Keep in mind that this time frame is estimated based on the half-life of Orencia. It can also be affected by your health conditions, so it can be different for each individual person. Discuss with your healthcare provider if you have questions about how long the medication stays in your body.
No, Orencia isn't the same as methotrexate. Methotrexate is another medication that can prevent RA from worsening, but it works differently than Orencia. If you have RA, your provider might prescribe both medications to treat your symptoms. In fact, research shows that for people who still have RA symptoms with methotrexate, adding Orencia to the treatment might improve their symptoms. Talk with your provider if you've more questions about Orencia or methotrexate.
No, weight gain wasn't a reported side effect of Orencia during clinical trials.
No. While some people experience hair loss with some other arthritis medications, such as methotrexate or adalimumab (Humira), hair loss isn't a side effect reported by people who took Orencia in clinical trials.
There's limited research regarding whether Orencia is safe to take during pregnancy. Available data from animal studies show that Orencia didn't cause birth defects. But results in animal studies might not always apply to people. If you're pregnant or thinking of getting pregnant, talk to your provider about the risks and benefits of using Orencia.
There isn't much information about how Orencia might affect breastfeeding. A single report showed that very little of this medication gets into breast milk and doesn't cause side effects for the breastfed baby. But to be safe, don't breastfeed your baby while taking Orencia without talking to your provider first.
