Amjevita side effects: What they are and how to manage them

If you’ve been prescribed Amjevita (adalimumab-atto), chances are you’ve spent some quality time
reading about immune systems, inflammation, and maybe a terrifyingly long medication guide. Amjevita is a
biosimilar to Humira, which means it works in a very similar way to calm down an overactive immune system. But like
its “big sibling,” it also comes with a list of possible side effects that can look a little intimidating at first
glance.

The goal of this guide is simple: explain Amjevita side effects in plain English, help you
recognize what’s common versus what’s serious, and give you practical tips on how to manage them. This article is
informative only and can’t replace medical advice from your own healthcare team, but it can help you feel much more
prepared for your conversations with them.

What is Amjevita and how does it work?

Amjevita (adalimumab-atto) is a tumor necrosis factor (TNF) blocker. TNF is a protein made by your
immune system that helps fight infections, but in autoimmune and inflammatory diseases, your body produces too much
of it. That extra TNF can lead to chronic inflammation and symptoms like joint pain, gut issues, psoriasis plaques,
or eye inflammation.

By blocking TNF, Amjevita helps reduce inflammation in conditions such as:

• Rheumatoid arthritis and psoriatic arthritis
• Ankylosing spondylitis and related spinal conditions
• Crohn’s disease and ulcerative colitis
• Plaque psoriasis and hidradenitis suppurativa
• Certain forms of uveitis (eye inflammation)

The trade-off: calming the immune response also means your body may have a harder time fighting infections and
might react in other ways. That’s where side effects come in.

Boxed warnings: serious infections and cancer risk

Amjevita carries a boxed warning (the FDA’s strongest type of medication warning) for two major
concerns: serious infections and certain cancers, especially lymphomas and some skin cancers. TNF blockers like
Amjevita can increase your risk of infections such as:

• Tuberculosis (TB)
• Invasive fungal infections (for example, histoplasmosis)
• Bacterial sepsis (a severe bloodstream infection)
• Opportunistic infections caused by organisms that typically don’t make healthy people sick

These infections can, in rare cases, lead to hospitalization or be life-threatening. Your provider should check you
for TB before starting Amjevita and may repeat testing over time.

There is also a small but real increased risk of certain cancers, such as lymphoma, leukemia, and some types of
skin cancer. The risk appears higher in people already dealing with chronic inflammatory diseases, and in some
reports, it’s been more pronounced in children, teens, and young adults treated with TNF blockers. Your doctor will
weigh this risk against the risk of letting your disease go untreated or poorly controlled.

Common Amjevita side effects

Not every side effect is dramatic or dangerous. Many people experience only mild issues that improve as their body
adjusts to the medication. Some of the more common Amjevita side effects reported include:

Injection site reactions

Because Amjevita is given as a subcutaneous injection, reactions where the needle goes in are very common.
Symptoms can include:

• Redness or discoloration
• Swelling or puffiness
• Itching or mild burning
• Tenderness, soreness, or a small bruise
• A small, firm bump under the skin that fades over time

These reactions are usually mild and temporary, lasting a few hours to a few days. If the redness,
warmth, or pain is spreading or getting worse instead of better, that could be a sign of infection that needs
medical attention.

Mild infections

Because Amjevita affects your immune system, you’re more likely to pick up common infections. Mild infections can
include:

• Upper respiratory infections (colds, sinus infections, flu-like illnesses)
• Bronchitis
• Urinary tract infections
• Minor skin or soft-tissue infections

These may feel like typical colds or minor infections, but they may take a little longer to clear. Always let your
doctor know if you’re noticing more frequent infections or ones that don’t improve.

Other mild, non-serious side effects

People taking Amjevita may also report:

• Headache
• Nausea or stomach discomfort
• Abdominal pain
• Back pain or muscle aches
• Rash or itching not limited to the injection site
• Feeling tired or low energy

These side effects are usually manageable and may lessen over time. If they’re persistent or significantly impact
your daily life, your healthcare provider may suggest adjustments or supportive treatments.

Serious Amjevita side effects to watch for

Some side effects of Amjevita require urgent medical attention. Contact your healthcare provider right away, or go
to an emergency department, if you notice any of the following.

Serious infections

Call your doctor immediately if you develop signs such as:

• Persistent fever or chills
• Feeling very tired or weak
• Shortness of breath or trouble breathing
• Severe cough, sometimes with blood or mucus
• Unexplained weight loss or night sweats
• Warm, red, painful skin areas that may indicate a serious skin infection

Your doctor may pause Amjevita while the infection is evaluated and treated. Never just power through a serious
infection because you don’t want to “bother” your provider – that’s what they’re there for.

Cancer and blood-related problems

While rare, cancers and blood disorders have been reported with TNF blockers. Seek medical care if you notice:

• Unusual lumps or swelling (for example, in your neck, armpits, or groin)
• Unexplained weight loss or drenching night sweats
• Easy bruising or bleeding
• Frequent nosebleeds or tiny red spots on the skin

Liver problems

Amjevita can, in rare cases, affect the liver. Warning signs include:

• Yellowing of the skin or eyes (jaundice)
• Very dark urine
• Light-colored stools
• Severe fatigue, nausea, or abdominal pain on the right side

Nervous system problems

Very rarely, TNF blockers have been associated with demyelinating disorders (conditions that damage the protective
covering of nerves), similar to multiple sclerosis. Contact your doctor if you notice:

• Vision changes
• Weakness in your arms or legs
• Numbness or tingling that doesn’t go away
• Problems with balance, walking, or coordination

Heart failure

In some cases, TNF blockers can worsen existing heart failure or, rarely, contribute to new-onset heart failure.
Call your doctor urgently if you experience:

• Shortness of breath, especially when lying down
• Unexpected weight gain over a few days
• Swelling in your ankles, legs, or feet

Serious allergic reactions

Although uncommon, serious allergic reactions can occur. Get emergency help if you notice:

• Swelling of the face, lips, tongue, or throat
• Trouble breathing or swallowing
• Severe rash, hives, or blisters
• Sudden dizziness or fainting

Who may be at higher risk of side effects?

Your personal risk of Amjevita side effects depends on many factors, including other health conditions and
medications. You may have a higher risk of serious problems if you:

• Have a history of chronic or recurrent infections
• Have or have had tuberculosis, hepatitis B, or live in an area where certain fungal infections are common
• Have certain blood disorders, cancer, or a strong family history of lymphoma
• Have heart failure, demyelinating disease, or severe liver disease
• Take other immune-suppressing medications (like steroids or certain chemotherapy drugs)

Before you start Amjevita, your provider will usually:

• Check for TB (with a skin test or blood test and sometimes a chest X-ray)
• Screen for hepatitis B and possibly other infections
• Review your vaccination status and medical history

Be as open and detailed as you can. Something that doesn’t seem important to you might matter a lot when your
immune system is being modulated by a TNF blocker.

How to manage Amjevita side effects day to day

Before and during treatment

• Stay up to date on vaccines.
  Inactivated vaccines (like the flu shot, COVID-19 boosters, and most standard adult vaccines) are usually okay
  and often recommended. Live vaccines may need to be timed carefully or avoided; your doctor will advise you.
• Report infections early.
  Don’t wait until you’re very sick. Call if you develop a fever, persistent cough, painful urination, or worsening
  sinus symptoms.
• Ask about regular monitoring.
  Your clinician may order periodic blood tests to check your blood counts and liver function.

Coping with injection site reactions

• Let the medication warm to room temperature (as instructed) before injecting to reduce stinging.
• Rotate injection sites between the abdomen and thighs to avoid repeatedly poking the same spot.
• Clean the skin gently with an alcohol swab and let it dry fully before injecting.
• Use a cool compress after the injection if you notice redness or mild swelling.

If you’re having significant pain, large areas of redness, or symptoms that look like infection (increasing warmth,
pus, or streaks), contact your provider. They may want to see the area or adjust your plan.

Reducing infection risk

• Wash your hands frequently, especially after being in public places or around sick people.
• Try to avoid close contact with anyone who has a known contagious illness when possible.
• Let your doctor know if you’re exposed to TB or certain viral illnesses.
• Ask about preventive strategies if you’ll be traveling to areas with endemic fungal or parasitic infections.

Managing mild side effects

For manageable issues like mild headaches or nausea, your provider may suggest:

• Over-the-counter pain relievers that are safe with your conditions and meds
• Taking injections at night so mild flu-like symptoms don’t disrupt your day
• Staying well-hydrated and eating smaller, more frequent meals if you feel queasy

Never start new medications or supplements (even “natural” ones) without checking with your doctor or pharmacist,
as they can interact with your treatment or your underlying condition.

When to call your doctor vs. when to call 911

It’s not always obvious what’s urgent. Here’s a simple rule of thumb:

• Call your doctor promptly if you have symptoms like a new cough, mild fever, rash, urinary
  burning, or injection site reactions that aren’t improving.
• Seek emergency care (call 911 in the U.S.) if you have chest pain, severe shortness of breath,
  signs of a severe allergic reaction, confusion, or symptoms of a stroke or severe infection.

If you’re ever unsure which category you fall into, err on the side of calling for urgent help.

Questions to discuss with your healthcare provider

Before starting or while taking Amjevita, it can help to ask:

• How do Amjevita’s benefits compare to its risks in my specific situation?
• What signs or symptoms mean I should skip my next dose and call you first?
• Which vaccines should I get before or during treatment?
• How often will I need blood tests or follow-up visits?
• Are there other treatments that might be safer for me if I have certain risk factors?

The more you understand your treatment, the more confident and in control you’re likely to feel.

Real-world experiences: living with Amjevita side effects

Every person’s story with Amjevita is unique. Some people feel dramatically better with minimal side effects.
Others have to work with their healthcare team to tweak the plan or, in some cases, switch therapies entirely. The
following examples are fictional composites based on common experiences, not real individuals, but they reflect the
kinds of patterns people often report.

“The injection sting is annoying, but I can function again”

One common scenario involves someone with long-standing rheumatoid arthritis who starts Amjevita after trying
several other medications. Within a few weeks, they notice that morning stiffness improves, and they’re able to get
out of bed without planning a whole strategy. The trade-off? Each injection stings a little and leaves a small red
patch for a day or two.

After some trial and error, they find that:

• Taking the injection in the evening gives them time to rest afterward.
• Letting the syringe sit out for the recommended time before injecting makes it hurt less.
• Using a cool pack briefly after the shot tames the redness and itching.

For them, the mild, predictable injection site reactions are a worthwhile trade for significantly fewer flare-ups
and more productive days.

“We had to pause after a few infections”

Another person with Crohn’s disease may experience fewer abdominal cramps and less diarrhea on Amjevita, but they
also pick up a couple of respiratory infections during the first winter on therapy. Instead of pushing through
multiple rounds of antibiotics and feeling constantly wiped out, they schedule a detailed conversation with their
gastroenterologist.

Together they:

• Review blood work and infection history.
• Pause Amjevita temporarily while a persistent sinus infection is treated.
• Update vaccines, including flu and recommended boosters.
• Discuss preventive strategies for future winters (like earlier evaluation at the first sign of symptoms).

In this kind of case, infection risk doesn’t automatically mean Amjevita must be stopped forever. But it does mean a
more cautious, closely monitored approach, sometimes with dose timing adjustments or extra preventive care.

“Side effects were a signal that we needed a different plan”

Sometimes, Amjevita isn’t the right long-term fit. For example, someone might develop severe headaches, unusual
neurologic symptoms, or significant changes in their lab results. In partnership with a rheumatologist or other
specialist, they may be evaluated for possible demyelinating disease, blood problems, or other conditions. Based on
the findings, the clinician may decide that continuing a TNF blocker is too risky and switch to a different class
of medication.

While it can feel frustrating to stop a drug that was helping with symptoms, this is a good example of why regular
monitoring and honest reporting of side effects is so important. The goal is always to find a treatment that helps
control disease while keeping long-term risks as low as possible.

“Feeling more empowered about the risks”

Many people say that simply understanding what to watch for makes Amjevita feel less scary. Instead of viewing the
medication guide as a list of things that will happen, they start to see it as a checklist of what to
monitor and how to respond. They set reminders for follow-up labs, keep a simple symptom diary, and make a plan
with their healthcare team about when to call the office versus when to seek emergency care.

This mindset shift can turn a long side-effect list from “doom scroll” into a practical tool. Amjevita is a
powerful medication meant for serious diseases, but with careful monitoring and open communication, many people use
it safely and successfully.

Bottom line

Amjevita can be a game-changer for chronic inflammatory and autoimmune conditions, but it’s not a casual
medication. The most important side effects involve serious infections and a small but
meaningful risk of certain cancers, along with rare blood, liver, heart, and nervous system problems.
There are also more common, usually milder issues like injection site reactions, headaches, and increased minor
infections.

Understanding these side effects, knowing what’s common versus serious, and having a plan with your healthcare team
can help you make an informed decision and feel more confident if you and your provider decide that Amjevita is the
right treatment for you.

Always talk with your doctor, nurse, or pharmacist before starting, stopping, or changing how you take Amjevita.
They know your full medical history and can help you weigh the benefits and risks for your specific situation.