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Last reviewed: November 2020
Currently under review
If you’ve been prescribed golimumab, or are considering it as an option, you’re not alone. Golimumab is a treatment for people with Colitis.
Our information can help you decide if this treatment is right for you. It looks at:
This is about golimumab in general and should not replace advice from your health professional. For more information, talk to your IBD team or read the leaflet that comes with your medicine. You can also check the website: medicines.org.uk
We need your help to improve our information to better support people with Crohn’s and Colitis. Fill in our short survey to let us know what we're doing well and how we can better meet your needs.
Golimumab is known by the brand name Simponi.
Golimumab is a man-made antibody. The antibody is made from living cells, so it’s known as a biological medicine.
Golimumab targets a protein in the body called tumour necrosis factor-alpha (TNF-alpha). TNF-alpha is naturally produced by your body. It plays an important role helping your immune system fight off infections. But too much TNF-alpha can cause damage to the cells lining the gut. This is thought to partly cause the gut inflammation of people with Crohn’s or Colitis. Golimumab binds to TNF-alpha, blocking its harmful effects and reducing inflammation. This helps to relieve symptoms.
You may also hear golimumab called an ‘anti-TNF’ medicine. Other anti-TNF medicines are:
Golimumab can be used to treat moderately to severely active Ulcerative Colitis in adults. It may be given to you if other treatments (such as steroids or immunosuppressants, like azathioprine, mercaptopurine or methotrexate):
You are being offered golimumab to try to get your Colitis into remission. Keeping your Colitis under control is good for your long-term health. It reduces your risk of complications and of needing surgery.
Golimumab is not currently licenced for Crohn’s Disease. Recent research has shown it may be beneficial in some people with Crohn’s who have not responded to other anti-TNF medicines.
Golimumab is also to treat rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis.
Golimumab has changed my life. I began to see an improvement within a week and was able to go back to work full time and live a pretty normal life – sometimes even forgetting I had Colitis.
Kerry
Living with Ulcerative Colitis
You may have been given a choice of biologic medicine. Our information on medicines for Crohn’s and Colitis can help you decide.
There are many things to consider when choosing a treatment. As well as overall effectiveness, you may want to ask your IBD team which medicine is likely to start working fastest. You may also want to think about whether injections or infusions fit better with your lifestyle. Our Guide to Appointments has some questions to get you started. It can help you focus on what matters most to you.
Golimumab can be effective at getting and keeping your Colitis under control (in remission).
To see how effective a medicine is, we can look at data from clinical trials. Clinical trials are used to test a medicine. However, this data may not completely represent what happens when medicines are given to you by your IBD team. In clinical trials, people are often removed from the trial if they do not respond quickly to a medicine. However, this shouldn’t happen when you start taking golimumab. Your IBD team may advise you take it for a longer time to see if you respond. They’ll also make sure the dose is right for you before suggesting you stop taking it. before suggesting you stop taking it. This means golimumab may be more effective than the data from clinical trials shows.
The best clinical trials include people who were not taking the medicine. This is known as a placebo or control group. This is important. It allows us to see how many people have got better because of the medicine, as well as people who may have got better anyway (without the medicine).
The table below shows data from clinical trials of golimumab in adults with moderate to severely active Ulcerative Colitis.
More than twice as many people had their Colitis under control (in remission) after taking golimumab for one year compared to people who had not been taking golimumab (placebo). But, not everyone responds to golimumab.
Everyone responds differently when taking a new medicine. You may feel better soon after starting treatment, but it may take up to 14 weeks.
However, golimumab doesn’t work for everyone. It’s important that you are checked by your IBD team to see how well it is working for you.
Golimumab is given as an injection under the skin. Golimumab cannot be taken by mouth as a tablet because it would be destroyed by your digestive system.
Your treatment will be supervised by your IBD team. The first dose is usually given in hospital, or by a trained nurse at home. You will then be trained to inject this medicine yourself. If you prefer, it may be possible for someone else, such as a family member, to be trained to give you the injections.
Golimumab comes ready to use in either a pre-filled syringe or a pre-filled injection ‘pen’. You may not see the needle in the injection pen, as it’s inside. The syringes or pens come in a pack. The pack also contains an alcohol pad to clean your skin before injecting.
Usually, golimumab will be sent directly to your home by a special delivery company. Golimumab can only be prescribed by a specialist in the hospital. It is not a medicine that your GP can prescribe for you to pick up from your local pharmacy. You won’t have to pay for your golimumab prescription, as long as you’re entitled to NHS care.
Golimumab must be kept in the fridge, or it will not work. But, if you are travelling, it can be stored at room temperature (25°C) out of sunlight for up to 30 days. If it’s not used within this time you will need to get rid of it. Do not put it back in the fridge. Unused medicines should be disposed of safely by your pharmacist. Find out more about travelling with medicines in Travel.
Using the pre-loaded pen was very simple, more practical than having infusions. I never felt the needle, just a minor pain when the drug was injected. It helps to sit comfortably so you’re more relaxed when injecting.
Michelle
Living with Ulcerative Colitis
Pain at the injection site is a common side effect. You may also get redness, itching and swelling. You should expect to feel some pain, but these tips can help to make it easier to manage:
If you still have problems with injecting, ask your IBD team for help.
You’ll have a first dose of 200mg, followed by 100mg two weeks later. These induction doses are higher to give a fast response. You’ll then have maintenance dosing every four weeks if you respond well. If you weigh less than 80kg you will usually inject 50mg every four weeks. If you weigh 80kg or more, you will inject 100mg every four weeks.
If golimumab doesn’t work for you, or it becomes less effective, your doctor may suggest that you try a higher dose (for those weighing less than 80kg). This will be based on your symptoms, blood test results and the levels of medicine in your blood. Speak to your IBD team if you think this treatment is not working as well as it should be. You must not make any dose changes unless your IBD team have told you to.
You may need more than one injection pre-filled pen or syringe for your induction doses.
I only weigh 55kg, but I’m having the 100mg dose because of the severity and complexity of my case.
Injecting soon becomes second nature. Just make sure you take note of the date that you inject and when your next one is due, it can be very easy to forget, especially as it’s in 4 week intervals
Izzy
Living with Crohn's Colitis
You are likely to have a planned course of treatment lasting up to a year if golimumab is working well for you. After that, your treatment plan may be extended. You will be checked at least every 12 months to make sure golimumab is still right for you.
There are a few reasons why you and your IBD team may think it’s right to stop or change your treatment:
Golimumab is not effective – if this medicine hasn’t worked for you within 3-4 months. This will depend on the practice at your hospital. Your IBD team may try changing your dose before suggesting you stop treatment.
You have a right to take part in decisions about your treatment. Tell your IBD team what matters most to you, so they can give you the information and support you need. Our Guide to Appointments can help you have these conversations. Do not stop taking your medicine unless your IBD team have said it’s ok. If you have to stop taking this medicine but you’re still unwell, you may be able to try a different biologic. See our information on biologic medicines.
You may take golimumab with other medicines for your Colitis, such , such as 5-ASAs (like mesalazine), thiopurines (azathioprine or mercaptopurine) or methotrexate. Taking more than one medicine is known as combination therapy – for more on this, see our information on taking medicines.
Taking a combination of anti-TNF medicines with azathioprine or methotrexate may be more effective. This can reduces the risk of golimumab becoming less effective over time. You should speak to your IBD team about the risk of extra side effects with combination therapy. You should decide together what the best treatment option is for you
Checks before treatment – such as blood tests and imaging – are important to make sure that golimumab is right for you.
To help your IBD team, tell them if you have a history of:
And tell your IBD team if:
You’ll need regular checks while taking golimumab, including blood tests. This helps your IBD team fit your treatment to your needs. It can help make sure that any problems with treatment are avoided or caught at an early stage. Tell your IBD team if you notice any new symptoms or side effects.
It’s important that you attend your appointments and have blood checks to make sure this medicine is prescribed safely.
If you feel dizzy or tired after taking this medicine do not drive or use any tools or machines.
This medicine affects the way your immune system works. Your immune system is still able to fight off infections, just not quite as well as other people. You may find that infections affect you more than they used to, or it takes you longer to recover. Tell your IBD team if you develop signs of an infection, such as a sore throat, fever or any new symptoms that concern you. They may advise you to wait until you feel better before injecting. Less often, more serious infections can be a side effect of golimumab. See the section below on Side effects.
Even though your risk of complications may be higher when taking golimumab, it shouldn’t stop you from living life as before. There are a few extra precautions your IBD team may advise you to take to keep safe and reduce your risk:
All medicines can have unwanted effects, although not everyone will get them. Some side effects can happen right away, others may happen later. Some can even last for a short time after you stop treatment.
Some side effects may be mild and go away on their own or when the medicine is stopped. Others may be more serious and will need managing, or may mean that the treatment is not right for you. Try to consider how unwell any side effects are making you feel, as well as the benefits of taking this medicine to keep your Colitis under control.
Speak to your IBD team if you experience any side effects.
Around 1 in every 10 people taking golimumab may have upper respiratory tract infections (like colds, with symptoms including a sore throat and a runny or blocked nose).
Common: Somewhere between 1 in every 10 people to 1 in every 100 people taking golimumab may develop this side effect.
Uncommon: Somewhere between 1 in every 100 people to 1 in every 1000 people taking golimumab may develop this side effect.
Rare: Somewhere between 1 in every 1000 people to 1 in every 10,000 people taking golimumab may develop this side effect.
This is not a full list of side effects. For more information see the Patient Information Leaflet provided with your medicine or visit medicines.org.uk/emc/.
We encourage you to report any side effects to the Medicines and Healthcare Products Regulatory Agency (MHRA) through the Yellow Card scheme. Your doctor should also report it. Report your side effect at yellowcard.mhra.gov.uk.
The only side effect I got was a headache the next day, which eased with paracetamol.
Michelle
Living with Ulcerative Colitis
Golimumab is often taken alongside other medicines safely. See the earlier section Taking golimumab with other Colitis treatments.
However, golimumab may interact with other medicines. Speak to your doctor or pharmacist if you’re taking, or plan to take any other medicines. This includes over-the-counter medicines (medicines that you buy yourself) and any herbal, complementary, or alternative medicines or therapies.
Do not take medicines that contain anakinra or abatacept. These medicines are commonly used for Rheumatoid Arthritis.
Tell any doctor, dentist or health professional treating you that you are taking golimumab. Always carry the alert card that comes with the medicine while you are taking it and for up to six months after your last dose.
It’s not safe to have ‘live’ vaccines while taking golimumab. It can take up to five months after your last dose for golimumab to completely leave your body. However, it’s safe to have live vaccines 3 months after your last dose. Ask your IBD team to make sure your vaccinations are up to date before you start adalimumab, or if you’re planning to travel. If you’ve recently had a live vaccine you may have to wait 4 weeks before starting golimumab.
In the UK, live vaccines include:
Everyone with Crohn’s or Colitis taking a biologic medicine should have the yearly flu vaccine. This is not a live vaccine and is safe to have while taking golimumab.
If someone you live with is due to have a live vaccine, ask your IBD team if you need to take any precautions.
Golimumab does not affect fertility. If you don’t want to get pregnant you should use contraception.
Talk to your IBD team if you're taking golimumab and planning a pregnancy or are already pregnant. If you decide to continue taking golimumab, it should not stop you from having a normal pregnancy and a healthy baby. Research shows that anti-TNF medicines, like golimumab, do not have affect your pregnancy, or harm your baby. Long-term health, infection rates and development do not appear to be affected in children of mothers taking anti-TNFs during pregnancy. This includes mothers who took anti-TNFs until birth).
Golimumab does not appear to affect foetuses, but there hasn’t been enough research to rule out the possibility completely. To be cautious, drug companies state that should only be used during pregnancy if needed to keep your condition under control. This is because the medicine could cross the placenta. They recommend using contraception to prevent pregnancy while taking golimumab and for at least six months after your last dose. However, as golimumab is generally considered safe. Your IBD team may advise the safest option is to keep taking it during pregnancy to keep your Colitis under control.
When deciding whether to continue taking golimumab, you should also consider the risks of having a flare-up while you’re pregnant. Having active Crohn’s or Colitis can lead to premature (early) birth, low birth weight and rates of miscarriage. It’s important to keep your condition under control in pregnancy. If your Colitis is not well controlled (in remission), then your IBD team may recommend you take golimumab for the first six months (first and second trimesters), but stop during the third trimester. This aims to reduce the exposure of your baby. If your condition is not well controlled, your IBD team may recommend you take golimumab throughout your entire pregnancy to keep you well.
Taking golimumab during pregnancy is likely to affect when your baby can have any live vaccines. This includes the BCG for tuberculosis and the rotavirus vaccine. It should not affect the rest of your baby’s vaccination schedule.
National guidance advises that if you take golimumab during your pregnancy your baby should not have live vaccines until they are at least six months old. However, golimumab drug companies advise that your baby should not have any live vaccines for six months after your last adalimumab dose during pregnancy.
You must tell your baby’s healthcare team you were taking golimumab while pregnant. Decisions on what vaccines your baby should have and when they should have them needs to be made on an individual basis. Your IBD team and midwife should be able to help you come to a decision.
Take extra care if your baby does have the rotavirus vaccine, as live virus can be shed in the baby’s poo for up to 14 days. Make sure you wash your hands and/or wear gloves when changing their nappy.
There is some evidence that your baby may be more prone to infections if you take azathioprine or mercaptopurine along with anti-TNFs, like golimumab, during pregnancy.
Discuss the risks and benefits of taking golimumab while pregnant with your doctor and IBD team. You can find out more in our information on pregnancy and reproductive health.
There is less research on men wanting to father a child while taking anti-TNF medicines. But, it’s generally considered safe for a man to conceive a child.
You can take golimumab while breastfeeding. Small amounts of golimumab have been found in breast milk in animal studies, but golimumab hasn’t been found in human breast milk.
The drug company advises that you stop taking golimumab at least six months before you start breastfeeding. However, there is very little risk to your baby. Your IBD team may suggest you keep taking golimumab while breastfeeding if it’s keeping your Crohn’s or Colitis under control. Golimumab is destroyed by the digestive system when taken orally, so it wouldn’t be absorbed by your baby. Speak to your IBD team if you’re worried.
Alcohol is not known to have any interaction with golimumab.
Taking medicines and managing side effects can be difficult – we understand and we’re here to help. Our Helpline can answer general questions about treatment options and can help you find support from others with the conditions.
Your IBD team are also there to help. You can talk to them about your dosage, how they’ll be monitoring you and what alternatives may be available. You should also get in touch with your IBD team if you have any new symptoms or side effects.
It can take time to find the medicine that’s right for you. Don’t be afraid to ask questions and seek out extra support when you need it.
This information is general and doesn’t replace specific advice from your health professional. Talk to your doctor or IBD team for more information. You can also check the Patient Information Leaflet that comes with your medicine or visit medicines.org.uk/emc/.
Health professionals can order some publications in bulk by using our online ordering system. If you would like a printed copy of any of our information, please contact our helpline.
Our helpline is a confidential service providing information and support to anyone affected by Crohn's or Colitis. Our team can:
Email helpline@crohnsandcolitis.org.uk
This closed-group community on Facebook is for everyone affected by Crohn's or Colitis. You can share your experiences and receive support from others.
Our Local Networks of volunteers across the UK organise events and provide opportunities to get to know other people in an informal setting, as well as to get involved with educational, awareness-raising and fundraising activities. You may find just being with other people and realising that you are not alone can be reassuring. Families and relatives may also find it useful to meet other people with Crohn's or Colitis. All events are open to members of Crohn’s & Colitis UK.
We follow strict processes to make sure our information is based on up-to-date evidence and easy to understand.
Please email us at evidence@crohnsandcolitis.org.uk if:
You can also write to us at Crohn’s & Colitis UK, 1 Bishop Square, Hatfield, AL10 9NE, or contact us through our Helpline: 0300 222 5700
We know it can be difficult to live with, or support someone living with these conditions. But you’re not alone. We provide up-to-date, evidence-based information and can support you to live well with Crohn’s or Colitis.
Our helpline team can help by:
Providing information about Crohn’s and Colitis.
Listening and talking through your situation.
Helping you to find support from others in the Crohn’s and Colitis community.
Signposting you to specialist organisations.
Please be aware we’re not medically or legally trained. We cannot provide detailed financial or benefits advice or specialist emotional support.
Please contact us via telephone, email or LiveChat - 9am to 5pm, Monday to Friday (except English bank holidays).
If you need specific medical advice about your condition, your GP or IBD team will be best placed to help.
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