golimumab: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
golimumab: clinical details
Prescribing considerations
- Initiate and supervise treatment through an experienced clinician; provide the Patient Card.
- Exclude clinically important active infection and assess recurrent and opportunistic infection risks.
- Screen for active and latent tuberculosis and hepatitis B before treatment.
- Review vaccination status and avoid live vaccines during treatment.
- Consider heart failure, previous malignancy, demyelinating disease, hepatic impairment and planned surgery.
- Record the product name and batch number for traceability.
- Discuss pregnancy, breastfeeding and infant live-vaccine implications.
Contraindications and cautions
- Hypersensitivity to golimumab or an excipient
- Active tuberculosis
- Sepsis or another severe or opportunistic infection
- Moderate or severe heart failure
Monitoring
- Monitor for infection, including tuberculosis, before, during and after treatment.
- Monitor hepatitis B carriers for reactivation during treatment and for several months afterwards.
- Investigate persistent fever, bruising, bleeding or pallor for haematological abnormalities.
- Assess new neurological or heart-failure symptoms, severe allergy, lupus-like features and clinically significant liver abnormalities.
- Use appropriate clinical and laboratory monitoring for golimumab, the underlying disease and concomitant immunosuppressants.
- In ulcerative colitis, continue surveillance for dysplasia or colorectal cancer according to individual risk.
Clinical pharmacology
Golimumab is a human IgG1 kappa monoclonal antibody that binds soluble and transmembrane TNF-alpha, blocking receptor activation. After subcutaneous administration, mean absolute bioavailability is about 51% and estimated terminal half-life is approximately 12 days.
Formulation and product differences
- The product described is a single-use pre-filled syringe with a fixed needle.
- Its needle cover contains natural-rubber latex and may cause reactions in latex-sensitive people.
- Other devices and biosimilar products are available; injection training, handling and storage instructions are product-specific.
golimumab preparations and strengths
Injection
Route: Parenteral
Strengths: 50 mg, 100 mg
golimumab interactions
Formal interaction studies are limited. Important combinations include:
Anakinra
Concurrent use is not recommended because serious infection and low neutrophil counts may be more likely without added clinical benefit.
Abatacept
Concurrent use is not recommended because it increases infection risk without demonstrated additional benefit.
Other biological treatments for the same condition
Overlapping immune suppression may increase infection and other adverse-effect risks, so concurrent use is generally avoided.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.