Certolizumab (Cimzia): Uses, Dose, Side effects, MOA


Certolizumab is a medication that falls under a class of drugs known as anti-TNFs, which help to prevent the harm caused by illnesses in the body.

It is used to treat rheumatoid arthritis, psoriatic arthritis, Crohn’s disease, and ankylosing spondylitis, and can help relieve symptoms like joint pain, fatigue, and morning stiffness. The brand name of this medication is Cimzia.

Uses of Certolizumab (Cimzia):

Cimzia is a medication prescribed to adults for treating the following health conditions:

Health Condition


Active rheumatoid arthritisInflammation in joints with methotrexate or without it, when methotrexate treatment is ineffective
Axial spondyloarthritisInflammation and pain in the spine’s joints, including ankylosing spondylitis, when X-ray doesn’t show the disease but signs of inflammation are visible
Psoriatic arthritisJoint inflammation and red, scaly patches on the skin, with or without methotrexate, when methotrexate treatment is ineffective
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How to use Certolizumab (Cimzia):

To use Certolizumab, follow your doctor’s instructions and the dosage schedule. This medication is injected under the skin in the stomach or thigh area.

Do not inject it into areas that are sore, injured, red, crusty, or hard. If your condition does not improve or gets worse, inform your doctor.

Adverse effects of Certolizumab (Cimzia):

Like any medication, Certolizumab may have negative effects. However, your doctor has prescribed this medication because they believe the benefits will outweigh the risks.

Many individuals who use this medication do not experience any significant negative effects [ref].

Serious infections:

Your risk of infection may increase when taking Certolizumab, as it may weaken your immune system.

The most common side effects of Cimzia (occurring in up to 1 in 10 individuals) are bacterial infections, including abscesses (a swollen area where pus has accumulated), and viral infections (such as herpes, papillomavirus, and influenza). However, severe infections were less common.

Injection site reaction:

Reactions at the injection site are possible with Certolizumab. Like with most injectable medications, the likelihood of this side effect may increase if you use a higher dose.

An injection site reaction may cause symptoms such as discomfort, bruising, swelling, and skin discoloration.

Low blood cell count:

Low blood cell counts are possible with Certolizumab, although they are rare. This increases your risk of getting severe infections, bleeding, and anemia.

You will most likely need to stop taking Certolizumab if your blood count becomes too low.

If you experience any infection-related symptoms, such as fever, fatigue, chills, coughing, or breathing difficulties, or bleeding symptoms, such as pale skin, a fast heartbeat, dizziness, or blood in your stool or urine, contact your doctor right away.

Allergic reaction:

Possible allergic reactions exist with Certolizumab use. If you experience any symptoms of an allergic reaction, including hives, rashes, or swelling of the face, lips, tongue, eyelids, or throat, call your doctor or seek emergency medical attention right away.

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Here is a table summarizing the side effects of Certolizumab (Cimzia) system-wise:


Side effects

ImmuneSerious infections, including bacterial and viral infections (such as herpes and influenza)
InjectionInjection site reactions, including discomfort, bruising, edema, and skin discoloration
BloodLow blood cell counts, increase the risk of major infections, bleeding, and anemia
AllergicPossible allergic reactions, including hives, rashes, and swelling of the face and throat
RespiratoryUpper respiratory tract infections
DigestiveAbdominal pain, diarrhea, nausea, and vomiting
MusculoskeletalBack pain, muscle pain, spasms, and joint pain
SkinRash, itching, and eczema
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Dosage information of Certolizumab [ref]



Active rheumatoid arthritis (RA)400 mg subcutaneously (under the skin) at weeks 0, 2, and 4, followed by 200 mg every other week or 400 mg every four weeks
Psoriatic arthritis400 mg subcutaneously at weeks 0, 2, and 4, followed by 200 mg every other week or 400 mg every four weeks
Axial spondyloarthritis400 mg subcutaneously at weeks 0, 2, and 4, followed by 200 mg every other week or 400 mg every four weeks
Crohn’s disease400 mg subcutaneously at weeks 0, 2, and 4, followed by 200 mg every two weeks
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Mechanism of action of Certolizumab (Cimzia):

Cimzia is a drug that can help reduce inflammation in the body. It does this by sticking to a protein called TNFα, which is involved in causing inflammation.

Cimzia is particularly good at neutralizing TNFα, which means it can stop it from causing inflammation. However, it doesn’t affect another protein called TNFβ.

Studies have shown that Cimzia can reduce the amount of TNFα produced by cells in the body, and can also reduce the production of other inflammatory substances like IL1β.

Cimzia doesn’t cause any harmful effects on other cells in the body, such as white blood cells [ref].

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Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

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