Simponi® 50 mg solution for injection in pre-filled pen – patient leaflet, side effects, dosage

1. What Simponi is and what it is used for

Simponi contains the active substance called golimumab.

Simponi belongs to a group of medicines called ‘TNF blockers’. It is used in adults for the treatment of the following inflammatory diseases: • Rheumatoid arthritis

• Psoriatic arthritis

• Axial spondyloarthritis, including ankylosing spondylitis and

  non-radiographic axial spondyloarthritis

• Ulcerative colitis

In children 2 years of age and older, Simponi is used for the treatment of polyarticular juvenile idiopathic arthritis.

Simponi works by blocking the action of a protein called ‘tumour necrosis factor alpha’ (TNF-α). This protein is involved in inflammatory processes of the body, and blocking it can reduce the inflammation in your body.

Rheumatoid arthritis

Rheumatoid arthritis is an inflammatory disease of the joints. If you have active rheumatoid arthritis you will first be given other medicines. If you do not respond well enough to these medicines, you may be given Simponi which you will take in combination with another medicine called methotrexate to:

• Reduce the signs and symptoms of your disease.
• Slow down the damage to your bones and joints.
• Improve your physical function.

Psoriatic arthritis

Psoriatic arthritis is an inflammatory disease of the joints, usually accompanied by psoriasis, an inflammatory disease of the skin. If you have active psoriatic arthritis you will first be given other medicines. If you do not respond well enough to these medicines, you may be given Simponi to:

• Reduce the signs and symptoms of your disease.
• Slow down the damage to your bones and joints.
• Improve your physical function.

Ankylosing spondylitis and non-radiographic axial spondyloarthritis

Ankylosing spondylitis and non-radiographic axial spondyloarthritis are inflammatory diseases of the spine. If you have ankylosing spondylitis or non-radiographic axial spondyloarthritis, you will first be given other medicines. If you do not respond well enough to these medicines, you may be given Simponi to:

• Reduce the signs and symptoms of your disease.
• Improve your physical function.

Ulcerative colitis

Ulcerative colitis is an inflammatory disease of the bowel. If you have ulcerative colitis you will first be given other medicines. If you do not respond well enough to these medicines, you will be given Simponi to treat your disease.

Polyarticular juvenile idiopathic arthritis

Polyarticular juvenile idiopathic arthritis is an inflammatory disease that causes joint pain and swelling in children. If you have polyarticular juvenile idiopathic arthritis you will first be given other medicines. If you do not respond well enough to these medicines, you will be given Simponi in combination with methotrexate to treat the disease.

2. What you need to know before you use Simponi

Do not use Simponi

• If you are allergic (hypersensitive) to golimumab or any of the other

  ingredients of this medicine (listed in Section 6).

• If you have tuberculosis (TB) or any other severe infection. • If you have moderate or severe heart failure.

If you are not sure if any of the above applies to you, talk to your doctor, pharmacist or nurse before using Simponi.

Warnings and precautions

Talk to your doctor, pharmacist or nurse before using Simponi.

Infections

Tell your doctor straight away if you already have or get any symptoms of infection, during or after your treatment with Simponi. Symptoms of infection include fever, cough, shortness of breath, flu-like symptoms, diarrhoea, wounds, dental problems or a burning feeling when urinating. • You may get infections more easily while using Simponi. • Infections may progress more rapidly and may be more severe.

In addition, some previous infections may reappear.

Tuberculosis (TB)

Tell your doctor straight away if symptoms of TB appear during or after your treatment. Symptoms of TB include persistent cough, weight loss, tiredness, fever or night sweats.

• Cases of TB have been reported in patients treated with Simponi,

  in rare occasions even in patients who have been treated with medicines for TB. Your doctor will test you to see if you have TB. Your doctor will record these tests on your Patient Reminder Card.

• It is very important that you tell your doctor if you have ever had

  TB, or if you have been in close contact with someone who has had or has TB.

• If your doctor feels that you are at risk of TB, you may be treated

  with medicines for TB before you begin using Simponi.

  Hepatitis B virus (HBV)

  • Tell your doctor if you are a carrier or if you have or have had

    HBV before you are given Simponi.

  • Tell your doctor if you think you might be at risk of contracting HBV • Your doctor should test you for HBV

  • Treatment with TNF blockers such as Simponi may result in

    reactivation of HBV in patients who carry this virus, which can be life-threatening in some cases.

Invasive fungal infections

If you have lived in or travelled to an area where infections caused by specific type of fungi that can affect the lungs or other parts of the body (called histoplasmosis, coccidioidomycosis, or blastomycosis), are common, tell your doctor straight away. Ask your doctor if you don’t know if these fungal infections are common in the area in which you have lived or travelled.

Cancer and lymphoma

Tell your doctor if you have ever been diagnosed with lymphoma (a type of blood cancer) or any other cancer before you use Simponi. • If you use Simponi or other TNF blockers, your risk for developing

lymphoma or another cancer may increase.

• Patients with severe rheumatoid arthritis and other inflammatory

  diseases, who have had the disease for a long time, may be at higher than average risk of developing lymphoma.

• There have been cases of cancers, including unusual types, in

  children and teenage patients taking TNF-blocking agents, which sometimes resulted in death.

• On rare occasions, a specific and severe type of lymphoma called

  hepatosplenic T-cell lymphoma has been observed in patients taking other TNF-blockers. Most of these patients were adolescent or young adult males. This type of cancer has usually resulted in death. Almost all of these patients had also received medicines known as azathioprine or 6-mercaptopurine. Tell your doctor if you are taking azathioprine or 6-mercaptopurine with Simponi.

• Patients with severe persistent asthma, chronic obstructive pulmonary

  disease (COPD), or are heavy smokers may be at increased risk for cancer with Simponi treatment. If you have severe persistent asthma, COPD or are a heavy smoker, you should discuss with your doctor whether treatment with a TNF blocker is appropriate for you. • Some patients treated with golimumab have developed certain

  kinds of skin cancer. If any changes in the appearance of the skin or growths on the skin occur during or after therapy, tell your doctor.

Heart failure

Tell your doctor straight away if you get new or worsening symptoms of heart failure. Symptoms of heart failure include shortness of breath or swelling of your feet.

• New and worsening congestive heart failure has been reported with

  TNF blockers, including Simponi. Some of these patients died. • If you have mild heart failure and you are being treated with Simponi,

  you must be closely monitored by your doctor.

Nervous system disease

Tell your doctor straight away if you have ever been diagnosed with or develop symptoms of a demyelinating disease such as multiple sclerosis. Symptoms may include changes in your vision, weakness in your arms or legs or numbness or tingling in any part of your body. Your doctor will decide if you should receive Simponi.

Operations or dental procedures

• Talk to your doctor if you are going to have any operations or dental

  procedures.

• Tell your surgeon or dentist performing the procedure that you

  are having treatment with Simponi by showing them your Patient Reminder Card.

Autoimmune disease

Tell your doctor if you develop symptoms of a disease called lupus. Symptoms include persistent rash, fever, joint pain and tiredness. • On rare occasions, people treated with TNF blockers have

developed lupus.

Blood disease

In some patients the body may fail to produce enough of the blood cells that help your body fight infections or help you to stop bleeding. If you develop a fever that does not go away, bruise or bleed very easily or look very pale, call your doctor right away. Your doctor may decide to stop treatment.

If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before using Simponi.

Vaccinations

Talk to your doctor if you have had, or are due to have a vaccine. • You should not receive certain (live) vaccines while using Simponi. • Certain vaccinations may cause infections. If you received Simponi

while you were pregnant, your baby may be at higher risk for getting such an infection for up to approximately six months after the last dose you received during pregnancy. It is important that you tell your baby’s doctors and other health care professionals about your Simponi use so they can decide when your baby should receive any vaccine.

Talk to your child’s doctor regarding vaccinations for your child. If possible, your child should be up to date with all vaccinations before using Simponi.

Therapeutic infectious agents

Talk to your doctor if you have recently received or are scheduled to receive treatment with a therapeutic infectious agent (such as BCG instillation used for the treatment of cancer).

Allergic reactions

Tell your doctor straight away if you develop symptoms of an allergic reaction after your treatment with Simponi. Symptoms of an allergic reaction may include swelling of the face, lips, mouth or throat which may cause difficulty in swallowing or breathing, skin rash, hives, swelling of the hands, feet or ankles.

• Some of these reactions may be serious or, rarely, life-threatening. • Some of these reactions occurred after the first administration of

  Simponi.

Children

Simponi is not recommended for children less than 2 years of age with polyarticular juvenile idiopathic arthritis because it has not been studied in this group.

Other medicines and Simponi

• Tell your doctor or pharmacist if you are using, have recently used

  or might use any other medicines, including any other medicines to treat rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, or ulcerative colitis.

• You should not take Simponi with medicines containing the active

  substance anakinra or abatacept. These medicines are used for the treatment of rheumatic diseases.

• Tell your doctor or pharmacist if you are taking any other medicines

  that affect your immune system.

• You should not receive certain (live) vaccines while using Simponi.

  If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before using Simponi.

  Pregnancy and breast-feeding

  Talk to your doctor before using Simponi if:

  • You are pregnant or are planning to become pregnant while using

    Simponi. There is limited information about the effects of this medicine in pregnant women. If you are being treated with Simponi, you must avoid becoming pregnant by using adequate contraception during your treatment and for at least 6 months after the last Simponi injection. Simponi should only be used during pregnancy if it is clearly necessary for you.

  • Before starting breast-feeding, your last treatment with Simponi must be at least 6 months ago. You must stop breast-feeding if you are to be given Simponi.
  • If you received Simponi during your pregnancy, your baby may have a higher risk for getting an infection. It is important that you tell your baby’s doctors and other health care professionals about your Simponi use before the baby receives any vaccine (for more information see section on vaccination).

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

Simponi has minor influence on your ability to drive and use tools or machines. Dizziness may however occur after you take Simponi. If this happens, do not drive or use any tools or machines.

Simponi contains latex and sorbitol

Latex sensitivity

A part of the pre-filled pen, the needle cover, contains latex. Because latex may cause severe allergic reactions, talk to your doctor before using Simponi if you or your carer are allergic to latex.

Sorbitol intolerance

This medicine contains 20.5 mg sorbitol (E420) in each pre-filled pen.

3. How to use Simponi

Always use this medicine exactly as your doctor or pharmacist has told you. You should check with your doctor or pharmacist if you are not sure.

How much Simponi is given

Rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis, including ankylosing spondylitis and non-radiographic axial spondyloarthritis:

• The recommended dose is 50 mg (the content of 1 pre-filled pen)

  given once a month, on the same date each month. • Talk to your doctor before taking your fourth dose. Your doctor will determine if you should continue Simponi treatment. ○ If you weigh more than 100 kg, the dose might be increased to

  100 mg (the content of 2 pre-filled pens) given once a month, on the same date each month.

Polyarticular juvenile idiopathic arthritis in children 2 years of age and older:

• For patients weighing at least 40 kg, the recommended dose is 50 mg given once a month, on the same date each month. For patients weighing less than 40 kg, a 45 mg/0.45 mL pre-filled pen is available. Your doctor will tell you the correct dose to use.
• Talk to your doctor before you take the fourth dose. Your doctor will determine if you should continue Simponi treatment.

Ulcerative colitis

• The table below shows how you will usually use this medicine.

How Simponi is given

• Simponi is given by injection under the skin (subcutaneously). • At the start, your doctor or nurse may inject Simponi. However, you and your doctor may decide that you may inject Simponi yourself. In this case you will get training on how to inject Simponi yourself.

Talk to your doctor if you have any questions about giving yourself an injection. You will find detailed “Instructions for Use” at the end of this leaflet.

If you use more Simponi than you should

If you have used or been given too much Simponi (either by injecting too much on a single occasion, or by using it too often), talk to your doctor or pharmacist straight away. Always take the outer carton and this leaflet with you, even if it is empty.

If you forget to use Simponi

If you forget to use Simponi on your planned date, inject the forgotten dose as soon as you remember.

Do not use a double dose to make up for a forgotten dose.

When to inject your next dose:

• If you are less than 2 weeks late, inject the forgotten dose as soon as you remember and stay on your original schedule. • If you are more than 2 weeks late, inject the forgotten dose as soon as you remember and talk to your doctor or pharmacist to ask when you need to take the next dose.

If you are not sure what to do, talk to your doctor or pharmacist.

If you stop using Simponi

If you are considering stopping Simponi, talk to your doctor or pharmacist first.

If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. Some patients may experience serious side effects and may require treatment. The risk of certain side effects is greater with the 100 mg dose compared with the 50 mg dose. Side effects may appear up to several months after the last injection.

Tell your doctor straight away if you notice any of the following serious side effects of Simponi which include:

• allergic reactions which may be serious, or rarely, life-threatening

  (rare). Symptoms of an allergic reaction may include swelling of the face, lips, mouth or throat which may cause difficulty in swallowing or breathing, skin rash, hives, swelling of the hands, feet or ankles. Some of these reactions occurred after the first administration of Simponi.

• serious infections (including TB, bacterial infections including serious blood infections and pneumonia, severe fungal infections and other opportunistic infections) (common).

  Symptoms of an infection can include fever, tiredness, (persistent) cough, shortness of breath, flu-like symptoms, weight loss, night sweats, diarrhoea, wounds, dental problems and a burning feeling when urinating.

• reactivation of hepatitis B virus if you are a carrier or have had

  hepatitis B before (rare). Symptoms can include yellowing of the skin and eyes, dark brown-coloured urine, right-sided abdominal pain, fever, feeling sick, being sick, and feeling very tired. • nervous system disease such as multiple sclerosis (rare).

  Symptoms of nervous system disease can include changes in your vision, weakness in your arms or legs, numbness or tingling in any part of your body.

• cancer of the lymph nodes (lymphoma) (rare). Symptoms of

  lymphoma can include swelling of the lymph nodes, weight loss, or fever.

• heart failure (rare). Symptoms of heart failure can include shortness

  of breath or swelling of your feet.

• signs of immune system disorders called:

  • lupus (rare). Symptoms can include joint pain or a rash on

    cheeks or arms that is sensitive to the sun.

  • sarcoidosis (rare). Symptoms can include a persistent cough,

    being short of breath, chest pain, fever, swelling of your lymph nodes, weight loss, skin rashes, and blurred vision. • swelling of small blood vessels (vasculitis) (rare). Symptoms can

include fever, headache, weight loss, night sweats, rash, and nerve problems such as numbness and tingling.

• skin cancer (uncommon). Symptoms of skin cancer can include

  changes in the appearance of your skin or growths on your skin. • blood disease (common). Symptoms of blood disease can include

  a fever that does not go away, bruising or bleeding very easily or looking very pale.

• blood cancer (leukaemia) (rare). Symptoms of leukaemia can

  include fever, feeling tired, frequent infections, easy bruising, and night sweats.

Tell your doctor straight away if you notice any of the above symptoms.

The following additional side effects have been observed with Simponi:

Very common side effects (may affect more than 1 in 10 people): • Upper respiratory tract infections, sore throat or hoarseness,

runny nose

Common side effects (may affect up to 1 in 10 people): • Abnormal liver tests (increased liver enzymes) found during blood

tests done by your doctor

• Feeling dizzy
• Headache
• Feeling numb or having a tingling feeling
• Superficial fungal infections
• Abscess
• Bacterial infections (such as cellulitis)
• Low red blood cell counts
• Low white blood cell counts
• Positive blood lupus test
• Allergic reactions
• Indigestion
• Stomach pain
• Feeling sick (nausea)
• Flu
• Bronchitis
• Sinus infection
• Cold sores
• High blood pressure
• Fever
• Asthma, shortness of breath, wheezing

• Stomach and bowel disorders which include inflammation of

  the stomach lining and colon which may cause fever • Pain and ulcers in the mouth

• Injection site reactions (including redness, hardness, pain, bruising,

  itching, tingling and irritation)

• Hair loss
• Rash and itching of the skin
• Difficulty sleeping
• Depression
• Feeling weak
• Bone fractures
• Chest discomfort

Uncommon side effects (may affect up to 1 in 100 people): • Kidney infection

• Cancers, including skin cancer and non-cancerous growths or lumps,

  including skin moles

• Skin blisters

• Severe infection throughout the body (sepsis), sometimes including

  low blood pressure (septic shock)

• Psoriasis (including on the palms of your hand and/or the soles

  of your feet and/or in the form of skin blisters)

• Low platelet count
• Combined low platelet, red, and white blood cell count • Thyroid disorders
• Increase in blood sugar levels
• Increase in blood cholesterol levels
• Balance disorders
• Vision disturbances
• Inflamed eye (conjunctivitis)
• Eye allergy
• Sensation of heart beating irregularly
• Narrowing of the blood vessels in the heart
• Blood clots
• Flushing
• Constipation
• Chronic inflammatory condition of the lungs
• Acid reflux
• Gall stones
• Liver disorders
• Breast disorders

• Menstrual disorders

  Rare side effects (may affect up to 1 in 1,000 people): • Failure of the bone marrow to produce blood cells

  • Severely decreased number of white blood cells
  • Infection of the joints or the tissue around them
  • Impaired healing
  • Inflammation of blood vessels in internal organs
  • Leukaemia
  • Melanoma (a type of skin cancer)
  • Merkel cell carcinoma (a type of skin cancer)
  • Lichenoid reactions (itchy reddish-purple skin rash and/or threadlike white-grey lines on mucous membranes)
  • Scaly, peeling skin

  • Immune disorders that could affect the lungs, skin and lymph nodes

    (most commonly presenting as sarcoidosis)

  • Pain and discolouration in the fingers or toes
  • Taste disturbances
  • Bladder disorders
  • Kidney disorders
  • Inflammation of the blood vessels in your skin which results in rash

Side effects of which the frequency is not known:

• A rare blood cancer affecting mostly young people

  (hepatosplenic T-cell lymphoma)

• Kaposi’s sarcoma, a rare cancer related to infection with human herpes virus 8. Kaposi’s sarcoma most commonly appears as purple lesions on the skin

• Worsening of a condition called dermatomyositis

  (seen as a skin rash accompanying muscle weakness)

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Simponi

• Keep this medicine out of the sight and reach of children. • Do not use this medicine after the expiry date which is stated on the label and the carton after “EXP”. The expiry date refers to the last day of that month.
• Store in a refrigerator (2°C-8°C). Do not freeze.
• Keep the pre-filled pen in the outer carton in order to protect it from light.
• This medicine can also be stored out of the refrigerator at temperatures up to a maximum of 25°C for a single period of up to 30 days, but not beyond the original expiry date printed on the carton. Write the new expiry date on the carton including day/month/year (no more than 30 days after the medicine is removed from the refrigerator). Do not return this medicine to refrigerator if it has reached room temperature. Discard this medicine if not used by the new expiry date or the expiry date printed on the carton, whichever is earlier.
• Do not use this medicine if you notice that the liquid is not a clear to light yellow colour, cloudy, or contains foreign particles. • Do not throw away any medicines via wastewater or household waste. Ask your doctor or pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

If the medicine becomes discolored or shows any other signs of deterioration, you should seek the advice of your pharmacist who will tell you what to do.

6. Contents of the pack and other information

What Simponi contains

The active substance is golimumab. One 0.5 mL pre-filled pen contains 50 mg of golimumab.

The other ingredients are sorbitol (E420), histidine, histidine hydrochloride monohydrate, polysorbate 80 and water for injections. For more information on sorbitol (E420), see Section 2.

What Simponi looks like and contents of the pack

Simponi is supplied as solution for injection in a single-use pre-filled pen. Simponi is available in pack containing 1 pre-filled pen.

The solution is clear to slightly opalescent (having a pearl-like shine), colourless to light yellow and may contain a few small translucent or white particles of protein. Do not use Simponi if the solution is discoloured, cloudy or you can see foreign particles in it.

Manufacturer:

Janssen Biologics B.V.

Einsteinweg 101

2333 CB Leiden

The Netherlands

Procured from within the EU and repackaged for the PL Holder: Abacus Medicine Ltd., Abbey House, 282 Farnborough Road, Farnborough, GU14 7NA, United Kingdom

PL 45763/1232

POM

Simponi^® is a registered trademark of Johnson & Johnson.

For any information about this medicine, please contact the local representative of the Product Licence Holder:

Abacus Medicine Ltd.

tel: +44(0)2036301244

email: MedInfo@abacusmedicine.co.uk

or

drugsafetyuk@abacusmedicine.co.uk

This leaflet was last revised on 06/02/2025

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