Of the available Inflammatory Bowel Disease (IBD) treatments, many of them involve an injection or intravenous infusion. Several of the more common IBD medications are taken as injections. These are usually administered by a physician for the first time, after which the patient can administer them on their own at home. Other IBD treatments are taken as intravenous infusions, which are administered at a clinic over a period of 1-4 hours.
This guide gives you tips for injection treatments. These injected IBD treatments include brand names Humira, Cimzia, and Simponi (in this article, we do not focus on infusion IBD treatments such as Remicade, Inflectra, Tysabri, or Entyvio).
Examples of IBD Injection Treatments
Adalimumab (Humira®) is the most widely used IBD biologic treatment on the market, administered as a subcutaneous injection into the abdomen or thigh. Once instructed by a physician, the patient can administer it at home. The injection process takes about 10 seconds. Typically, when starting adalimumab patients take four injections for their first dose (4 pens, 160mg). After two weeks, they take two injections (2 pens, 80mg). Thereafter, patients perform one
injection (1 pen, 40mg) every two weeks.
Certolizumab pegol (Cimzia®) is another self injected IBD medication. Patients usually receive an injection every two weeks for the first three injections, after which they perform an injection once a month. Certolizumab pegol is injected under the skin by either a healthcare professional or by the patient.
Golimumab (Simponi®) requires a starter dose of two injections, after which it is usually injected once every four weeks. After being instructed by a physician, the patient can administer the injection at home.
Hacks for Injection Treatments for IBD
Poking yourself with a needle can be downright intimidating. Follow these tips for injection treatments—with the right approach and some practice, you can reach the point where you feel at ease throughout the entire process. It’s one more step towards making your life with IBD that much simpler.
1. If you’re just starting, practice on a piece of fruit.
Ask your doctor for an extra syringe for practice, and use it to practice on a piece of firm fruit, such as a plum or tomato. This will help you judge the amount of pressure you’ll need to use for a successful injection.
2. Numb the area with ice.
If you feel the need, numb the area with an ice pack during the 10 minutes prior to injecting.
3. Use a topical numbing cream
There are various creams, many ending with the familiar painkiller suffix “-caine”, which you can apply to numb the injection area. Speak with a nurse about topical anesthetics to see what they suggest, as nurses are trained to help patients manage pain. Allow ample time for the cream to take effect, as some can take up to 30 minutes to achieve a full numbing effect.
4. Allow the medication to come to room temperature
For ease of injection, allow refrigerated medications to come to room temperature before injecting. Many of these chilled IBD medications will include this in their instructions. A tip: to speed up the process, roll the tube quickly between two hands for several minutes.
5. To ignore the pain, redirect your attention
Patients use various mind tricks to help redirect the brain’s attention away from the discomfort of an injection. Try counting the seconds in a loud voice to keep your brain busy as the medication is injected.
6. Use relaxation techniques
Tense muscles can lead to more painful injections. Play calm music before and during an injection, and use deep breathing exercises to command your muscles to relax. Pick a quiet, peaceful environment that offers a respite from your busy life (and the busy lives of your loved ones!). Use visualization techniques that allow you to imagine the muscle loosening into a sleepy, relaxed state.
7. Consider switching to an oral treatment
On your journey with IBD, continue to educate yourself about new IBD treatment options. For example, due to their respectively smaller molecular structure, biosimilars are promising as oral treatments, whereas the bulkier molecular structure of the familiar biologic treatments often requires administration through an injection or infusion. ABT-494 is a promising treatment option by the makers of Humira that hopes to give patients an oral alternative. Check your candidacy for ABT-494 here.
(2018) Crohn’s & Colitis Foundation. Biologic Therapies. Retrieved from http://www.crohnscolitisfoundation.org/resources/biologic-therapies.html
Lichtenstein, G. R. (2017). Introduction to Biosimilar Use in Patients With Inflammatory Bowel Disease. Gastroenterology & Hepatology, 13(10), 612–614. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718178/