If you have certain types of arthritis or are having a transplant, your doctor may prescribe Orencia.

Orencia is a prescription drug.

Orencia is also used to help prevent acute (sudden) graft-versus-host disease in adults and some children undergoing hematopoietic stem cell transplantation.

To learn about these conditions and how Orencia is used for them, see the “What is Orencia used for?” section below.

Orencia is a liquid solution and a powder that is mixed into it. It is given by either:

If you are injecting Orencia under your skin, you may be able to give yourself injections. Your doctor will show you how to inject. If you are getting Orencia by IV, you will get your doses from a healthcare professional.

Is Orencia a biologic?

Yes. Orencia contains the drug abatacept, which is a biologic medication. A biologic is made from parts of living cells.

Orencia is not available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.) Instead, abatacept comes only as the brand-name drug Orencia.

“Information about Orencia’s side effects, how it’s taken, and more can be found below.”

Orencia may cause mild or serious side effects. Some of the more common side effects of Orencia are described in the lists below. All possible side effects are not included in these lists.

In studies, children ages 2 years old and older taking Orencia had similar side effects as adults did.

The doctor or the pharmacy can tell you more about the side effects of Orencia. They can suggest ways to reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Orencia can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Orencia’s patient information.

Mild side effects of Orencia can be included.

  • There is a throbbing head.
  • Respiratory infections
  • It is a cold.
  • nausea

Many drugs can have mild side effects that go away in a few days or weeks. If they become intolerable, talk to your doctor or pharmacist.

Serious side effects

There are serious side effects from Orencia, but they are not common. If you have serious side effects, call your doctor. If you think you have a medical emergency, you should call the emergency number.

Serious side effects can include:

The “Side effect focus” section gives more information on the serious side effects.

Side effect focus

There are some side effects Orencia may cause.


You may develop infections when you’re taking Orencia. And sometimes, these infections can become serious.

If you have had infections in the past, your doctor will consider the risks and benefits before starting Orencia.

Also, if you have any conditions that raise your risk for infections, you may develop more infections with Orencia use. For example, if you have chronic obstructive pulmonary disease (COPD), you may have a higher risk for Respiratory infectionss with Orencia.

People who take Orencia are the most likely to develop infections.

Also, your doctor will want to make sure that you don’t have certain infections before you start taking Orencia. These include hepatitis B and tuberculosis. Knowing whether you have these infections will help your doctors determine if Orencia is safe for you. See the “What should be considered before starting Orencia?” section below for details.

Note: Certain other infections are also possible in people receiving Orencia for graft-versus-host disease prevention. See the “Epstein-Barr virus and cytomegalovirus” section just below for details.

What can help?

To help prevent infections, your doctor may suggest updating your vaccinations before you start taking Orencia. Talk with your doctor to see if you need any vaccines before starting this drug.

Handwashing is a simple, effective way to help prevent infection. You should do this regularly. For tips on how to properly wash your hands, check out this article.

If you feel unwell, call your doctor. They can check to see if you have an illness.

“If you develop an infectious disease, your doctor may recommend that you stop taking Orencia for a short time. Don’t stop taking Orencia without talking to your doctor.”

Epstein-Barr virus and cytomegalovirus

If you’re receiving Orencia to help prevent acute (sudden) graft-versus-host disease, the drug may cause or reactivate infection with cytomegalovirus or Epstein-Barr virus.

Both are serious infections. If you have had either in the past, Orencia can cause the virus to come back. Symptoms can include:

  • There is a high degree of fever.
  • fatigue is low energy
  • swollen lymph nodes
  • reduced appetite.

What can help?

Orencia is usually given with other drugs to help prevent infections. You will be monitored for any symptoms of these infections during your Orencia treatment.


It’s not known if Orencia increases your risk for cancer.

In studies, lung and immune system cancers were seen more in people with rheumatoid arthritis who took Orencia than in people taking a placebo. (A placebo is a treatment with no active drug.)

Other cancers that were seen in people during studies include:

After Orencia was approved for use, some people developed skin cancer while taking it. It isn’t known what condition Orencia was being used to treat. And it’s important to know that when side effects are reported after a drug is approved, it’s often hard to tell whether the side effect was caused by the drug or something else.

It is not known if Orencia causes cancer. If you have concerns about cancer, talk to your doctor.

What can help?

If you have had skin cancer in the past, tell your doctor about it. If you have a history of skin cancer, your doctor may not prescribe Orencia.

If you have any risk factors for skin cancer, your doctor may check your skin from time to time while you’re taking this drug. But your doctor may check your skin even if you don’t have risk factors for skin cancer.

And if you notice any growths or changes in your skin during or after taking Orencia, tell your doctor.

Allergic reaction

Some people may have an allergic reaction to Orencia.

A mild allergic reaction can include some symptoms.

  • There is a skin rash.
  • It is itchy.
  • The flu.shing (warmth, swelling, or redness in your skin)

A more severe allergic reaction is not uncommon. There are symptoms of a severe allergic reaction.

“It’s swelling under your skin, usually in your lips, hands, or feet. They can include swelling of your mouth, throat, and tongue, which can cause trouble breathing.”

If you have an allergic reaction to Orencia, call your doctor. If you think you have a medical emergency, call the emergency number.

Your doctor will recommend the dosage of Orencia that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.


Orencia is a liquid solution and a powder that is mixed into it. It is given by either:

Recommended dosages

The Orencia dose your doctor prescribes depends on your body weight.

For rheumatoid arthritis and polyarticular juvenile idiopathic arthritis, you’ll get Orencia as either an Injection under your skin. or IV infusion. If you’re getting:

  • You will take the drug once a week.
  • You will get the drug once, then 2 weeks later and then 2 weeks after that. You will get Orencia once every 4 weeks after those three doses.

For psoriatic arthritis, you’ll get Orencia as an Injection under your skin.. And you’ll take the drug once each week.

For graft-versus-host disease prevention, you’ll get Orencia as an IV infusion. It’ll be given on the day before your transplant and on days 5, 14, and 28 afterward.

Depending on the condition you are taking Orencia for, your doctor may prescribe other drugs for you.

Questions about Orencia’s dosage

There are a lot of questions about Orencia.

  • What if I miss a dose of Orencia? If you miss a dose of Orencia, call your doctor. They’ll help you decide when it’s best to have your next dose. To help avoid missing a dose, set a medication reminder on your phone or write a note on your calendar.
  • Will I need to use Orencia long term? Orencia treats long-lasting diseases. So you may need to take it long term. For graft-versus-host disease prevention, you’ll only take Orencia for about 1 month. Talk with your doctor about how long you should use this drug.
  • How long does Orencia take to work? Everyone may have a different experience with Orencia treatment. A study in people with rheumatoid arthritis showed that some people had improvement in their condition after 6 months. And people who continued taking Orencia still showed that improvement at 12 months. Talk with your doctor about what you can expect with treatment.

“Your doctor will explain to you how to take Orencia. They will explain how much to take and how often. Follow your doctor’s instructions.”

Taking Orencia

Orencia is a liquid solution and a powder that is mixed into it. It is given by either:

If you are taking Orencia, you may be able to give it to yourself. Your doctor will show you how to use an autoinjector. You will inject Orencia into these areas.

  • Your belly button is 2 inches away.
  • The front of your thighs.
  • The part of your arms that is not in the plane of your body.

If you’re getting Orencia by IV infusion, you’ll get your doses from a healthcare professional. These infusions typically last about 30 minutes, or 60 minutes if you’re receiving Orencia for acute (sudden) graft-versus-host disease prevention.

Taking Orencia with other drugs

Your doctor may have you take other drugs with Orencia.

For polyarticular juvenile idiopathic arthritis and for rheumatoid arthritis, Orencia may be given by itself or with methotrexate.

For graft-versus-host disease prevention, you’ll receive Orencia along with methotrexate and a type of drug called a calcineurin inhibitor (such as cyclosporine or tacrolimus). Your doctor may also prescribe medications to help prevent certain viral infections, such as cytomegalovirus or Epstein-Barr virus. Examples of these drugs include acyclovir, valacyclovir, and ganciclovir.

Orencia and food

“Eating doesn’t affect how your body absorbs Orencia. You can take the medication with or without food.”

Find out what the answers are to some questions.

How does Orencia work?

Orencia works by targeting cells called T lymphocytes. These cells are part of your immune system, which works to help your body fight off infections.

Overactive T lymphocytes are seen in people with rheumatoid arthritis, psoriatic arthritis, and polyarticular juvenile idiopathic arthritis. These are the conditions Orencia is used to treat.

Overactivity of the immune system, including T lymphocytes, is also seen in people with acute (sudden) graft-versus-host disease. Orencia is used to help prevent this condition after a certain kind of transplant. By reducing this activity of the immune system, Orencia can lower your risk of developing this condition.

Orencia stops T lymphocytes from being activated. The experts think that blocking the activity of T lymphocytes slows the progression of certain diseases.

Does Orencia cause weight gain?

No, Orencia doesn’t cause weight gain or weight loss. If you have concerns about changes in your weight during Orencia treatment, talk with your doctor. They can help you create a plan to manage a healthy body weight.

What’s the difference between Orencia and Humira?

Both Orencia and Humira are biologic medications, which means they’re made from parts of living cells. And these two drugs are both taken as injections.

But each drug targets a different part of your immune system:

Humira and Orencia can cause similar side effects, including serious ones such as infections and cancer. But Humira has a boxed warning for these side effects.

The most serious warnings about a drug are the boxed warnings. People are warned of side effects that may be dangerous.

“Even though it can cause side effects, Orencia doesn’t have a boxed warning for cancer.”

The side effect severity of Orencia and Humira may be different.

If you have more questions about how Orencia and Humira are different, talk to your doctor.

Orencia is used for long-term conditions.

  • Rheumatoid arthritis (RA). For RA, Orencia is given to adults. With RA, you have joint pain, swelling, and stiffness. This condition isn’t caused by overusing your joints. Instead, it’s caused by your immune system attacking your joints.
  • Psoriatic arthritis (PsA). For PsA, Orencia can be given to adults. With PsA, you have painful and swollen joints. But you also have psoriasis plaques on your skin. (Plaques are areas of red or pink, scaley patches.) This condition is caused by your immune system attacking certain tissues in your body.
  • Polyarticular juvenile idiopathic arthritis (pJIA). For JIA, Orencia can be given to people ages 2 years and older. pJIA is the most common type of arthritis in children. And it’s also thought to be caused by the immune system attacking the joints.

Orencia is also used to help prevent acute (sudden) graft-versus-host disease caused by hematopoietic stem cell transplantation. For this purpose, it can be given to adults and children ages 2 years and older. And for this use, Orencia is given along with methotrexate and a type of drug called a calcineurin inhibitor.

Your immune system is attacking cells in your body.

Orencia works on these conditions by lowering the activity of a certain immune system cell. For more information about how Orencia works, see the “What are some frequently asked questions about Orencia?” section above.

“Orencia shouldn’t be used with other drugs that work on the immune system. Talk to your doctor about drugs that may or may not be used with Orencia.”

You need to tell your doctor about any other drugs you are taking. Things to discuss with your doctor.

  • Any medical conditions you have.
  • Whether you are pregnant or breastfeeding.


Taking a drug can affect how it works. These effects are called interactions.

Before taking Orencia, you should tell your doctor about all your medication. You should also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about the possible interactions with Orencia.

Interactions with drugs or supplements

Orencia can interact with a lot of drugs.

If you combine Orencia with any of these drugs, you are more likely to get a serious infections.

This list does not include all drugs that may interact with Orencia. Your doctor or pharmacist can tell you more about the interactions that may occur with Orencia.

Other interactions

Orencia may interact with vaccines. Read on to learn more.

Orencia and vaccines.

It isn’t known whether Orencia will cause vaccines to not work as well as they should. More studies are needed to fully understand what effects, if any, the drug has on vaccine effectiveness.

But that said, if you’re taking Orencia, you shouldn’t get any live vaccines. (Live vaccines contain live forms of germs they’re meant to protect you from.) Examples of live vaccines include measles, mumps, rubella (MMR) and chickenpox.

Orencia lowers the activity of your immune system. The vaccine is meant to protect you from a live form of the virus. If you have a weakened immune system, you could get a vaccine.

Before you start treatment with Orencia, you should talk with your doctor to make sure your vaccinations are up to date. You will need at least 3 months to get any live vaccines after Orencia is stopped.

Talk to your doctor about getting vaccines.

The results of blood sugar tests.

If you get Orencia by intravenous (IV) infusion and you check your blood sugar levels, you may see higher readings than usual. (With an IV infusion, the drug is injected into your vein over a period of time.)

The form of Orencia that is given by IV is made of maltose. This substance reacts with some blood sugar test strips. The blood sugar reading on your monitor may be incorrect.

So be sure to talk with your doctor and pharmacist if you check your blood sugar levels and you’re using Orencia. This is especially important to do if you have diabetes, because changes in blood sugar levels can be concerning if you have this condition.

“Your pharmacist can recommend strips that don’t react with maltose.”


If you have a medical condition that affects your health, Orencia may not be right for you. Before you take Orencia, talk to your doctor about your health history. Those described below are factors to consider.

Tuberculosis (TB). It’s not known if Orencia is safe for people with either latent TB or active TB. (With latent TB, you have TB in your body. But you don’t have symptoms, and you can’t pass it to others. With active TB, you have a TB and it’s causing symptoms.)

Before starting Orencia, your doctor will order a test to check and see if you have TB. If your test is positive for TB, your doctor may recommend TB treatment before prescribing Orencia.

Hepatitis B. It’s not known if Orencia is safe for people with hepatitis B. Certaindrugs such as Orencia, may reactivate hepatitis B. (With reactivation, the virus is already inside your body, and it flares up.) Your doctor may order a test to check and see if you have hepatitis B before you start taking Orencia. If you test positive for hepatitis B, your doctor may not prescribe Orencia for you.

Allergic reaction. If you’ve had an allergic reaction to Orencia or any of its ingredients, you shouldn’t take Orencia. Ask your doctor what other medications are better options for you.

Chronic obstructive pulmonary disease (COPD). In studies of Orencia, adults with COPD had higher rates of side effects with this drug. If you have COPD, talk with your doctor before starting Orencia. They may monitor you more closely than usual for worsened breathing during Orencia treatment.

Reduced immune system activity. If you have a weakened immune system, you might have a higher risk of infections with Orencia. Talk with your doctor about whether the drug is safe for you.

Risk factors for skin cancer. Orencia may increase your cancer risk, particularly your risk of skin cancer. If you already have an increased risk of skin cancer, you’ll likely have regular skin exams during Orencia treatment. See “Cancer” in the “What are Orencia’s side effects?” section above for details.

Cytomegalovirus or Epstein-Barr virus. If you’re receiving Orencia to help prevent acute (sudden) graft-versus-host disease, the drug can cause or reactivate either viral infection. For graft-versus-host disease prevention, Orencia is usually given with certain drugs to help prevent these infections. Your doctor may test you for both infections before you start the Orencia treatment. And they’ll monitor you for signs of any infection while you’re receiving Orencia.

Use with alcohol

“Some drugs work better with alcohol in their mix. It doesn’t interact with Orencia.”

Talk to your doctor about the risks of drinking alcohol while using Orencia.

Pregnancy and breastfeeding

It is not known if Orencia is harmful to pregnant people. Before taking this drug, you should talk with your doctor.

It is not known if Orencia passes into human breast milk. Talk to your doctor about the risks of breastfeeding while using this drug.

There are many factors that affect the cost of prescription drugs. What your insurance plan covers is one of the factors.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Orencia manufacturer’s website to view possible support options.

“Don’t take more Orencia than your doctor prescribes. Side effects can be serious if you use more than this. Your doctor will be watching you for possible overdose symptoms if you take too much Orencia.”

What to do in case you take too much Orencia

Call your doctor if you think you’ve taken too much Orencia. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use their online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Before starting Orencia, you should talk to your doctor or pharmacist about any questions you have.

Talk to your doctor about other treatment options. Here are some articles that you might find useful.

Ask your doctor about Orencia treatment.

  • Will I be able to receive vaccines while using Orencia?
  • Can Orencia be taken to her home?
  • Can I use Orencia if I have diabetes?
  • Where should I inject Orencia?

You can read advice and stories from others with your condition in the Bezzy PsA and Bezzy RA communities. You can also learn more about rheumatoid arthritis (RA) and its treatment options by subscribing to the Healthline RA newsletter.


How should I store Orencia while traveling?



It is important to properly store your Orencia prefilled syringes or autoinjector during your trip.

The Orencia prefilled syringes and autoinjectors should be kept out of the reach of children. They should be kept at a temperature of 36F and 46F until you are ready to take the drug.

To properly store Orencia while traveling, the drug’s manufacturer recommends storing your prefilled syringes or autoinjectors in their original carton inside a cool carrier bag. This could include a bag with insulation that’s able to keep Orencia at the proper temperature.

The manufacturer recommends keeping the medication with you, rather than storing it in your luggage.

“If you believe Orencia may have been in temperatures outside of the acceptable range, you can call the drug’s manufacturer.”

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.