Anti-Tumour Necrosis Factor (Anti-TNF)

Drug Class:	Commonly Known As:	Category:
Tumor Necrosis Factor Inhibitor		Adult

Anti-Tumour Necrosis Factor (Anti-TNF) - Side Effects, Precautions, and Contraindications

What side effects can Anti-Tumour Necrosis Factor (Anti-TNF) cause?

Infection: symptoms include colds, sinusitis, urinary tract infections and skin infections

If you develop a fever, sore throat or feel generally unwell, see a doctor immediately. The doctor whom you consult should be told that you are on anti-TNFα.

Injection site reactions: symptoms include bruising, redness, itching, pain and swelling

If you are using subcutaneous injection, rotate the injection site each time.

Infusion reactions: symptoms include flushing, chills, chest tightness, shortness of breath, hypotension or hypertension

Medications may be given before the infusion to prevent these reactions.

Low blood cell count (platelet, red and/or white blood cell)
Headache
Rash

It is important to monitor the effects of your new treatment, particularly during the first few months of treatment. For your safety, you need to do regular blood tests for monitoring.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

Swollen face/eyes/lips/tongue
Difficulty in breathing
Itchy skin rashes over your whole body

Some rare but serious side effects include:

Severe infections such as pneumonia, fungal infection, activation of tuberculosis and hepatitis B
Combined low blood cell count (symptoms include infection, feeling very tired or weak, bleeding)
Lung inflammation
Severe muscle weakness
Seizures

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Long term use of anti-TNFα may increase the risk of lymphoma and other cancers. You may be more at risk if you are also taking certain immunosuppressant. Your doctor will monitor you on any signs of cancer.

Before taking Anti-Tumour Necrosis Factor (Anti-TNF) , what precautions must I follow?

Inform your healthcare professional if:

You are allergic to this medication or any of the other ingredients of this medication.
You plan to start a family or to breastfeed. Certain biologics are safer than other in pregnancy.
You are taking any other medications, including over-the-counter medicines, supplements, traditional medications and herbal remedies.

Avoid overcrowded places and stay away from people who are sick to prevent getting an infection.
Reactivation of infection such as tuberculosis (TB) and hepatitis B may happen when you are on medication, hence, your doctor will check for such infection before starting anti-TNFα.
If you have heart problems, as anti-TNFα may make your symptoms worse, therefore your doctor may monitor your heart closely before and after the treatment.

What food or medicine must I avoid when I take Anti-Tumour Necrosis Factor (Anti-TNF) ?

Avoid eating raw, undercooked or half-cooked food.
Pneumococcal and influenza (flu) vaccinations are safe and may be given if required. Avoid live vaccines such as MMR (measles, mumps and rubella), OPV (oral polio vaccine), yellow fever or BCG (tuberculosis). Discuss with your doctor before receiving any vaccines. Also, direct contact with persons who have taken oral polio vaccine or those with infections should be avoided.