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Last reviewed: December 2023
Next review date: December 2026
This information is for people with Colitis who are on golimumab treatment or who are thinking about starting it. This information can help you to decide if this treatment is right for you. It looks at:
This information is about golimumab in general. It should not replace advice from your IBD team. For more information, read the leaflet that comes with your medicine. You can also check the website: medicines.org.uk
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Golimumab is known by the brand name Simponi.
Golimumab belongs to a group of medicines called biologic medicines. These medicines are made by a biological rather than a chemical process. They are produced in a lab by living cells.
Golimumab targets a protein in the body called tumour necrosis factor-alpha (TNF-alpha). TNF-alpha is naturally made by your body. It plays a key role in fighting off infections. Too much TNF-alpha can damage the cells that line the gut. This may partly be the cause of gut inflammation for people with Crohn’s or Colitis. Golimumab binds to TNF-alpha, blocking its harmful effects and reducing inflammation. This can help to relieve symptoms.
Golimumab is sometimes called an ‘anti-TNF’ medicine. Other anti-TNF medicines are:
Golimumab is used to treat people over 18 years old who have moderate to severe Colitis. The aim of using this medicine is to get your Colitis under control and keep it under control. See our information below on remission. Keeping your Colitis under control is good for your long-term health. It lowers your risk of complications and need for surgery.
It may be given to you if other treatments, such as steroids or immunosuppressants, like azathioprine, mercaptopurine or methotrexate:
Golimumab is not yet licenced for Crohn’s Disease. Research has found that it may help some people with Crohn’s who have not responded to other anti-TNF medicines.
Remission is when you feel better because your Crohn's or Colitis is being controlled well. Medical tests, like blood tests and endoscopy, may show your gut is affected less by your condition. Your symptoms, such as diarrhoea, abdominal pain, fatigue or weight loss will improve. However, some symptoms, like fatigue, may not go away completely.
Golimumab is also used to treat some types of arthritis.
There are lots of things to think about when you start a new treatment. Your IBD team will discuss your options with you. When thinking about a new treatment you might want to consider the potential benefits, possible risks and the goals of your treatment. Some things to think about include:
Our Appointment guide has a list of questions you might want to ask. It can help you focus on what matters most to you. You might find our information about other medicines and surgery for Colitis helpful.
Use this tool to understand more about potential treatment options that suit your needs. The tool is designed to help you:
Golimumab can help to get your Colitis under control and keep it under control.
Find out more about how we talk about the effectiveness of medicines.
The table below shows data from clinical trials of golimumab in adults with moderate to severe Colitis.
More than twice as many people had their Colitis under control after taking golimumab for one year, compared to people who had not been taking it. But not everyone responds to golimumab.
Everyone responds differently when taking a new medicine. Some people start feeling better within 14 weeks of starting treatment with golimumab. For others, it may take longer. Golimumab might not work at all for some people.
Your IBD team may check to see how well your medicine is working for you.
Golimumab is given as an injection under the skin. It can not be taken by mouth because your stomach would break it down.
Your treatment will be supervised by your IBD team. Your first dose will usually be given in hospital, or by a trained nurse at home. You will then be trained to inject this medicine yourself. It may be possible for someone else, such as a family member, to be trained to give you your 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 is inside. The syringes and pens come in a pack. Each pack contains an alcohol pad to clean your skin before you inject.
A special delivery company sends your golimumab to your home. 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 prescription if you’re entitled to NHS care.
Keep golimumab injections in the fridge, between 2°C and 8°C. They should be kept in their original carton to protect them from light.
You can keep golimumab injections out of the fridge for up to 30 days. This might be useful if you’re travelling. You must keep them in the original carton at room temperature (up to 25°C). They must be kept out of direct sunlight. Do not put it back in the fridge. Do not use the injections if they are left out of the fridge for more than 30 days. Ask your pharmacist to get rid of any unused medicines. Find out more about travelling with medicines in our information on Travelling with Crohn's or Colitis.
Pain at the injection site is a common side effect. You may also get redness, itching and swelling. You should expect a little pain, but the tips below might help 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. This will be followed by 100mg two weeks later. These higher first doses give a fast response. If you respond well, you’ll have a maintenance dose every four weeks. 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 you weigh less than 80kg and golimumab doesn’t work for you, or if it becomes less effective, your doctor may ask you to try a higher dose. 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. You must not make any dose changes unless your IBD team have told you to.
Dosing schedule
You may need more than one injection pre-filled pen or syringe for your induction doses.
If golimumab works well for you, you’ll continue taking it for up to a year. After that, your IBD team will look at whether it still helps. If it does, you will most likely continue treatment. If you continue using it, your IBD team should assess you at least every 12 months. This is to make sure golimumab is still right for you.
There are a few reasons why you and your IBD team may want to stop or change your treatment:
Do not stop taking your medicine without discussing it with your IBD team. If golimumab is no longer the best treatment for you, your IBD team should discuss other treatment options with you.
You may take golimumab with other medicines for your Colitis, 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 golimumab with azathioprine or methotrexate may be more effective. This can reduce 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 is for you.
Before you start golimumab, your IBD team may ask you some questions and do some tests. This is to make sure that golimumab is right for you. Tell your IBD team if:
And tell your IBD team if:
You’ve ever had chicken pox or measles. If you’ve not, you may be able to be vaccinated against these before you start treatment
After you start golimumab, you should have regular checks. These are to see how well it’s working and to check for any side effects. It’s important that you tell your IBD team about any new symptoms or side effects as soon as they occur.
After 12 months of treatment, your IBD team should give you a check-up to see whether you should continue having golimumab. Based on your symptoms they might recommend that you continue treatment. If your condition is in complete remission, they may discuss stopping golimumab. See our section on Stopping or changing treatment for more information.
Do not drive or use any tools or machines if you become dizzy or tired after taking this medicine.
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 recommend that you take. These can help to keep you safe and reduce your risk:
When you start taking golimumab your healthcare professional should give you a Patient Alert Card. This card has important information that you and any healthcare professionals who treat you should be aware of. Always keep the Alert Card with you while you are taking golimumab. Make sure you show the card to anyone involved in your care or treatment. This includes pharmacists, dentists or A&E doctors. If you do not have a Patient Alert Card, ask your IBD team for one.
All medicines can have side effects, but not everyone gets them. Some side effects can happen right away, others may happen after you have been taking golimumab for a while. Some side effects are mild and may go away on their own, or after you stop taking golimumab. Others may be more serious, could need treatment or may be long-lasting. Some side effects might mean that golimumab is not right for you. You may be more likely to have certain side effects if you receive the 100 mg dose compared with the 50 mg dose.
Speak to your IBD team if you experience any side effects.
Some people might get serious side effects that need urgent treatment. These do not happen often, but it is important to know what to look out for.
Up to 1 in every 10 people taking golimumab might have an allergic reaction. But serious allergic reactions are very rare.
Signs to look out for include:
After the allergic reaction has been treated, contact your IBD team to let them know what has happened.
If you take golimumab, you may get infections more easily. This is because golimumab can affect your immune system. You might get more infections than you are used to. Or if you get an infection, it might last longer or be more serious than usual. Sometimes, previous infections can reappear, such as Tuberculosis or Hepatitis B virus.
Symptoms of an infection. The list below are symptoms to watch out for in yourself or others. Look out for:
Around 1 in every 10 people taking golimumab may have upper respiratory tract infections (like colds, with symptoms including a sore throat, hoarseness, and a runny or blocked nose).
In this section, we talk about side effects as being ‘common’, ‘uncommon’ and ‘rare’. To find out what these terms mean, you can look in the table below.
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. You can report your side effects at yellowcard.mhra.gov.uk
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 or medicines that you buy yourself and any herbal, complementary, or alternative medicines or therapies.
Do not take medicines that have 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 this medicine. You should carry this all the time while you’re taking golimumab and for up to six months after your last dose.
It’s not safe to have ‘live’ vaccines while taking golimumab. This is because live vaccinations can, in some situations, cause severe infections in immumocompromised individuals.
The current recommendation is not to have live vaccines while taking golimumab.
Ask your IBD team to make sure your vaccinations are up to date before you start golimumab, or if you’re planning to travel.
In the UK, live vaccines include:
Everyone with Crohn’s or Colitis taking a biological medicine should have the yearly flu vaccine and COVID-19 vaccine. These are not live vaccines and are safe to have while taking golimumab.
There is a small risk that people who have recently had a live vaccine could pass on the weakened form of the virus to close contacts who are immunosuppressed. This could then cause an infection. For most of the live vaccines used in the UK the virus is not passed on to contacts. You can reduce the risk by following simple precautions such as:
If someone you live with is due to have a live vaccine, ask your IBD team if you need to take any precautions.
The annual flu vaccine and pneumococcal and COVID-19 vaccines are not live vaccines. They are safe to have while you are taking golimumab
Golimumab has not been found to affect fertility. Speak to your IBD team if you are thinking of trying for a baby.
Manufacturers advise that people who could get pregnant should use effective contraception while taking golimumab. This is to prevent pregnancy. They recommend carrying on using contraception for at least 6 months after your last injection of golimumab.
There is a moderate amount of research that looks at the use of golimumab during pregnancy. From the information available, golimumab does not seem to cause problems during pregnancy or to babies exposed during pregnancy.
Experts agree that taking golimumab while you are pregnant is probably a low risk. But, there hasn’t been enough research to rule out the possibility completely. To be cautious, drug companies say that golimumab should only be used during pregnancy if needed to keep your condition under control.
During pregnancy, it’s important to keep your condition under control. Stopping golimumab may increase your risk of a flare-up. Your IBD team may advise that the safest option is for you to keep taking it even during pregnancy. Having active Crohn’s or Colitis while pregnant can lead to premature (early) birth, low birth weight and higher rates of miscarriage.
If you take golimumab during pregnancy, your baby may temporarily have a higher risk of getting an infection. It’s important that you tell your baby’s doctors and other health care professionals if you took golimumab during pregnancy. It’s particularly important to tell them before your baby receives any vaccines (see your baby and live vaccines).
Your baby may be more prone to infections if you take azathioprine or mercaptopurine along with anti-TNFs, like golimumab, during pregnancy.
You and your IBD team should discuss whether the benefits of taking Golimumab outweigh any risks to you and your baby. You can find out more in our information on pregnancy and reproductive health.
Taking golimumab during pregnancy may affect when your baby can have live vaccines. This includes the BCG for tuberculosis and the rotavirus vaccine. It should not affect the rest of your baby’s vaccination schedule.
If you take golimumab during pregnancy, you may be told that your baby should not have live vaccines until they are a bit older. National guidelines state that you may need to wait until your baby is between 6 and 12 months old. Drug manufacturers that produce golimumab recommend you wait until six months after your last golimumab dose during pregnancy. But sometimes the benefit of giving a live vaccine earlier might be greater than the potential risk.
You must tell your baby’s healthcare team you were taking golimumab while pregnant. Decisions on what vaccines your baby should have and when will be made on an individual basis. Your IBD team and midwife or baby’s healthcare team should be able to help you come to a decision.
When your baby is old enough to have live vaccines, you should take extra care if they have the rotavirus vaccine. 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.
Most experts feel that golimumab is OK to use 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. Molecules of golimumab are large, so the amount that may go into breastmilk is thought to be low. Medicines like golimumab are broken down and destroyed by your gut. Golimumab in breastmilk is likely to be broken down in your baby’s gut when they feed. So very little will be absorbed by your baby.
There is very little information about taking golimumab during breastfeeding. Because there is not much information, the drug company that makes golimumab advises that you stop taking it for at least six months before you start breastfeeding. But experts agree that golimumab is unlikely to be harmful to your baby. Tell your IBD team if you are thinking about breastfeeding while taking golimumab. They can help you weigh up the benefits of breastfeeding during treatment against any possible risks.
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:
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