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When using the Cyltezo prefilled syringe, it's important to be aware of certain risks associated with its use:

Serious Infections: Cyltezo can increase the risk of serious infections, including tuberculosis (TB), bacterial sepsis, and invasive fungal infections. Patients should be tested for latent TB before starting treatment and monitored for signs of infection during and after therapy. If a serious infection develops, Cyltezo should be discontinued.

Malignancies: There have been reports of lymphoma and other malignancies, some fatal, in patients treated with TNF blockers like Cyltezo. A rare type of T-cell lymphoma, hepatosplenic T-cell lymphoma (HSTCL), has occurred in adolescent and young adult patients with inflammatory bowel disease treated with TNF blockers.

Hypersensitivity Reactions: Serious allergic reactions, including anaphylaxis and angioneurotic edema, have been reported. If a severe allergic reaction occurs, Cyltezo should be discontinued, and appropriate therapy initiated.

Hepatitis B Virus Reactivation: In patients who are chronic carriers of hepatitis B virus (HBV), Cyltezo may increase the risk of HBV reactivation, which can be fatal. Patients should be evaluated for HBV infection before starting treatment and monitored during and after therapy. If HBV reactivation occurs, Cyltezo should be stopped, and antiviral therapy should be initiated.

Neurologic Reactions: Rare cases of new onset or worsening of central and peripheral nervous system demyelinating diseases, such as multiple sclerosis and Guillain-Barré syndrome, have been associated with TNF blockers. Caution is advised when considering Cyltezo for patients with these disorders; discontinuation should be considered if they develop.

Hematological Reactions: Rare reports of pancytopenia, including aplastic anemia, have been observed with TNF blockers. Medically significant cytopenias have been infrequently reported with adalimumab products. If significant hematologic abnormalities occur, discontinuation of Cyltezo should be considered.

Congestive Heart Failure: Cases of worsening or new onset congestive heart failure (CHF) have been reported with TNF blockers. Caution is advised when using Cyltezo in patients with heart failure; they should be monitored carefully.

Autoimmunity: Treatment with adalimumab products may result in the formation of autoantibodies and, rarely, in the development of a lupus-like syndrome. If symptoms of a lupus-like syndrome develop, Cyltezo should be discontinued.

Immunizations: Patients on Cyltezo should not receive live vaccines. Pediatric patients should be brought up to date with all immunizations before starting Cyltezo therapy. The safety of administering live or live-attenuated vaccines in infants exposed to adalimumab products in utero is unknown; risks and benefits should be considered before vaccinating these infants.

Latex Sensitivity: The needle cap of the Cyltezo prefilled syringe contains natural rubber latex, which may cause allergic reactions in individuals sensitive to latex.

Patients should discuss these risks with their healthcare provider to determine if Cyltezo is appropriate for their condition.

When using Cyltezo, it's important to be aware of potential interactions with other medications:

• Immunosuppressants: Combining Cyltezo with drugs like Cyclosporine or Mycophenolic Acid can significantly increase the risk of serious infections. Patients should be closely monitored for signs of infection, such as fever, chills, or sore throat.

• Biologic Therapies: Using Cyltezo alongside other biologic treatments, such as anakinra or abatacept, is generally not recommended due to an elevated risk of serious infections without additional therapeutic benefit.

• Live Vaccines: Patients on Cyltezo should avoid live vaccines, as the medication can interfere with the body's ability to mount an appropriate immune response to these vaccines.

• Medications Metabolized by Cytochrome P450 Enzymes: Cyltezo may affect the metabolism of drugs processed by the cytochrome P450 system, such as Warfarin, cyclosporine, or Theophylline. Monitoring drug levels and adjusting dosages may be necessary when starting or stopping Cyltezo.

Always inform your healthcare provider about all medications and supplements you are taking to ensure safe and effective use of Cyltezo.