Cimzia certolizumab pegol Kit — NDC 50474-700-62 (Billing 50474-0700-62)
This is a package of Cimzia certolizumab pegol Kit from UCB, Inc., marketed since Apr 2008 and currently FDA-listed. It is the main listing for this product, which comes in 2 package sizes.
NDC database record
One package, one record: these facts belong to NDC 50474-700-62 alone.
- Record
- FDA NDC Directory package listing · Human prescription drug
- Code segments
- 50474 labeler · 700 product · 62 package
- Package marketed since
- Apr 20, 2008
- Sample package
- No — commercial package
- Listing certified through
- Dec 31, 2027
- Barcode (UPC-A, from the NDC)
- 3 5047470062 4
- Medicaid fills, this package
- 10,099 prescriptions in the last four reported quarters
- FDA record last changed
- Jul 24, 2026
Identity & classification
Regulatory identifiers FDA, NLM and CMS codes for this package
Drug-database identifiers Medi-Span GPI and First Databank GCN / HICL / AHFS classification
- GSN (GCN sequence number): 063903
- GCN: 99615
- GPI-14 (Medi-Span): 52505020106420
- HICL (First Databank): 035554
- AHFS class code: 90:24.16.92
- RxCUI (RxNorm): 795081
Where does this data come from?
- FDA openFDA NDC Directory · synced Oct 1, 2026
- FDA label on DailyMed · label index refreshed Oct 3, 2026
- RxNorm (NLM RxNav) · catalog refreshed Oct 1, 2026
- Medi-Span GPI (licensed)
- First Databank (licensed) · refreshed Oct 1, 2026
RxNorm drug class
This medicine belongs to the Tumor Necrosis Factor Blocker class.
Where does this data come from?
- RxClass (NLM) · catalog refreshed Oct 1, 2026
Clinical
- Cimzia is used to treat several inflammatory conditions driven by an overactive immune protein called TNFα. In adults, it can be used for Crohn's disease, rheumatoid arthritis, pso...
- Cimzia comes as a prefilled syringe that you inject under the skin — usually into your thigh or abdomen — after getting trained by your healthcare provider. Take it out of the frid...
- How do I give myself this injection, and does it hurt?
- The biggest concern with Cimzia is serious infections — including tuberculosis, fungal infections, and bacterial infections. Call your doctor right away if you develop a fever, chi...
Patient education
Supplement & herbal interactions
Where does this data come from?
- MedlinePlus (NLM) · refreshed Oct 1, 2026
- FDA label on DailyMed · label index refreshed Oct 3, 2026
Ask a licensed pharmacist directly — free, answered by our team.
Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per each | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | Not in the retail survey — common for institutional, discontinued, or low-volume packs. | |
| Medicaid paysCMS SDUD · 12 mo | $1,866.86 | — |
| Medicare drug plans payPart D · Q2 2026 | $6,138.03 | — |
| Medicare Part B allowsASP · J0717 | $3.444 / J0717 unit | — |
Where does this data come from?
- CMS NADAC weekly file
- CMS ASP pricing files · refreshed Sep 20, 2026
- CMS Medicaid State Drug Utilization Data · through Q4 2025
- CMS Part D plan pricing files · refreshed Sep 24, 2026
- VA National Acquisition Center price file
Billing & reimbursement
Where does this data come from?
- CMS ASP NDC-HCPCS crosswalk · refreshed Sep 22, 2026
- DMEPDAC NDC-HCPCS crosswalk
- openFDA NSDE billing units · refreshed Sep 7, 2026
Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Marketing end | Status |
|---|---|---|---|---|
| 50474-0700-61 50474-700-61 | 2 KIT in 1 CARTON / 1 KIT in 1 KIT * 1 mL in 1 VIAL, GLASS * 1 mL in 1 VIAL, GLASS Sample | 2008-04-20 | — | Active |
| 50474-0700-62 You're viewing this Main listing | 2 KIT in 1 CARTON / 1 KIT in 1 KIT * 1 mL in 1 VIAL, GLASS * 1 mL in 1 VIAL, GLASS | 2008-04-20 | — | Active |
In Medicaid, this is the most-dispensed pack of this product — about 100% of fills over the last four reported quarters. See all packs ↓
Pack size FAQ
What quantity is in this package?
What NDC number is used to bill for this package of Cimzia certolizumab pegol Kit?
Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Cimziathis 50474-0700-62 | UCB, | 2 kits | — | — | FDA listed | — |
Where does this data come from?
- FDA openFDA NDC Directory · synced Oct 1, 2026
- FDA Purple Book · refreshed Sep 5, 2026
- CMS NADAC weekly file
Availability & biosimilar status
Biologics have no small-molecule generics; biosimilar competition is tracked in the FDA Purple Book.
Where does this data come from?
- FDA Purple Book · refreshed Sep 5, 2026
What it looks like
Where does this data come from?
- FDA label on DailyMed · label index refreshed Oct 3, 2026
Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
Where does this data come from?
IACT rows and label-wide narrative are kept separate; availability and product-level specificity depend on the submitted label.- FDA label on DailyMed · label index refreshed Oct 3, 2026
- FDA openFDA NDC Directory · synced Oct 1, 2026
Inactive ingredient FAQ
Are inactive ingredients the same for every manufacturer?
Why might an inactive ingredient be missing?
Can inactive ingredients matter?
Manufacturer & labeler
More NDCs from UCB, Inc. labeler code 50474
- Keppra levetiracetam 500 mg Tablet, Film Coated NDC 50474-595-40
- Keppra levetiracetam 750 mg Tablet, Film Coated NDC 50474-596-40
- Keppra levetiracetam 1000 mg Tablet, Film Coated NDC 50474-597-66
- Keppra XR levetiracetam 500 mg Tablet, Film Coated, Extended Release NDC 50474-598-66
- Keppra XR levetiracetam 750 mg Tablet, Film Coated, Extended Release NDC 50474-599-66
- Briviact brivaracetam 75 mg Tablet, Film Coated NDC 50474-670-66
- Cimzia certolizumab pegol 200 mg/mL Injection, Solution NDC 50474-710-79
- Cimzia certolizumab pegol 200 mg/mL Injection, Solution NDC 50474-750-10
- Briviact brivaracetam 100 mg Tablet, Film Coated NDC 50474-770-09
- Bimzelx bimekizumab 160 mg/mL Injection, Solution NDC 50474-780-78
- Bimzelx bimekizumab 160 mg/mL Injection, Solution NDC 50474-781-84
- Bimzelx bimekizumab 320 mg/2mL Injection, Solution NDC 50474-782-84
Where does this data come from?
- FDA openFDA NDC Directory · synced Oct 1, 2026
- Drugs@FDA
Full prescribing information FDA SPL
🚨 Boxed Warning ▾
WARNING: SERIOUS INFECTIONS and MALIGNANCY SERIOUS INFECTIONS Patients treated with CIMZIA are at increased risk for developing serious infections that may lead to hospitalization or death [see Warnings and Precautions (5.1) and Adverse Reactions (6.1) ] . Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. CIMZIA should be discontinued if a patient develops a serious infection or sepsis.
Reported infections include: Active tuberculosis, including reactivation of latent tuberculosis. Patients with tuberculosis have frequently presented with disseminated or extrapulmonary disease. Patients should be tested for latent tuberculosis before CIMZIA use and during therapy.
Treatment for latent infection should be initiated prior to CIMZIA use. Invasive fungal infections, including histoplasmosis, coccidioidomycosis, candidiasis, aspergillosis, blastomycosis, and pneumocystosis. Patients with histoplasmosis or other invasive fungal infections may present with disseminated, rather than localized disease.
Antigen and antibody testing for histoplasmosis may be negative in some patients with active infection. Empiric anti-fungal therapy should be considered in patients at risk for invasive fungal infections who develop severe systemic illness. Bacterial, viral and other infections due to opportunistic pathogens, including Legionella and Listeria.
The risks and benefits of treatment with CIMZIA should be carefully considered prior to initiating therapy in patients with chronic or recurrent infection. Patients should be closely monitored for the development of signs and symptoms of infection during and after treatment with CIMZIA, including the possible development of tuberculosis in patients who tested negative for latent tuberculosis infection prior to initiating therapy. [see Warnings and Precautions (5.1) and Adverse Reactions (6.1) ]. MALIGNANCY Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with TNF blockers, of which CIMZIA is a member [see Warnings and Precautions (5.2) ].
WARNING: SERIOUS INFECTIONS and MALIGNANCY See full prescribing information for complete boxed warning. Increased risk of serious infections leading to hospitalization or death including tuberculosis (TB), bacterial sepsis, invasive fungal infections (such as histoplasmosis), and infections due to other opportunistic pathogens ( 5.1 ). CIMZIA should be discontinued if a patient develops a serious infection or sepsis ( 5.1 ).
Perform test for latent TB; if positive, start treatment for TB prior to starting CIMZIA ( 5.1 ). Monitor all patients for active TB during treatment, even if initial latent TB test is negative ( 5.1 ) Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with TNF blockers, of which CIMZIA is a member ( 5.2 ).
🎯 Indications and Usage ▾
1 INDICATIONS AND USAGE CIMZIA is a tumor necrosis factor (TNF) blocker indicated for: Reducing signs and symptoms of Crohn's disease and maintaining clinical response in adult patients with moderately to severely active disease who have had an inadequate response to conventional therapy ( 1.1 ) Treatment of adults with moderately to severely active rheumatoid arthritis ( 1.2 ) Treatment of active polyarticular juvenile idiopathic arthritis (pJIA) in patients 2 years of age and older ( 1.3 ) Treatment of adult patients with active psoriatic arthritis.
( 1.4 ) Treatment of adults with active ankylosing spondylitis ( 1.5 ) Treatment of adults with active non-radiographic axial spondyloarthritis with objective signs of inflammation ( 1.6 ) Treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy ( 1.7 )
1.1Crohn's Disease CIMZIA is indicated for reducing signs and symptoms of Crohn's disease and maintaining clinical response in adult patients with moderately to severely active disease who have had an inadequate response to conventional therapy.
1.2Rheumatoid Arthritis CIMZIA is indicated for the treatment of adults with moderately to severely active rheumatoid arthritis (RA).
1.3Polyarticular Juvenile Idiopathic Arthritis CIMZIA is indicated for the treatment of active polyarticular juvenile idiopathic arthritis (pJIA) in patients 2 years of age and older.
1.4Psoriatic Arthritis CIMZIA is indicated for the treatment of adult patients with active psoriatic arthritis (PsA).
1.5Ankylosing Spondylitis CIMZIA is indicated for the treatment of adults with active ankylosing spondylitis (AS). [see Clinical Studies (14.5) ]
1.6Non-radiographic Axial Spondyloarthritis CIMZIA is indicated for the treatment of adults with active non-radiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation [see Clinical Studies (14.6) ].
1.7Plaque Psoriasis CIMZIA is indicated for the treatment of adults with moderate-to-severe plaque psoriasis (PsO) who are candidates for systemic therapy or phototherapy [see Clinical Studies (14.7) ]
⏱️ Dosage and Administration ▾
2 DOSAGE AND ADMINISTRATION CIMZIA is administered by subcutaneous injection . Injection sites should be rotated and injections should not be given into areas where the skin is tender, bruised, red or hard. When a 400 mg dose is needed (given as two subcutaneous injections of 200 mg), injections should occur at separate sites in the thigh or abdomen.
The solution should be carefully inspected visually for particulate matter and discoloration prior to administration. The solution should be a clear to opalescent, colorless to yellow liquid, essentially free from particulates and should not be used if cloudy or if foreign particulate matter is present. CIMZIA does not contain preservatives; therefore, unused portions of drug remaining in the syringe or vial should be discarded.
CIMZIA is administered by subcutaneous injection ( 2 ). Crohn's Disease ( 2.1 ) 400 mg initially and at Weeks 2 and 4. If response occurs, follow with 400 mg every four weeks Rheumatoid Arthritis ( 2.2 ) 400 mg initially and at Weeks 2 and 4, followed by 200 mg every other week; for maintenance dosing, 400 mg every 4 weeks can be considered Polyarticular Juvenile Idiopathic Arthritis ( 2.3 ) 10 kg (22 lbs) to less than 20 kg (44 lbs): 100 mg initially and at Weeks 2 and 4, followed by 50 mg every other week 20 kg (44 lbs) to less than 40 kg (88 lbs): 200 mg initially and at Weeks 2 and 4, followed by 100 mg every other week Greater than or equal to 40 kg (88 lbs): 400 mg initially and at Weeks 2 and 4, followed by 200 mg every other week Psoriatic Arthritis ( 2.4 ) 400 mg initially and at week 2 and 4, followed by 200 mg every other week; for maintenance dosing, 400 mg every 4 weeks can be considered.
Ankylosing Spondylitis ( 2.5 ) 400 mg (given as 2 subcutaneous injections of 200 mg each) initially and at weeks 2 and 4, followed by 200 mg every other week or 400 mg every 4 weeks. Non-radiographic Axial Spondyloarthritis ( 2.6 ) 400 mg (given as 2 subcutaneous injections of 200 mg each) initially and at weeks 2 and 4, followed by 200 mg every other week or 400 mg every 4 weeks. Plaque Psoriasis ( 2.7 , 14.7 ) 400 mg (given as 2 subcutaneous injections of 200 mg each) every other week.
For some patients (with body weight less than or equal to 90 kg), a dose of 400 mg (given as 2 subcutaneous injections of 200 mg each) initially and at Weeks 2 and 4, followed by 200 mg every other week may be considered.
2.1Crohn's Disease The recommended initial adult dose of CIMZIA is 400 mg (given as two subcutaneous injections of 200 mg) initially, and at Weeks 2 and 4. In patients who obtain a clinical response, the recommended maintenance regimen is 400 mg every four weeks.
2.2Rheumatoid Arthritis The recommended dose of CIMZIA for adult patients with rheumatoid arthritis is 400 mg (given as two subcutaneous injections of 200 mg) initially and at Weeks 2 and 4, followed by 200 mg every other week. For maintenance dosing, CIMZIA 400 mg every 4 weeks can be considered [see Clinical Studies (14.2) ] .
2.3Polyarticular Juvenile Idiopathic Arthritis The recommended dose of CIMZIA for patients 2 years of age and older with pJIA is based on weight as shown below. Weight range (2 years of age and older) Loading dose Maintenance dose (beginning at Week 6) 10 kg (22 lbs) to less than 20 kg (44 lbs) 100 mg at Week 0, 2 and 4 50 mg every 2 weeks 20 kg (44 lbs) to less than 40 kg (88 lbs) 200 mg at Week 0, 2 and 4 100 mg every 2 weeks Greater than or equal to 40 kg (88 lbs) 400 mg at Week 0, 2 and 4 200 mg every 2 weeks There is no dosage form for Cimzia that allows for patient self-administration for doses below 200 mg.
Doses less than 200 mg require administration by a health care professional using the vial kit.
2.4Psoriatic Arthritis The recommended dose of CIMZIA for adult patients with psoriatic arthritis is 400 mg (given as 2 subcutaneous injections of 200 mg each) initially and at week 2 and 4, followed by 200 mg every other week. For maintenance dosing, CIMZIA 400 mg e… [Excerpted — this section continues on DailyMed.]
💊 Dosage Forms and Strengths ▾
3 DOSAGE FORMS AND STRENGTHS For injection: 200 mg lyophilized powder in a single-dose vial ( 3 ) Injection: 200 mg/mL solution in a single-dose prefilled syringe ( 3 ) For Injection: 200 mg of white to off-white lyophilized powder in a single-dose vial for reconstitution Injection: 200 mg/mL clear to opalescent, colorless to yellow solution in a single-dose prefilled syringe
⛔ Contraindications ▾
4 CONTRAINDICATIONS CIMZIA is contraindicated in patients with a history of hypersensitivity reaction to certolizumab pegol or to any of the excipients. Reactions have included angioedema, anaphylaxis, serum sickness, and urticaria [see Warnings and Precautions (5.4) ] . Serious hypersensitivity reaction to certolizumab pegol or to any of the excipients. ( 4 )
⚠️ Warnings and Cautions ▾
5 WARNINGS AND PRECAUTIONS Serious Infections : CIMZIA should not be initiated in patients with an active infection. Monitor for infection during and after treatment; discontinue if a serious infection develops. If invasive fungal infection develops in patients who reside or travel to regions where mycoses are endemic, consider empiric antifungal therapy.
( 5.1 ) Malignancies : Cases of lymphoma and other malignancies have been observed among patients receiving TNF blockers, including CIMZIA. ( 5.2 ) Heart Failure : Monitor patients for new onset or worsening congestive heart failure. ( 5.3 ) Hypersensitivity Reactions : Discontinue CIMZIA and institute appropriate therapy if anaphylaxis or other serious hypersensitivity reactions occur.
( 5.4 ) Hepatitis B Virus Reactivation : Test for HBV infection before starting CIMZIA. Monitor HBV carriers during and several months after therapy. If reactivation occurs, stop CIMZIA and begin anti-viral therapy ( 5.5 ) Neurologic Reactions : Exacerbation or new onset demyelinating disease may occur; use caution in patients with pre-existing or recent-onset demyelinating disorders.
( 5.6 ) Hematological Reactions (including leukopenia, pancytopenia and thrombocytopenia) : Use with caution in patients who have ongoing, or a history of, significant hematologic abnormalities. Advise patients to seek immediate medical attention if symptoms develop; consider discontinuing CIMZIA in patients with confirmed abnormalities. ( 5.7 ) Use with Anakinra, Abatacept, Rituximab and Natalizumab : Increased risk of serious infections; concomitant use is not recommended.
( 5.8 , 7.1 ) Autoimmunity : Discontinue CIMZIA if lupus-like syndrome develops. ( 5.9 ) Live vaccines : Avoid use with CIMZIA ( 5.10 , 7.2 )
5.1Risk of Serious Infections Patients treated with CIMZIA are at an increased risk for developing serious infections involving various organ systems and sites that may lead to hospitalization or death. Opportunistic infections due to bacterial, mycobacterial, invasive fungal, viral, parasitic, or other opportunistic pathogens including aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, histoplasmosis, legionellosis, listeriosis, pneumocystosis and tuberculosis have been reported with TNF blockers. Patients have frequently presented with disseminated rather than localized disease.
Treatment with CIMZIA should not be initiated in patients with an active infection, including clinically important localized infections. Patients greater than 65 years of age, patients with co-morbid conditions, and/or patients taking concomitant immunosuppressants (e.g. corticosteroids or methotrexate) may be at a greater risk of infection. The risks and benefits of treatment should be considered prior to initiating therapy in patients: with chronic or recurrent infection who have been exposed to tuberculosis with a history of an opportunistic infection who have resided or traveled in areas of endemic tuberculosis or endemic mycoses, such as histoplasmosis, coccidioidomycosis, or blastomycosis with underlying conditions that may predispose them to infection Tuberculosis Cases of reactivation of tuberculosis or new tuberculosis infections have been observed in patients receiving CIMZIA, including patients who have previously or concomitantly received treatment for latent or active tuberculosis.
Reports included cases of pulmonary and extrapulmonary (i.e., disseminated) tuberculosis. Evaluate patients for tuberculosis risk factors and test for latent infection prior to initiating CIMZIA and periodically during therapy. Treatment of latent tuberculosis infection prior to therapy with TNF-blocking agents has been shown to reduce the risk of tuberculosis reactivation during therapy.
Prior to initiating CIMZIA, assess if treatment for latent tuberculosis is needed; and consider an induration of 5 mm or greater a positive tuberculin skin test result, even for patients previously vaccinated with Bacille Calmette-Guerin (… [Excerpted — this section continues on DailyMed.]
🤒 Adverse Reactions ▾
6 ADVERSE REACTIONS The most serious adverse reactions were: Serious Infections [see Warnings and Precautions (5.1) ] Malignancies [see Warnings and Precautions (5.2) ] Heart Failure [see Warnings and Precautions (5.3) ] Hypersensitivity Reactions [see Warnings and Precautions (5.4) ] Hepatitis B Virus Reactivation [see Warnings and Precautions (5.5) ] Neurologic Reactions [see Warnings and Precautions (5.6) ] Hematologic Reactions [see Warnings and Precautions (5.7) ] Autoimmunity [see Warnings and Precautions (5.9) ] Immunosuppression [see Warnings and Precautions (5.11) ] Most common adverse reactions (≥7%): upper respiratory tract infection, rash, and urinary tract infection ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact UCB, Inc. at 1-866-822-0068 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
6.1Clinical Trials Experience Because clinical studies are conducted under widely varying and controlled conditions, adverse reaction rates observed in clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug, and may not predict the rates observed in a broader patient population in clinical practice. In premarketing controlled trials of all adult patient populations combined the most common adverse reactions (≥ 8%) were upper respiratory infections (18%), rash (9%) and urinary tract infections (8%).
Adverse Reactions Most Commonly Leading to Discontinuation of Treatment in Premarketing Controlled Trials The proportion of patients with Crohn's disease who discontinued treatment due to adverse reactions in the controlled clinical studies was 8% for CIMZIA and 7% for placebo. The most common adverse reactions leading to the discontinuation of CIMZIA (for at least 2 patients and with a higher incidence than placebo) were abdominal pain (0.4% CIMZIA, 0.2% placebo), diarrhea (0.4% CIMZIA, 0% placebo), and intestinal obstruction (0.4% CIMZIA, 0% placebo).
The proportion of patients with rheumatoid arthritis who discontinued treatment due to adverse reactions in the controlled clinical studies was 5% for CIMZIA and 2.5% for placebo. The most common adverse reactions leading to discontinuation of CIMZIA were tuberculosis infections (0.5%); and pyrexia, urticaria, pneumonia, and rash (0.3%). Controlled Studies with Crohn's Disease The data described below reflect exposure to CIMZIA at 400 mg subcutaneous dosing in studies of patients with Crohn's disease.
In the safety population in controlled studies, a total of 620 patients with Crohn's disease received CIMZIA at a dose of 400 mg, and 614 subjects received placebo (including subjects randomized to placebo in Study CD2 following open-label dosing of CIMZIA at Weeks 0, 2, 4). In controlled and uncontrolled studies, 1,564 patients received CIMZIA at some dose level, of whom 1,350 patients received 400 mg CIMZIA. Approximately 55% of subjects were female, 45% were male, and 94% were Caucasian.
The majority of patients in the active group were between the ages of 18 and 64. During controlled clinical studies, the proportion of patients with serious adverse reactions was 10% for CIMZIA and 9% for placebo. The most common adverse reactions (occurring in ≥ 5% of CIMZIA-treated patients, and with a higher incidence compared to placebo) in controlled clinical studies with CIMZIA were upper respiratory infections (e.g. nasopharyngitis, laryngitis, viral infection) in 20% of CIMZIA-treated patients and 13% of placebo-treated patients, urinary tract infections (e.g. bladder infection, bacteriuria, cystitis) in 7% of CIMZIA-treated patients and in 6% of placebo-treated patients, and arthralgia (6% CIMZIA, 4% placebo).
Other Adverse Reactions The most commonly occurring adverse reactions in controlled trials of Crohn's disease were described above. Other serious or significant adverse reactions reported in controlled and uncontrolled studies in Crohn's disease and other diseases, occurring in patients receiving CIMZIA at doses of 400 mg or other… [Excerpted — this section continues on DailyMed.]
🔄 Drug Interactions ▾
7 DRUG INTERACTIONS Laboratory Tests : May cause erroneously elevated aPTT results. ( 7.3 )
7.1Use with Anakinra, Abatacept, Rituximab, and Natalizumab An increased risk of serious infections has been seen in clinical studies of other TNF-blocking agents used in combination with anakinra or abatacept, with no added benefit. Formal drug interaction studies have not been performed with rituximab or natalizumab. Because of the nature of the adverse events seen with these combinations with TNF blocker therapy, similar toxicities may also result from the use of CIMZIA in these combinations.
There is not enough information to assess the safety and efficacy of such combination therapy. Therefore, the use of CIMZIA in combination with anakinra, abatacept, rituximab, or natalizumab is not recommended [see Warnings and Precautions (5.8) ] .
7.2Live Vaccines Avoid use of live (including attenuated) vaccines during or immediately prior to initiation of therapy with CIMZIA [see Warnings and Precautions (5.10) ] .
7.3Laboratory Tests Interference with certain coagulation assays has been detected in patients treated with CIMZIA. Certolizumab pegol may cause erroneously elevated activated partial thromboplastin time (aPTT) assay results in patients without coagulation abnormalities. This effect has been observed with the PTT-Lupus Anticoagulant (LA) test and Standard Target Activated Partial Thromboplastin time (STA-PTT) Automate tests from Diagnostica Stago, and the HemosIL APTT-SP liquid and HemosIL lyophilized silica tests from Instrumentation Laboratories.
Other aPTT assays may be affected as well. Interference with thrombin time (TT) and prothrombin time (PT) assays has not been observed. There is no evidence that CIMZIA therapy has an effect on in vivo coagulation.
👥 Use in Specific Populations ▾
8 USE IN SPECIFIC POPULATIONS
8.1Pregnancy Pregnancy Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to CIMZIA during pregnancy. For more information, healthcare providers or patients can contact: MotherToBaby Pregnancy Studies conducted by the Organization of Teratology Information Specialists (OTIS). The OTIS AutoImmune Diseases Study at 1-877-311-8972 or visit http://mothertobaby.org/pregnancy-studies/.
Risk Summary Limited data from an ongoing pregnancy exposure registry on use of CIMZIA in pregnant women are not sufficient to inform a risk of major birth defects or other adverse pregnancy outcomes. However, certolizumab pegol plasma concentrations obtained from two studies of CIMZIA use during the third trimester of pregnancy demonstrated that placental transfer of certolizumab pegol was negligible in most infants at birth, and low in other infants at birth (see Data ) . There are risks to the mother and fetus associated with active rheumatoid arthritis or Crohn's disease.
The theoretical risks of administration of live or live-attenuated vaccines to the infants exposed in utero to CIMZIA should be weighed against the benefits of vaccinations (see Clinical Considerations ) . No adverse developmental effects were observed in animal reproduction studies during which pregnant rats were administered intravenously a rodent anti-murine TNFα pegylated Fab' fragment (cTN3 PF) similar to certolizumab pegol during organogenesis at up to 2.4 times the recommended human dose of 400 mg every four weeks.
The background risk of major birth defects and miscarriage for the indicated population(s) are unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risks of major birth defects and miscarriage in clinically recognized pregnancies are 2 to 4% and 15 to 20%, respectively.
Clinical Considerations Disease-Associated Maternal and/or Embryo/Fetal Risk Published data suggest that the risk of adverse pregnancy outcomes in women with rheumatoid arthritis or Crohn's disease is correlated with maternal disease activity and that active disease increases the risk of adverse pregnancy outcomes, including fetal loss, preterm delivery (before 37 weeks of gestation), low birth weight (less than 2500 g) and small for gestational age birth. Fetal/Neonatal Adverse Reaction Due to its inhibition of TNFα, CIMZIA administered during pregnancy could affect immune responses in the in utero -exposed newborn and infant.
The clinical significance of BLQ or low levels is unknown for in utero -exposed infants. Additional data available from one exposed infant suggest that CIMZIA may be eliminated at a slower rate in infants than in adults (see Data ). The safety of administering live or live-attenuated vaccines in exposed infants is unknown.
Dosing During Pregnancy and the Postpartum Period Based on a pharmacokinetic study in pregnant women with psoriasis or rheumatological diseases who were administered certolizumab pegol during pregnancy until at least 12 weeks postpartum, plasma certolizumab pegol concentrations throughout pregnancy were within the range observed in non-pregnant women with the same chronic inflammatory diseases. No dosage adjustment is required for pregnant women [see Clinical Pharmacology (12.3) ]. Data Human Data A limited number of pregnancies have been reported in an ongoing pregnancy exposure registry.
Due to the small number of CIMZIA-exposed pregnancies with known outcomes (n=217), no meaningful comparisons between the exposed group and control groups may be conducted to determine an association with CIMZIA and major birth defects or adverse pregnancy outcomes. A multicenter clinical study was conducted in 16 women treated with CIMZIA at a maintenance dose of 200 mg every 2 weeks or 400 mg every 4 weeks during the third trimester of pregnancy for rheumatological diseases or Crohn… [Excerpted — this section continues on DailyMed.]
🤰 Pregnancy ▾
8.1Pregnancy Pregnancy Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to CIMZIA during pregnancy. For more information, healthcare providers or patients can contact: MotherToBaby Pregnancy Studies conducted by the Organization of Teratology Information Specialists (OTIS). The OTIS AutoImmune Diseases Study at 1-877-311-8972 or visit http://mothertobaby.org/pregnancy-studies/.
Risk Summary Limited data from an ongoing pregnancy exposure registry on use of CIMZIA in pregnant women are not sufficient to inform a risk of major birth defects or other adverse pregnancy outcomes. However, certolizumab pegol plasma concentrations obtained from two studies of CIMZIA use during the third trimester of pregnancy demonstrated that placental transfer of certolizumab pegol was negligible in most infants at birth, and low in other infants at birth (see Data ) . There are risks to the mother and fetus associated with active rheumatoid arthritis or Crohn's disease.
The theoretical risks of administration of live or live-attenuated vaccines to the infants exposed in utero to CIMZIA should be weighed against the benefits of vaccinations (see Clinical Considerations ) . No adverse developmental effects were observed in animal reproduction studies during which pregnant rats were administered intravenously a rodent anti-murine TNFα pegylated Fab' fragment (cTN3 PF) similar to certolizumab pegol during organogenesis at up to 2.4 times the recommended human dose of 400 mg every four weeks.
The background risk of major birth defects and miscarriage for the indicated population(s) are unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risks of major birth defects and miscarriage in clinically recognized pregnancies are 2 to 4% and 15 to 20%, respectively.
Clinical Considerations Disease-Associated Maternal and/or Embryo/Fetal Risk Published data suggest that the risk of adverse pregnancy outcomes in women with rheumatoid arthritis or Crohn's disease is correlated with maternal disease activity and that active disease increases the risk of adverse pregnancy outcomes, including fetal loss, preterm delivery (before 37 weeks of gestation), low birth weight (less than 2500 g) and small for gestational age birth. Fetal/Neonatal Adverse Reaction Due to its inhibition of TNFα, CIMZIA administered during pregnancy could affect immune responses in the in utero -exposed newborn and infant.
The clinical significance of BLQ or low levels is unknown for in utero -exposed infants. Additional data available from one exposed infant suggest that CIMZIA may be eliminated at a slower rate in infants than in adults (see Data ). The safety of administering live or live-attenuated vaccines in exposed infants is unknown.
Dosing During Pregnancy and the Postpartum Period Based on a pharmacokinetic study in pregnant women with psoriasis or rheumatological diseases who were administered certolizumab pegol during pregnancy until at least 12 weeks postpartum, plasma certolizumab pegol concentrations throughout pregnancy were within the range observed in non-pregnant women with the same chronic inflammatory diseases. No dosage adjustment is required for pregnant women [see Clinical Pharmacology (12.3) ]. Data Human Data A limited number of pregnancies have been reported in an ongoing pregnancy exposure registry.
Due to the small number of CIMZIA-exposed pregnancies with known outcomes (n=217), no meaningful comparisons between the exposed group and control groups may be conducted to determine an association with CIMZIA and major birth defects or adverse pregnancy outcomes. A multicenter clinical study was conducted in 16 women treated with CIMZIA at a maintenance dose of 200 mg every 2 weeks or 400 mg every 4 weeks during the third trimester of pregnancy for rheumatological diseases or Crohn's disease. The last dose of C… [Excerpted — this section continues on DailyMed.]
🧒 Pediatric Use ▾
8.4Pediatric Use The safety and effectiveness of CIMZIA for active polyarticular juvenile idiopathic arthritis has been established in pediatric patients 2 years of age and older. The use of CIMZIA in this age group is supported by evidence from adequate and well-controlled studies of CIMZIA in adults with RA, pharmacokinetic data from adults with RA and pediatric patients with JIA with active polyarthritis, and safety data from an open-label clinical study in 193 pediatric patients 2 to < 18 years of age with JIA with active polyarthritis.
The observed pre-dose (trough) concentrations are generally comparable between adults with RA and pediatric patients with JIA with active polyarthritis [see Pharmacokinetics (12.3) ]. The safety and effectiveness for CIMZIA in pediatric patients less than 2 years of age with pJIA have not been established. The safety and effectiveness of CIMZIA have not been established in pediatric patients for other indications.
CIMZIA was evaluated for the treatment of pediatric patients with moderately to severely active Crohn's disease. Effectiveness was not demonstrated in an open-label, randomized, parallel-group, multiple dose study for a period of up to 62 weeks in 99 subjects aged 6 to 17 years. The study was ended prematurely because of a high number of patient discontinuations.
Due to its inhibition of TNFα, CIMZIA administered during pregnancy could affect immune responses in the in utero -exposed newborn and infant [see Use in Specific Populations (8.1) ].
🧓 Geriatric Use ▾
8.5Geriatric Use Clinical studies of CIMZIA did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger adult patients. Population pharmacokinetic analyses of patients enrolled in CIMZIA clinical studies concluded that there was no apparent difference in drug concentration regardless of age.
Because there is a higher incidence of infections in the elderly population in general, use caution when treating the elderly with CIMZIA [see Warnings and Precautions (5.1) ] .
🧬 Clinical Pharmacology ▾
12 CLINICAL PHARMACOLOGY
12.1Mechanism of Action Certolizumab pegol binds to human TNFα with a KD of 90pM. TNFα is a key pro-inflammatory cytokine with a central role in inflammatory processes. Certolizumab pegol selectively neutralizes TNFα (IC 90 of 4 ng/mL for inhibition of human TNFα in the in vitro L929 murine fibrosarcoma cytotoxicity assay) but does not neutralize lymphotoxin α (TNFβ).
Certolizumab pegol cross-reacts poorly with TNF from rodents and rabbits, therefore in vivo efficacy was evaluated using animal models in which human TNFα was the physiologically active molecule. Certolizumab pegol was shown to neutralize membrane-associated and soluble human TNFα in a dose-dependent manner. Incubation of monocytes with certolizumab pegol resulted in a dose-dependent inhibition of LPS-induced TNFα and IL-1β production in human monocytes.
Certolizumab pegol does not contain a fragment crystallizable (Fc) region, which is normally present in a complete antibody, and therefore does not fix complement or cause antibody-dependent cell-mediated cytotoxicity in vitro . It does not induce apoptosis in vitro in human peripheral blood-derived monocytes or lymphocytes, nor does certolizumab pegol induce neutrophil degranulation. A tissue reactivity study was carried out ex vivo to evaluate potential cross-reactivity of certolizumab pegol with cryosections of normal human tissues.
Certolizumab pegol showed no reactivity with a designated standard panel of normal human tissues.
12.2Pharmacodynamics Biological activities ascribed to TNFα include the upregulation of cellular adhesion molecules and chemokines, upregulation of major histocompatibility complex (MHC) class I and class II molecules, and direct leukocyte activation. TNFα stimulates the production of downstream inflammatory mediators, including interleukin-1, prostaglandins, platelet activating factor, and nitric oxide. Elevated levels of TNFα have been implicated in the pathology of Crohn's disease and rheumatoid arthritis.
Certolizumab pegol binds to TNFα, inhibiting its role as a key mediator of inflammation. TNFα is strongly expressed in the bowel wall in areas involved by Crohn's disease and fecal concentrations of TNFα in patients with Crohn's disease have been shown to reflect clinical severity of the disease. After treatment with certolizumab pegol, patients with Crohn's disease demonstrated a decrease in the levels of C-reactive protein (CRP).
Increased TNFα levels are found in the synovial fluid of rheumatoid arthritis patients and play an important role in the joint destruction that is a hallmark of this disease.
12.3Pharmacokinetics Absorption A total of 126 healthy subjects received doses of up to 800 mg certolizumab pegol subcutaneously (sc) and up to 10 mg/kg intravenously (IV) in four pharmacokinetic studies. Data from these studies demonstrate that single intravenous and subcutaneous doses of certolizumab pegol have predictable dose-related plasma concentrations with a linear relationship between the dose administered and the maximum plasma concentration (C max ), and the Area Under the certolizumab pegol plasma concentration versus time Curve (AUC).
A mean C max of approximately 43 to 49 mcg/mL occurred at Week 5 during the initial loading dose period using the recommended dose regimen for the treatment of patients with rheumatoid arthritis (400 mg sc at Weeks 0, 2 and 4 followed by 200 mg every other week). Certolizumab pegol plasma concentrations were broadly dose-proportional and pharmacokinetics observed in patients with rheumatoid arthritis, Crohn's disease, and plaque psoriasis were consistent with those seen in healthy subjects. Following subcutaneous administration, peak plasma concentrations of certolizumab pegol were attained between 54 and 171 hours post-injection.
Certolizumab pegol has bioavailability (F) of approximately 80% (ranging from 76% to 88%) following subcutaneous administration compared to intravenous administration. In pediatric pa… [Excerpted — this section continues on DailyMed.]
🧬 Mechanism of Action ▾
12.1Mechanism of Action Certolizumab pegol binds to human TNFα with a KD of 90pM. TNFα is a key pro-inflammatory cytokine with a central role in inflammatory processes. Certolizumab pegol selectively neutralizes TNFα (IC 90 of 4 ng/mL for inhibition of human TNFα in the in vitro L929 murine fibrosarcoma cytotoxicity assay) but does not neutralize lymphotoxin α (TNFβ).
Certolizumab pegol cross-reacts poorly with TNF from rodents and rabbits, therefore in vivo efficacy was evaluated using animal models in which human TNFα was the physiologically active molecule. Certolizumab pegol was shown to neutralize membrane-associated and soluble human TNFα in a dose-dependent manner. Incubation of monocytes with certolizumab pegol resulted in a dose-dependent inhibition of LPS-induced TNFα and IL-1β production in human monocytes.
Certolizumab pegol does not contain a fragment crystallizable (Fc) region, which is normally present in a complete antibody, and therefore does not fix complement or cause antibody-dependent cell-mediated cytotoxicity in vitro . It does not induce apoptosis in vitro in human peripheral blood-derived monocytes or lymphocytes, nor does certolizumab pegol induce neutrophil degranulation. A tissue reactivity study was carried out ex vivo to evaluate potential cross-reactivity of certolizumab pegol with cryosections of normal human tissues.
Certolizumab pegol showed no reactivity with a designated standard panel of normal human tissues.
📦 How Supplied / Storage and Handling ▾
16 HOW SUPPLIED/STORAGE AND HANDLING How Supplied CIMZIA (certolizumab pegol) for injection is a sterile white, lyophilized powder for subcutaneous use after reconstitution in the following packaging configuration. Package size NDC Pack Contents Carton of two 200 mg vials NDC 50474-700-62 Two 200 mg/vial glass vials with rubber stopper Two 1 mL Sterile Water for Injection, USP glass vials Two 3 mL plastic syringes Four 20-gauge needles (1 inch) Two 23-gauge needles (1 inch) Eight alcohol swabs CIMZIA (certolizumab pegol) injection is a sterile, clear to opalescent, colorless to yellow solution for subcutaneous use in the following packaging configurations.
Package size NDC Pack Contents Prefilled Syringe Starter Kit: each unit carton contains three cartons of two 200 mg/mL prefilled syringes per individual carton NDC 50474-710-81 Six 200 mg/mL prefilled syringes with a fixed 25 ½ gauge thin-wall needle 6 alcohol swabs Carton of two 200 mg/mL prefilled syringes NDC 50474-710-79 Two 200 mg/mL prefilled syringe with a fixed 25 ½ gauge thin-wall needle Two alcohol swabs Carton of one 200 mg/mL prefilled syringe NDC 50474-750-10 One 200 mg/mL prefilled syringe with a fixed 25 ½ gauge thin-wall needle One alcohol swab The needle shield inside the removable cap of the CIMZIA prefilled syringe contains a derivative of natural rubber latex which may cause allergic reactions and should be handled with caution by latex-sensitive individuals [see Warnings and Precautions (5.4) ].
Storage and Handling Refrigerate CIMZIA vials and prefilled syringes between 2°C to 8°C (36°F to 46°F) in the original carton to protect from light. Do not freeze. Do not shake.
Do not separate contents of carton prior to use. Do not use beyond expiration date, which is located on the drug label and carton. Unopened CIMZIA lyophilized vials may also be stored at room temperature up to a maximum of 25°C (77°F) for 6 months, but not exceeding the original expiration date.
If stored at room temperature, do not place back in refrigerator and write the new expiration date on the carton in the space provided. When necessary, CIMZIA prefilled syringes may be stored at room temperature up to 77 ° F (25 ° C) in the original carton to protect from light for a single period of up to 7 days. Once stored at room temperature, do not place back in refrigerator.
Write the date removed from the refrigerator in the space provided on the carton and discard if not used within the 7-day period.
📦 Storage and Handling ▾
Storage and Handling Refrigerate CIMZIA vials and prefilled syringes between 2°C to 8°C (36°F to 46°F) in the original carton to protect from light. Do not freeze. Do not shake.
Do not separate contents of carton prior to use. Do not use beyond expiration date, which is located on the drug label and carton. Unopened CIMZIA lyophilized vials may also be stored at room temperature up to a maximum of 25°C (77°F) for 6 months, but not exceeding the original expiration date.
If stored at room temperature, do not place back in refrigerator and write the new expiration date on the carton in the space provided.
📋 Description ▾
11 DESCRIPTION Certolizumab pegol is a TNF blocker. CIMZIA is a recombinant, humanized antibody Fab' fragment, with specificity for human tumor necrosis factor alpha (TNFα), conjugated to an approximately 40kDa polyethylene glycol (PEG2MAL40K). The Fab' fragment is manufactured in E. coli and is subsequently subjected to purification and conjugation to PEG2MAL40K, to generate certolizumab pegol.
The Fab' fragment is composed of a light chain with 214 amino acids and a heavy chain with 229 amino acids. The molecular weight of certolizumab pegol is approximately 91 kiloDaltons. CIMZIA (certolizumab pegol) for injection is supplied as a sterile white, lyophilized powder in a single-dose vial for subcutaneous use.
After reconstitution of the lyophilized powder with 1 mL Sterile Water for Injection, USP, the final concentration is 200 mg/mL with a deliverable volume of 1 mL (200 mg) and a pH of approximately 5.2. Each single-dose vial provides 200 mg certolizumab pegol, lactic acid (0.9 mg), polysorbate (0.1 mg), and sucrose (100 mg). CIMZIA (certolizumab pegol) injection is supplied as a sterile, clear to opalescent, colorless to yellow solution that may contain particulates in a single-dose prefilled syringe for subcutaneous use.
Each prefilled syringe delivers 1 mL of solution containing 200 mg certolizumab pegol, sodium acetate (1.36 mg), sodium chloride (7.31 mg), and Water for Injection, USP.
💬 Information for Patients ▾
17 PATIENT COUNSELING INFORMATION Advise the patient and/or caregiver to read the FDA-approved patient labeling (Medication Guide and Instructions for Use) Risk of Serious Infections Inform patients that CIMZIA may lower the ability of the immune system to fight infections. Instruct patients of the importance of contacting their doctor if they develop any symptoms of infection, including tuberculosis and reactivation of hepatitis B virus infections. Because caution should be exercised in prescribing CIMZIA to patients with clinically important active infections, advise patients of the importance of informing their health care providers about all aspects of their health [see Warnings and Precautions (5.1 , 5.5) ] .
Malignancies Counsel patients about the possible risk of lymphoma and other malignancies while receiving CIMZIA [see Warnings and Precautions (5.2) ] . Other Medical Conditions Advise patients to report any signs of new or worsening medical conditions such as heart disease, neurological disease, or autoimmune disorders [see Warnings and Precautions (5.3 , 5.6 , 5.9) . Advise patients to report promptly any symptoms suggestive of a cytopenia such as bruising, bleeding, or persistent fever [see Warnings and Precautions (5.7) ] .
Hypersensitivity Reactions Advise patients to seek immediate medical attention if they experience any symptoms of severe hypersensitivity reactions. Advise latex-sensitive patients that the needle shield inside the removable cap of the CIMZIA prefilled syringe contains a derivative of natural rubber latex [see Warnings and Precautions (5.4) ] . Preparation and Administration of CIMZIA Using the Prefilled Syringe Instruct patients and caregivers on how to inject the Prefilled Syringe.
Complete instructions are provided in the Instructions for Use packaged in each CIMZIA Prefilled Syringe kit. If refrigerated, remove the prefilled syringe from the carton and let it warm to room temperature. Inspect the liquid in the prefilled syringe.
It should be clear to opalescent, and colorless to yellow and free from particulates. Discard the syringe if cloudy, discolored or contains particulates. Suitable sites for injection include the thigh or abdomen.
Inject at least 1 inch from the previous site. Do not inject into areas where the skin is tender, bruised, red or hard, or where there are scars or stretch marks. Instruct patients and caregivers in proper syringe and needle disposal technique.
To avoid needle-stick injury, do not to place the needle cap back on the syringe or otherwise recap the needle. Properly dispose of needles and syringes in a puncture-proof container. Do not reuse the injection materials.
💬 Medication Guide ▾
This Medication Guide has been approved by the U.S. Food and Drug Administration. Revised: 09/2025 MEDICATION GUIDE CIMZIA ® (CIM-zee-uh) (certolizumab pegol) injection for subcutaneous use What is the most important information I should know about CIMZIA?
CIMZIA may cause serious side effects, including: CIMZIA is a prescription medicine called a Tumor Necrosis Factor (TNF) blocker that can lower the ability of your immune system to fight infections. Some people who received CIMZIA have developed serious infections, including tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some of these serious infections have caused hospitalization and death.
Your healthcare provider should test you for TB before starting CIMZIA. Your healthcare provider should monitor you closely for signs and symptoms of TB during treatment with CIMZIA. Before starting CIMZIA, tell your healthcare provider if you: think you have an infection or have symptoms of an infection such as: fever, sweat, or chills cough blood in phlegm warm, red, or painful skin or sores on your body burning when you urinate or urinate more often than normal muscle aches shortness of breath weight loss diarrhea or stomach pain feeling very tired are being treated for an infection. get a lot of infections or have infections that keep coming back. have diabetes, HIV-1 or a weak immune system.
People with these conditions have a higher chance for infections. have tuberculosis (TB), or have been in close contact with someone with TB. were born in, live, have lived, or traveled to certain countries where there is more risk for getting TB. Ask your healthcare provider if you are not sure. live, have lived, or traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased risk for getting certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, candidiasis, aspergillosis, blastomycosis, and pneumocystosis).
These infections may develop or become more severe if you receive CIMZIA. Ask your healthcare provider if you do not know if you have lived in an area where these infections are common. have or have had hepatitis B. use the medicine Kineret (anakinra), Orencia ® (abatacept), Rituxan ® (rituximab), or Tysabri ® (natalizumab). Stop using CIMZIA, and tell your healthcare provider right away if you have any of the symptoms of an infection listed above.
Cancer. For people who receive TNF blockers, including CIMZIA, the chances of getting certain types of cancers may increase. Some children, teenagers, and young adults who received TNF blockers, including CIMZIA, have developed lymphoma and other certain types of rare cancers, some of which have caused death.
These cancers are not usually seen in this age group. People with inflammatory diseases including rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis, especially those with very active disease, may be more likely to get lymphoma. Some people who receive TNF blockers, including CIMZIA, have developed a rare type of cancer which may cause death, called hepatosplenic T-cell lymphoma.
Most of these people were male teenagers and young adult males with Crohn's disease or ulcerative colitis. Also, most of these people had been treated with both a TNF blocker and another medicine called IMURAN ® (azathioprine) or PURINETHOL ® (6-mercaptopurine, 6-MP). Some people who receive CIMZIA, have developed certain types of skin cancer.
Tell your healthcare provider if you develop any changes in the appearance of your skin, including growths on your skin, during or after treatment with CIMZIA. You should see your healthcare provider periodically during treatment for skin examinations, especially if you have a history of skin cancer. What is CIMZIA?
CIMZIA is a prescription medicine called a Tumor Necrosis Factor (TNF) blocker used to: Lessen the signs and symptoms of moderately to severely… [Excerpted — this section continues on DailyMed.]
🧬 Pharmacokinetics ▾
12.3Pharmacokinetics Absorption A total of 126 healthy subjects received doses of up to 800 mg certolizumab pegol subcutaneously (sc) and up to 10 mg/kg intravenously (IV) in four pharmacokinetic studies. Data from these studies demonstrate that single intravenous and subcutaneous doses of certolizumab pegol have predictable dose-related plasma concentrations with a linear relationship between the dose administered and the maximum plasma concentration (C max ), and the Area Under the certolizumab pegol plasma concentration versus time Curve (AUC).
A mean C max of approximately 43 to 49 mcg/mL occurred at Week 5 during the initial loading dose period using the recommended dose regimen for the treatment of patients with rheumatoid arthritis (400 mg sc at Weeks 0, 2 and 4 followed by 200 mg every other week). Certolizumab pegol plasma concentrations were broadly dose-proportional and pharmacokinetics observed in patients with rheumatoid arthritis, Crohn's disease, and plaque psoriasis were consistent with those seen in healthy subjects. Following subcutaneous administration, peak plasma concentrations of certolizumab pegol were attained between 54 and 171 hours post-injection.
Certolizumab pegol has bioavailability (F) of approximately 80% (ranging from 76% to 88%) following subcutaneous administration compared to intravenous administration. In pediatric patients with JIA with active polyarthritis, mean peak plasma concentrations, measured 1 week following loading dose and maintenance dose were 58.8 µg/ml and 41.8 µg/ml, respectively. Similar peak plasma concentrations were observed across the different body weight groups (10 kg to less than 20 kg, 20 kg to less than 40 kg, and greater than or equal to 40 kg).
Distribution The steady state volume of distribution (Vss) was estimated as 4.7 to 8 L in the population pharmacokinetic analysis for adult patients with Crohn's disease, patients with rheumatoid arthritis, and adult patients with plaque psoriasis. The volume of distribution in pediatric patients with JIA with active polyarthritis was dependent on body size. Metabolism The metabolism of certolizumab pegol has not been studied in human subjects.
Data from animals indicate that once cleaved from the Fab' fragment the PEG moiety is mainly excreted in urine without further metabolism. Elimination PEGylation, the covalent attachment of PEG polymers to peptides, delays the metabolism and elimination of these entities from the circulation by a variety of mechanisms, including decreased renal clearance, proteolysis, and immunogenicity. Accordingly, certolizumab pegol is an antibody Fab' fragment conjugated with PEG in order to extend the terminal plasma elimination half-life (t 1/2 ) of the Fab'.
The terminal elimination phase half-life (t 1/2 ) was approximately 14 days for all doses tested. The clearance following IV administration to healthy subjects ranged from 9.21 mL/h to 14.38 mL/h. The clearance following sc dosing was estimated 17 mL/h in the Crohn's disease population PK analysis with an inter-subject variability of 38% (CV) and an inter-occasion variability of 16%.
Similarly, the clearance following sc dosing was estimated as 21.0 mL/h in the RA population PK analysis, with an inter-subject variability of 30.8% (%CV) and inter-occasion variability 22.0%. The clearance following subcutaneous dosing in patients with plaque psoriasis was 14 mL/h with an inter-subject variability of 22.2% (CV). The route of elimination of certolizumab pegol has not been studied in human subjects.
Studies in animals indicate that the major route of elimination of the PEG component is via urinary excretion. In pediatric patients with JIA with active polyarthritis, clearance was body weight dependent, and t 1/2 was similar to adult indications. Specific Populations Population pharmacokinetic analysis was conducted on data from adult patients with rheumatoid arthritis and adult patients with Crohn's disease, to evaluate the effect of age, race,… [Excerpted — this section continues on DailyMed.]
🧬 Pharmacodynamics ▾
12.2Pharmacodynamics Biological activities ascribed to TNFα include the upregulation of cellular adhesion molecules and chemokines, upregulation of major histocompatibility complex (MHC) class I and class II molecules, and direct leukocyte activation. TNFα stimulates the production of downstream inflammatory mediators, including interleukin-1, prostaglandins, platelet activating factor, and nitric oxide. Elevated levels of TNFα have been implicated in the pathology of Crohn's disease and rheumatoid arthritis.
Certolizumab pegol binds to TNFα, inhibiting its role as a key mediator of inflammation. TNFα is strongly expressed in the bowel wall in areas involved by Crohn's disease and fecal concentrations of TNFα in patients with Crohn's disease have been shown to reflect clinical severity of the disease. After treatment with certolizumab pegol, patients with Crohn's disease demonstrated a decrease in the levels of C-reactive protein (CRP).
Increased TNFα levels are found in the synovial fluid of rheumatoid arthritis patients and play an important role in the joint destruction that is a hallmark of this disease.
🔬 Clinical Studies ▾
14 CLINICAL STUDIES
14.1Crohn's Disease The efficacy and safety of CIMZIA were assessed in two double-blind, randomized, placebo-controlled studies in patients aged 18 years and older with moderately to severely active Crohn's disease, as defined by a Crohn's Disease Activity Index (CDAI) of 220 to 450 points, inclusive. CIMZIA was administered subcutaneously at a dose of 400 mg in both studies. Stable concomitant medications for Crohn's disease were permitted.
Study CD1 Study CD1 was a randomized placebo-controlled study in 662 patients with active Crohn's disease. CIMZIA or placebo was administered at Weeks 0, 2, and 4 and then every four weeks to Week 24. Assessments were done at Weeks 6 and 26.
Clinical response was defined as at least a 100-point reduction in CDAI score compared to baseline, and clinical remission was defined as an absolute CDAI score of 150 points or lower. The results for Study CD1 are provided in Table 3. At Week 6, the proportion of clinical responders was statistically significantly greater for CIMZIA-treated patients compared to controls.
The difference in clinical remission rates was not statistically significant at Week 6. The difference in the proportion of patients who were in clinical response at both Weeks 6 and 26 was also statistically significant, demonstrating maintenance of clinical response. Table 3: Study CD1 – Clinical Response and Remission, Overall Study Population Timepoint % Response or Remission (95% CI) Placebo (N = 328) CIMZIA 400 mg (N = 331) Week 6 Clinical Response Clinical response is defined as decrease in CDAI of at least 100 points, and clinical remission is defined as CDAI ≤ 150 points 27% (22%, 32%) 35% (30%, 40%) p-value < 0.05 logistic regression test Clinical Remission 17% (13%, 22%) 22% (17%, 26%) Week 26 Clinical Response 27% (22%, 31%) 37% (32%, 42%) Clinical Remission 18% (14%, 22%) 29% (25%, 34%) Both Weeks 6 & 26 Clinical Response 16% (12%, 20%) 23% (18%, 28%) Clinical Remission 10% (7%, 13%) 14% (11%, 18%) Study CD2 Study CD2 was a randomized treatment-withdrawal study in patients with active Crohn's disease.
All patients who entered the study were dosed initially with CIMZIA 400 mg at Weeks 0, 2, and 4 and then assessed for clinical response at Week 6 (as defined by at least a 100-point reduction in CDAI score). At Week 6, a group of 428 clinical responders was randomized to receive either CIMZIA 400 mg or placebo, every four weeks starting at Week 8, as maintenance therapy through Week 24. Non-responders at Week 6 were withdrawn from the study.
Final evaluation was based on the CDAI score at Week 26. Patients who withdrew or who received rescue therapy were considered not to be in clinical response. Three randomized responders received no study injections, and were excluded from the ITT analysis.
The results for clinical response and remission are shown in Table 4. At Week 26, a statistically significantly greater proportion of Week 6 responders were in clinical response and in clinical remission in the CIMZIA-treated group compared to the group treated with placebo. Table 4: Study CD2 - Clinical Response and Clinical Remission % Response or Remission (95% CI) CIMZIA 400 mg ×3 + Placebo N = 210 CIMZIA 400 mg N = 215 Week 26 Clinical Response Clinical response is defined as decrease in CDAI of at least 100 points, and clinical remission is defined as CDAI ≤ 150 points 36% (30%, 43%) 63% (56%, 69%) p <
0.05Clinical Remission 29% (22%, 35%) 48% (41%, 55%) Baseline use of immunosuppressants or corticosteroids had no impact on the clinical response to CIMZIA.
14.2Rheumatoid Arthritis The efficacy and safety of CIMZIA were assessed in four randomized, placebo-controlled, double-blind studies (RA-I, RA-II, RA-III, and RA-IV) in patients ≥ 18 years of age with moderately to severely active rheumatoid arthritis diagnosed according to the American College of Rheumatology (ACR) criteria. Patients had ≥ 9 swollen and tender joints and had active RA for at least 6 mon… [Excerpted — this section continues on DailyMed.]
🧪 Nonclinical Toxicology ▾
13 NONCLINICAL TOXICOLOGY
13.1Carcinogenesis, Mutagenesis, and Impairment of Fertility Long-term animal studies of CIMZIA have not been conducted to assess its carcinogenic potential. Certolizumab pegol was not genotoxic in the Ames test, the human peripheral blood lymphocytes chromosomal aberration assay, or the mouse bone marrow micronucleus assay. Since certolizumab pegol does not cross-react with mouse or rat TNFα, reproduction studies were performed in rats using a rodent anti-murine TNFα pegylated Fab fragment (cTN3 PF), similar to certolizumab pegol.
The cTN3 PF had no effects on the fertility and general reproductive performance of male and female rats at intravenous doses up 100 mg/kg, administered twice weekly.
📄 Carcinogenesis, Mutagenesis, Impairment of Fertility ▾
13.1Carcinogenesis, Mutagenesis, and Impairment of Fertility Long-term animal studies of CIMZIA have not been conducted to assess its carcinogenic potential. Certolizumab pegol was not genotoxic in the Ames test, the human peripheral blood lymphocytes chromosomal aberration assay, or the mouse bone marrow micronucleus assay. Since certolizumab pegol does not cross-react with mouse or rat TNFα, reproduction studies were performed in rats using a rodent anti-murine TNFα pegylated Fab fragment (cTN3 PF), similar to certolizumab pegol.
The cTN3 PF had no effects on the fertility and general reproductive performance of male and female rats at intravenous doses up 100 mg/kg, administered twice weekly.
📄 Patient Package Insert ▾
Instructions for Use CIMZIA ® (CIM-zee-uh) (certolizumab pegol) injection for subcutaneous use Prefilled Syringes Read this Instructions for Use booklet that comes with CIMZIA before you start receiving it, and before each injection of CIMZIA. This Instructions for Use booklet does not take the place of talking with your healthcare provider about your medical condition or treatment. These instructions are for 1 injection only.
You may need more than 1 injection at a time depending on your prescribed dose of CIMZIA. Do not share your CIMZIA Prefilled Syringe with needle attached with another person. You may give another person an infection or get an infection from them.
Important: The plastic needle shield inside the removable cap contains natural rubber. Tell your healthcare provider if you are allergic to latex. Supplies you will need to give your CIMZIA injection: See Figure A and Figure B .
1 CIMZIA prefilled syringe with needle attached. You may need 2 CIMZIA prefilled syringes with needles attached to give higher doses. 1 or 2 alcohol swabs 1 or 2 clean cotton balls or gauze pads 1 puncture-resistant sharps disposal container.
See " Disposal of your syringes with needles attached " at the end of this Instructions for Use booklet. CIMZIA comes in a tray containing either 1 or 2 prefilled glass syringes. Use a new CIMZIA syringe for each injection.
Storage information: Keep CIMZIA in the refrigerator between 36°F to 46°F (2°C to 8°C). Do not freeze. Do not shake.
Protect CIMZIA from light. Store CIMZIA in the carton it came in. Do not use CIMZIA if the medicine is expired.
Check the expiration date on the prefilled syringe or carton. If needed, CIMZIA syringes may be stored at room temperature up to 77°F (25°C) in the original carton to protect from light for a single period of up to 7 days. After your CIMZIA syringe has been stored at room temperature, do not place back in refrigerator.
Write the date removed from the refrigerator in the space provided on the carton and throw away (discard) if not used within the 7-day period. Setting up for your CIMZIA injection: Step 1. If refrigerated, take the carton containing the number of prefilled syringes needed for your dosage of CIMZIA out of the refrigerator.
Check the expiration date on the syringe carton and label. See Figure C . If the expiration date has passed, do not use the syringe.
Call your pharmacist for questions about the expiration date. Do not use CIMZIA if the carton has been opened or tampered with. Step 2.
Remove the prefilled syringe from the carton and let it warm to room temperature, this will take about 30 minutes. Do not warm the syringe in any other way. If you have a second syringe and are not using the syringe, put the carton containing the remaining prefilled syringe back in the refrigerator.
Step 3. Find a clean, flat work surface, such as a table. Step 4.
Make sure the liquid medicine in the prefilled syringe is clear to opalescent, and colorless to yellow and free from particles. Do not inject the medicine if it is cloudy, discolored, or contains particles. Call your healthcare provider or pharmacist if you have any questions about your CIMZIA prefilled syringe.
Step 5. Gather all the supplies you will need for your injection. Step 6.
Wash your hands with soap and warm water and dry with a clean towel. Selecting and preparing your injection site: Step 7. Choose your injection sites on your stomach or upper thighs.
See Figure D . Choose a new injection site each time you use CIMZIA. Each new injection should be given at least 1 inch from the site you used before.
If you choose your stomach, avoid the 2 inches around your belly button (navel). Do not inject into areas where your skin is tender, bruised, red or hard, or where you have scars or stretch marks. Change injection sites between your stomach and upper thighs to reduce the chance of having a skin reaction.
You may want to write down the site you use for your injection to help you remember to u… [Excerpted — this section continues on DailyMed.]
📖 Instructions for Use ▾
CIMZIA® (certolizumab pegol) Preparation and Administration of Lyophilized Powder for Injection (200 mg/vial) CIMZIA Lyophilized powder should be prepared and administered by a health care professional. Contents: 2 inner kits, each containing 1 vial of CIMZIA 200 mg, 1 vial of sterile water for injection (USP 1 mL), 1 single-dose plastic syringe, 4 alcohol swabs, two reconstitution needles, and one dosing needle. Refrigerate carton at 2 to 8°C (36 to 46°F).
DO NOT FREEZE. Do not separate contents of carton prior to use. Do not use beyond expiration date on container.
Unopened CIMZIA vials may also be stored at room temperature up to a maximum of 25°C (77°F) for 6 months, but not exceeding the original expiration date. If stored at room temperature, do not place back in refrigerator and write the new expiration date on the carton in the space provided. If refrigerated, remove CIMZIA from the refrigerator and allow the vial(s) to sit at room temperature for 30 minutes before reconstituting.
Do not warm the vial in any other way. Using appropriate aseptic technique, reconstitute each lyophilized vial of CIMZIA with 1 mL of sterile water for injection using a syringe with a fresh 20-gauge needle. The sterile water for injection should be directed at the vial wall rather than directly on CIMZIA.
(See Figure 1 .) The resultant solution will contain 200 mg/mL. Gently swirl each vial of CIMZIA for about one minute without shaking, ensuring that all of the powder comes into contact with the Sterile Water for Injection. The swirling should be as gentle as possible in order to avoid creating a foaming effect.
(See Figure 2 .) Continue swirling every 5 minutes as long as non-dissolved particles are observed. Full reconstitution may take as long as 30 minutes. The final reconstituted solution contains 200 mg/mL and should be clear to opalescent, colorless to yellow liquid and essentially free from particulates.
Once reconstituted, CIMZIA can be stored in the vials for up to 24 hours between 2° to 8° C (36° to 46° F) prior to injection. Do not freeze. When ready to inject, reconstituted CIMZIA should be at room temperature.
Do not leave reconstituted CIMZIA at room temperature for more than 2 hours prior to administration. Withdraw the reconstituted solution into a separate syringe for each vial using a new 20-gauge needle for each vial so that each syringe contains the required volume of CIMZIA. (See Figure 3 .) Replace the 20-gauge needle(s) on the syringes with a 23-gauge needle(s) for administration.
(See Figure 4 .) Inject the full contents of the syringe(s) subcutaneously by pinching the skin of the abdomen (See Figure 5 ) or thigh (See Figure 6 ). Where a 400 mg dose is required, two injections are required. Therefore, separate sites should be used for each 200 mg injection.
OR You can also visit the CIMZIA Web site at www.cimziahcp.com 9/2024 U.S. License No. 1736 Manufactured by UCB Inc.
Smyrna GA 30080 UCB Pharma S.A. Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6
📄 Package Label / Principal Display Panel ▾
PRINCIPAL DISPLAY PANEL - Kit Carton NDC 50474-700-62 Rx ONLY OPEN HERE cimzia ® (certolizumab pegol) 200 mg/vial FOR SUBCUTANEOUS USE ONLY Single-dose vial. Discard unused portion. No US standard of potency MUST BE RECONSTITUTED Dispense the enclosed Medication Guide to each patient.
See package insert for reconstitution and dosage information. After reconstitution with 1 mL of Sterile Water for Injection, USP, each mL contains 200 mg of certolizumab pegol. Storage Refrigerate carton at 2° to 8° C (36° to 46° F) in carton to protect from light.
Do Not Freeze. Unopened vials may be stored at room temperature up to a maximum of 25°C (77°F) for 6 months. If stored at room temperature, do not place back in refrigerator and discard after: ___/___/___ Contains 2 vials of certolizumab pegol, each containing 200 mg ucb DO NOT SEPARATE CONTENTS OF CARTON PRIOR TO USE PRINCIPAL DISPLAY PANEL - Kit Carton
PRINCIPAL DISPLAY PANEL - 1 mL Syringe Carton - 50474-710-79 NDC 50474-710-79 Rx ONLY Dispense the enclosed Medication Guide to each patient. Contains 2 single-dose, prefilled syringes each containing 200 mg/mL of CIMZIA and 2 alcohol swabs. cimzia ® (certolizumab pegol) 2 x 200 mg/mL PREFILLED SYRINGES FOR SUBCUTANEOUS INJECTION USE ONLY LIFT HERE TO OPEN Each syringe is intended for a single dose and any remaining product in the syringe should be discarded after a single use. DO NOT FREEZE DO NOT SHAKE PRINCIPAL DISPLAY PANEL - 1 mL Syringe Carton - 50474-710-79
PRINCIPAL DISPLAY PANEL - 1 mL Syringe Carton Box NDC 50474-710-81 Rx ONLY Dispense the enclosed Medication Guide to each patient. cimzia ® (certolizumab pegol) STARTER KIT 3 cartons of 2 x 200 mg/mL PREFILLED SYRINGES FOR SUBCUTANEOUS INJECTION USE ONLY The entire carton is to be dispensed as one unit. Each unit carton contains three individual cartons (doses). Each individual carton (dose) contains: 2 single-dose prefilled syringes (200 mg/1mL) and 2 alcohol swabs.
PRINCIPAL DISPLAY PANEL - 1 mL Syringe Carton Box
PRINCIPAL DISPLAY PANEL - 1 mL Syringe Carton - 50474-750-10 NDC 50474-750-10 Rx ONLY cimzia ® (certolizumab pegol) Injection 200 mg/vial FOR SUBCUTANEOUS USE ONLY Dispense the enclosed Medication Guide to each patient. Contents: One single-dose prefilled syringe. Discard unused portion. One alcohol swab. PRINCIPAL DISPLAY PANEL - 1 mL Syringe Carton - 50474-750-10
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About this NDC listing & data coverage
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This NDC identifies a kit — a package containing more than one component. Structured data (pricing, ingredients, equivalents) is often reported per component rather than for the kit NDC itself, which can make this page look thinner than the components' own pages.
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| NDC identity (package / product / labeler codes) | ✓ Available |
| Labeler | ✓ Available |
| Product & package description | ✓ Available |
| Marketing category & status | ✓ Available |
| Active ingredient / dosage form / route | ✓ Available |
| FDA label (SPL via DailyMed) | ✓ Available |
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| Inactive ingredients (structured) | — Not published for this NDC The labeler did not submit a structured excipient list, or no SPL is available. |
| NADAC pharmacy acquisition price (CMS) | — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey. |
| Orange Book / therapeutic-equivalence data | — Not published for this NDC Applies only to products approved under an NDA/ANDA; many listings are out of scope. |
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| Medicaid utilization (CMS SDUD) | ✓ Available |