8 Tips to Prepare for an RA Drug Injection

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Your treatment for rheumatoid arthritis may require regular injections beneath the skin of strong disease-modifying anti-rheumatic drugs (DMARDs), called biologics. These are medicines engineered from living organisms that moderate your immune system and stop it from attacking you.

Follow these preparation steps for the best results:

1. Get screened. Because biologics suppress your immune system, you may be more susceptible to infection. Before you start your injections, you'll probably be tested for tuberculosis (TB). You may have tuberculosis in your system without knowing it because the bacteria that cause TB can be dormant in your body. Biologics can activate them.

One biologic, rituximab (Rituxan), impairs your B cells, which may make you more likely to get the hepatitis B virus. You should be tested for hepatitis B before you start these injections.

2. Properly time any vaccines you need. If you need any live virus vaccines to prevent conditions like shingles, get them 1 to 3 months before starting your injections of biologics. If you need a flu vaccine, make sure it’s a "dead" (or attenuated) virus. Avoid the nasal flu vaccine, which is a "live" virus.

3. Review all your medications with your doctor. Go over all medicines for rheumatoid arthritis and any other condition—including vitamins, dietary supplements, and herbal remedies. Your doctor may need to change doses of certain drugs and monitor you for side effects. If you're taking antibiotics for an infection, finish them before you start your injections. (If you have a high fever, you'll probably also need to wait until it's gone.)

4. Get educated about your injectible drug. The more you know about this strong RA medication and its possible side effects, the better prepared you'll be. Ask your doctor for educational materials specific to the drug you'll be taking. Read the materials and watch any available videos. Visit the drug manufacturer’s website for more information, and then talk to your doctor and discuss any concerns before you start treatment.

5. Learn how to inject yourself. Have your doctor or nurse educator show you how, and bring someone with you to lend another set of eyes and ears and to learn how to help you if you need it later on. Usually, the medicine should be injected in the front of your thigh or your stomach. You'll have less discomfort if you don’t always inject yourself at exactly the same spot. Store your medication as directed, usually in the refrigerator. Take it out to warm up to room temperature before injecting.

6. Practice after-treatment safety steps. Watch for side effects. Tell your doctor if you develop a rash or have burning or itching at the site of your injection. 

7. Stick to your treatment schedule. This includes follow-up visits with your doctor and any lab tests. Your doctor will need to monitor your response to treatment and stay ahead of any side effects, so be sure to keep all lines of communication open with your doctor's office.

8. Eat a healthy diet. Good nutrition will boost your immune system and help you ward off illness. You want to stay as healthy as you can, especially when receiving drug treatment.

Key Takeaways

  • Before getting injections, get any needed screenings and make sure you have no infections.

  • Learn all you can about your RA drug, including side effects to watch for after treatment.

  • Eat healthy to stay strong, and follow your doctor's advice for staying healthy.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jul 18

  1. What Is Rheumatoid Arthritis? Arthritis Foundation. http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/what-is-rheumatoid-arthritis.php

  2. Best Foods for Arthritis. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/arthritis-diet/best-foods-for-arthritis/

  3. Precautions to Take Before Starting Biologics. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/biologics/precaution... 

  4. Assessing, Managing and Monitoring Biologic Therapies for Inflammatory Arthritis. Royal College of Nursing. https://www.rcn.org.uk/professional-development/publications/pdf-005579 

  5. Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care & Research. 2016;68(1):1-25.

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