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.
Moderate-to-severe rheumatoid arthritis (RA) in adults
Psoriatic arthritis (PsA) in adults
Moderate-to-severe polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older
Prevention of short-term graft versus host disease (GVHD) in combination with a calcineurin inhibitor and methotrexate in adults and children ages 2 years and older
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.
Source: DailyMed
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.
Can be used in children age 2 years and older (for certain conditions)
Comes as a prefilled syringe or autoinjector for easy at-home injections
Clinic infusions are available for people who don't like to give themselves injections and are generally given only once a month
SQ injections are given once weekly and IV infusions are given once monthly
Raises your risk for infections because it weakens your immune system
Can't be used with other biologic medications because higher risk of infection
Can take 3 to 6 months to notice an improvement in your symptoms (for arthritis)
Only treats the symptoms and isn't a cure for inflammatory problems
Make sure to mark your appointments on your calendar to see your provider and receive your Orencia (abatacept) dose if you're receiving it as an IV infusion. This will help make sure you're properly being monitored and won't miss any doses.
If you're receiving the Orencia (abatacept) IV infusion, let your provider know if you have diabetes and check your blood sugar at home. This is because Orencia (abatacept) can interfere with certain blood sugar test strips, which can cause falsely high blood sugar readings.
Tips for using the Orencia (abatacept) prefilled syringes or autoinjectors at home:
Your provider will likely have you give yourself your first dose of Orencia (abatacept) in their office or clinic to make sure you know how to give yourself the medication correctly. Refer to the instructions for use for the prefilled syringe or the ClickJect Autoinjector and contact your provider or pharmacist if you have any questions.
Store Orencia (abatacept) prefilled syringes or autoinjectors in the refrigerator and in its original packaging to protect it from light. When it's time for your dose, take a dose out of the refrigerator and lay it on a flat surface to warm up to room temperature. This will take about 30 minutes. Don't try to warm up the medication any other way (e.g., microwave, under hot water) because you might damage it.
Before you inject Orencia (abatacept), always check to make sure the liquid is clear and colorless to a pale yellow. If your medication is cloudy, discolored, or has specks floating in it, don't use it. Contact your provider or pharmacist to get a replacement.
Inject Orencia (abatacept) under the skin in the front of your middle thighs, lower part of your stomach, or your outer upper arms if someone else is giving you the injection. If you choose to inject into the stomach, inject 2 inches away from your belly button. Never inject into a muscle or vein.
To lower the risk of bruising and irritation, rotate between different injection sites each time so that the same area isn't used repeatedly. Don't inject Orencia (abatacept) into skin that's tender, red, bruised, scaly, hard, or has scars or stretch marks.
Throw away used syringes and needles in a sharps container or something made of heavy-duty plastic (e.g., empty milk carton, laundry detergent bottle) to lower the risk of needlestick injuries. Don't throw them away in your trash can.
Each Orencia (abatacept) prefilled syringe and autoinjector provides a single dose of medication. You must throw away any leftover medication after each use, even if there's still some remaining in the syringe.
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.
Risk factors: Active, chronic (long-term), or recurrent infection | Other conditions that raise your risk of infection | Taking medications that weaken your immune system
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).
Risk factors: Using Orencia (abatacept) IV infusion | Type 1 or type 2 diabetes | Using insulin | Using glucose meters that use GDH-PQQ
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.
Rheumatoid arthritis and psoriatic arthritis in adults
Intravenous (IV): Your provider will calculate the dose based on your body weight. The typical dose ranges from 500 mg to 1,000 mg infused IV every 2 weeks for 3 doses, then every month after that.
Under the skin injection: The typical dose is 125 mg injected under the skin once weekly.
Juvenile idiopathic arthritis
Intravenous (IV): Your child's provider will calculate the dose based on their body weight. The typical dose is 10 mg/kg infused IV every 2 weeks for 2 doses, then every month after that. Children weighing 75 kg or more will be given the adult dose for arthritis.
Under the skin injection: Your child's provider will calculate the dose based on your child's body weight. The typical dose is injected under the skin once weekly.
Children weighing 10 kg to less than 25 kg: 50 mg
Children weighing 25 kg to less than 50 kg: 87.5 mg
Children weighing 50 kg or more: 125 mg
Prevention graft-versus-host disease
Your provider will calculate the dose based on your body weight and age. The typical dose ranges from 10 mg/kg to 15 mg/kg infused through the veins the day before transplant, then on Day 5, 14, and 28 after transplant.
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.
Moderate-to-severe rheumatoid arthritis (RA) in adults
Psoriatic arthritis (PsA) in adults
Moderate-to-severe polyarticular juvenile idiopathic arthritis (pJIA) in children ages 2 years and older
Prevention of short-term graft versus host disease (GVHD) in combination with a calcineurin inhibitor and methotrexate in adults and children ages 2 years and older
Rheumatoid arthritis (RA)
Plaque psoriasis (PsO) and psoriatic arthritis (PsA)
Ankylosing spondylitis (AS)
Childhood arthritis (polyarticular juvenile idiopathic arthritis, JIA)
Rheumatoid arthritis (RA) - adults only
Juvenile idiopathic arthritis (JIA) - people age 2 and older
Psoriatic arthritis (PsA) - adults only
Ankylosing spondylitis (AS) - adults only
Crohn's disease (CD) - people age 6 and older
Ulcerative colitis (UC) - people age 5 and older
Plaque psoriasis - adults only
Hidradenitis suppurativa (HS) - people age 12 and older
Uveitis - people age 2 and older
By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.
Bristol-Myers Squibb Company. (2020). How to take Orencia: Instructions for injecting the Orencia prefilled syringe with BD UltraSafe Passive™ Needle Guard.
Bristol-Myers Squibb Company. (2023). How to take Orencia: Instructions for injecting the Orencia ClickJect™ Autoinjector.
Drugs and Lactation Database (LactMed). (2023). Abatacept. National Institute of Child Health and Human Development.
E.R. Squibb & Sons, L.L.C. (2023). Orencia- abatacept injection, powder, lyophilized, for solution; abatacept injection, solution [package insert]. DailyMed.
Justiz Vaillant, A., et al. (2024). Graft-Versus-Host Disease. StatPearls.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2021). Juvenile idiopathic arthritis (JIA).
Wagner, E. (2023). Do psoriatic arthritis biologics cause weight gain? My Psoriasis Team.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.