Implementation

• Administer a tuberculin skin test prior to administration of adalimumab. Patients with active latent TB should be treated for TB prior to therapy

» Administer initial injection under supervision of a health care professional

» Do not administer solutions that are discolored or contain particulate matter. Discard unused solution

» Other DMARDs should be continued during adalimumab therapy

• SC: Administer at a 45° angle in upper thighs or abdomen, avoiding the 2 inches around the navel. Put pressure on injection site for 10 sec, do not rub. Rotate injection sites; avoid areas that are tender, bruised, hard, or red

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