Important Safety Information
                Indications and Clinical Use:
                Rheumatoid arthritis (RA):
                PrCIMZIA® (certolizumab pegol) in combination with
                  methotrexate (MTX) is indicated for:
                
                  - 
                    reducing signs and symptoms, including major clinical response, and reducing
                    the progression of joint damage as assessed by X-ray, in adult patients with
                    moderately to severely active rheumatoid arthritis (RA)
                  
CIMZIA® may be used alone for reducing signs and symptoms in adult
                  patients with moderately to severely active rheumatoid arthritis (RA) who do not
                  tolerate MTX.
                Psoriatic arthritis (PsA): 
                CIMZIA® alone or in combination with MTX is indicated for:
                
                  - 
                    reducing signs and symptoms and inhibiting the progression of structural
                    damage as assessed by X-ray, in adult patients with moderately to severely
                    active psoriatic arthritis (PsA) who have failed one or more disease-modifying
                    anti-rheumatic drugs (DMARDs)
                  
Ankylosing spondylitis (AS): 
                CIMZIA® is indicated for:
                
                  - 
                    reducing signs and symptoms in adult patients with active ankylosing
                    spondylitis (AS) who have had an inadequate response to conventional therapy
                  
Non-radiographic axial
                    spondyloarthritis (nr-axSpA): 
                CIMZIA® is indicated for:
                
                  - 
                    he treatment of adults with severe active non-radiographic axial
                    spondyloarthritis with objective signs of inflammation as indicated by elevated
                    C-reactive protein (CRP) and/or magnetic resonance imaging (MRI) evidence who
                    have had an inadequate response to, or are intolerant to nonsteroidal
                    anti-inflammatory drugs (NSAIDs)
                  
Plaque psoriasis (PsO): 
                CIMZIA® is indicated for:
                
                  - 
                    the treatment of adult patients with moderate to severe plaque psoriasis who
                    are candidates for systemic therapy
                  
Geriatrics (≥65 years of age): Specific clinical studies have
                  not been performed in elderly subjects.
                Pediatrics (<18 years of age): Safety and efficacy of
                  CIMZIA® in pediatric patients have not been established. 
                Contraindications:
                
                  - 
                    Hypersensitivity to CIMZIA® (certolizumab pegol) or any of its
                    components
                  
                
                  - 
                    Active tuberculosis or other severe infections such as sepsis, abscesses and
                    opportunistic infections
                  
                
                  - 
                    Moderate to severe heart failure (NYHA Class III/IV)
                  
Most Serious Warnings and Precautions:
                Serious infections: serious infections, sepsis, tuberculosis
                  (including military disseminated and extrapulmonary disease), invasive fungal
                  infections (such as histoplasmosis) and other opportunistic infections, some of
                  which have been fatal, have been reported in patients receiving TNF blocking
                  agents including CIMZIA®. Many of these occurred in patients on
                  concomitant immunosuppressive therapy that, in addition to their underlying
                  disease, could predispose them to infections. CIMZIA® should not be
                  given to patients with a clinically important infection including chronic or
                  localized infections. Physicians should exercise caution when considering the
                  use of CIMZIA® in patients with a history of recurring infection.
                  Patients should be monitored for signs and symptoms of infection while on and
                  after treatment with CIMZIA®. 
                Any new infection that develops while on CIMZIA®, or after recent
                  treatment, should be closely monitored. CIMZIA® should be
                  discontinued if a patient develops a serious infection.
                Malignancy: lymphoma and other malignancies, some fatal, have
                  been reported in children and adolescent patients treated with TNF blockers, of
                  which CIMZIA® is a member. CIMZIA® is not indicated for
                  use in pediatric patients.
                Other Relevant Warnings and Precautions:
                
                  - Worsening congestive heart failure (CHF) and new onset CHF
- Hepatitis B virus reactivation
- Hematological reactions: pancytopenia (including aplastic anemia); cytopenia
                    (leukopenia, pancytopenia, thrombocytopenia)
- Neurologic reactions (new onset or exacerbation of CNS demyelinating disease,
                    including multiple sclerosis and PNS demyelinating disease, including
 Guillain-Barré syndrome)
- Use in combination with other biologic medicines is not recommended
- Patients in surgery and those being switched to another biologic DMARD should
                    be closely monitored for infections
- Hypersensitivity symptoms: angioedema, dyspnea, hypotension, rash, serum
                    sickness, urticaria, dizziness, hot flushes, pulmonary burning sensation, and
                    throat/uvula swelling
- Latex sensitivity
- Formation of autoantibodies
- Administration of live or live-attenuated vaccines is not recommended
- Use in patients with severe immunosuppression
- May cause erroneously elevated activated partial thromboplastin time (aPTT)
                    assay results in patients without coagulation abnormalities
- Women of childbearing potential and pregnant women: occurrence of major
                    congenital malformations and miscarriages was no greater than the background
                    occurrence of major congenital malformations and miscarriages in the general
                    population. CIMZIA® should be used in pregnancy only if clearly needed
- May be considered during breastfeeding
  
                For More Information:
                  Consult the product monograph at https://www.ucb-canada.ca/en/Our-Medicines/overview
                  for important information relating to adverse reactions, drug interactions, and
                  dosing information which have not been discussed here.
                  The product monograph is also available through Medical Information Services at
                  1-866-709-8444.