If you have certain types of arthritis or if you’re having a certain transplant, your doctor might suggest Orencia (abatacept) as a treatment option for you.

Orencia is a prescription medication that is used to treat a number of conditions.

It’s also used with other drugs to help prevent acute (sudden) graft-versus-host disease with hematopoietic stem cell transplantation. For this use, Orencia can be given to adults and children ages 2 years and older.

Orencia comes as a liquid solution that’s given as a subcutaneous injection (an injection under your skin). It also comes as a powder that’s mixed with water to form a solution. This solution is then given as an intravenous (IV) infusion (an injection into a vein that’s given over a period of time).

This article describes the dosages of Orencia, as well as its forms, strengths, and how to use the drug. To learn more about Orencia, see this in-depth article.

Note: This article covers Orencia’s typical dosages, which are provided by the drug’s manufacturer. But when using Orencia, always use the dosage that your doctor prescribes.

The section covers the common dosage information.

What are the forms of Orencia?

Orencia is available in a number of forms.

  • a liquid solution that’s given as a subcutaneous injection (an injection under your skin)
  • a powder that’s mixed with water to form a solution, which is given as an intravenous (IV) infusion (an injection into a vein that’s given over a period of time)

What strengths does Orencia come in?

The IV injection contains 250mg of powder. You may need more than one vial of Orencia. A healthcare professional will add sterile water to the drug powder to make a solution for IV injection.

Orencia can be given in prefilled syringes and ClickJect autoinjectors. The prefilled syringes are available in three strengths. The ClickJect autoinjector is available in a strength of 125.

What are the typical dosages of Orencia?

Depending on the drug you receive, your Orencia dose will be dependent on the IV or injection method.

The dosage of the drug will be dependent on your weight in kilogram. After taking your weight at your first appointment, your doctor will prescribe a dosage that is right for you. If your weight changes over time, they may adjust your dosage.

The table below shows the recommended dosages for adults who receive Orencia.

Body weight Dose Number of vials†
Less than 60 kg* (less than about 132 lb) 500 mg 2
60 to 100 kg (about 132 lb to 220 lb) 750 mg 3
More than 100 kg (more than about 220 lb) 1,000 mg 4

2.2 pounds is the weight of one kilo.
† Each vial of Orencia contains 250 mg of the drug.

The information below describes dosages that are commonly used or recommended. But be sure to use the dosage that your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for rheumatoid arthritis

If you use Orencia to treat rheumatoid arthritis, you can receive the drug by subcutaneous injection or IV infusion.

“You will get your Orencia by IV at your doctor’s office or an infusion center. Your weight will affect your dose. The table above has more information.”

You will get your first injection 2 weeks later and another 2 weeks after that. You will have an injection every 4 weeks after the first three doses.

The Orencia dosage is 125mg once per week. You may be able to give yourself injections at home. Your doctor will help you make a decision.

Your doctor will show you how to give yourself injections if you use Orencia at home. The “How to take Orencia” section gives information about where to inject Orencia.

You can receive one dose of Orencia before your first injection. The dose will be based on your weight. You should give yourself a injection the day after you get the IV.

Dosage for psoriatic arthritis

For psoriatic arthritis, Orencia can be given by IV infusion or subcutaneous injection.

“You can get the Orencia by IV at your doctor’s office or an infusion center. Your weight will affect your dose. The table above has more information.”

You will get your first injection 2 weeks later and another 2 weeks after that. You will have an injection every 4 weeks after the first three doses.

You will use 125 grams of Orencia once per week. You may be able to give yourself injections at home. Your doctor will help you make a decision.

Your doctor will show you how to give yourself injections if you use Orencia at home. The “How to take Orencia” section gives information about where to inject Orencia.

Dosage for polyarticular juvenile idiopathic arthritis

Orencia is used to treat polyarticular juvenile idiopathic arthritis in certain children. For details, see the “What’s the dosage of Orencia for children?” section just below.

Dosage for preventing acute graft-versus-host disease

Orencia is given as an IV infusion for helping to prevent acute (sudden) graft-versus-host disease. For this use, the recommended dosage is 10 mg per kg of body weight in adults. The maximum dosage of Orencia for this use is 1,000 mg.

If you weigh 70 kilogram, your dose would be 700.

You’ll be given an Orencia infusion on the day before your transplant and on days 5, 14, and 28 afterward. Your doctor will also prescribe the drug methotrexate (Trexall) and a type of drug called a calcineurin inhibitor. They might have you start taking these drugs before you begin Orencia treatment and continue taking them after your transplant.

Orencia is used to prevent acute Graft-versus-Host disease in children. The section below has more information.

What’s the dosage of Orencia for children?

The recommended dosages for children are described in this section.

Children’s dosage for polyarticular juvenile idiopathic arthritis

Polyarticular juvenile idiopathic arthritis is a condition that can be treated with Orencia. Children will receive Orencia by injection. Children can receive Orencia by IV or injection.

The table below shows the recommended dosage for children who receive Orencia by IV infusion.

Body weight Dose
Less than 75 kg 10 mg per kg of body weight
75 to 100 kg 750 mg
More than 100 kg 1,000 mg

The maximum dose of Orencia is 1,000.

“The Orencia dosage depends on your child’s weight. The table below shows the number of times a dose is given.”

Body weight Dose (once weekly)
10 kg to less than 25 kg 50 mg
25 kg to less than 50 kg 87.5 mg
50 kg or more 125 mg

If your child can receive Orencia injections at home, talk to their doctor.

2.2 pounds is the weight of one kilo.

Children’s dosage for preventing acute graft-versus-host disease

Orencia is given as an IV infusion for preventing acute (sudden) graft-versus-host disease in children ages 2 years and older.

The table shows the age of your child.

Age Dosage
6 years or older 10 mg per kg of body weight
2 years to less than 6 years 15 mg per kg of body weight for the first dose, then 12 mg per kg for the next doses

If your child is older than 6 and weighs 38 kilogram, they would receive a minimum of 380 million Orencia per injection.

Your child will have Orencia infusions on the day before their transplant and on days 5, 14, and 28 after it. Their doctor will also prescribe the drug methotrexate (Trexall) and a type of drug called a calcineurin inhibitor. These treatments might be started before Orencia treatment, and your child might continue to take them after their transplant.

Is Orencia used long term?

Orencia is a long-term treatment for arthritis. If you and your doctor determine that Orencia is safe and effective for you, you will likely use it for a long time.

You might only get Orencia for a month if you are having it to prevent the disease.

The section covers questions about Orencia.

How does dosing differ for an IV infusion and a subcutaneous injection of Orencia?

An intravenous (IV) infusion is an injection into a vein that’s given over time. If you receive Orencia by IV infusion, you’ll have each dose at your doctor’s office or an infusion center. Each infusion typically lasts about 30 minutes for arthritis treatment or about 60 minutes for preventing acute (sudden) graft-versus-host disease.

Your dosage of the infusion will depend on your body weight. For arthritis treatment, you’ll start with three infusions spaced 2 weeks apart, and after that you’ll have an infusion every 4 weeks. For graft-versus-host disease, you’ll have one infusion before your transplant and 3 more infusions afterward.

A subcutaneous injection is an injection under your skin. You might be able to give yourself Orencia injections at home using a prefilled syringe or the ClickJect autoinjector. The dosage for this form of the drug is 125 milligrams (mg) once per week.

The “What is Orencia\’s dosage?” section is where more details can be found.

What is a loading dose, and will I need one with Orencia?

A loading dose is a higher dose of a drug given at the beginning of treatment. The amount of the drug in your body is important to make sure that it can start treating your condition.

A loading dose of Orencia is only used in people with rheumatoid arthritis who want to receive the medication by subcutaneous injection. The loading dose will be based on your weight, and it’s given as a one-time IV infusion.

You can start a 125-mCi dose by injection once per week after this single loading dose. After receiving the loading dose, you should give yourself your first injection.

The Orencia you are prescribed may be affected by a number of factors. These include:

  • The type of condition you are using.
  • Your age.
  • your body weight
  • You are using the form of Orencia.

Orencia can be given in two different ways.

You and your doctor will discuss the best option for you.

If you’re given Orencia by IV infusion, you’ll receive the infusions at your doctor’s office or an infusion center. Each infusion typically takes 30 minutes for arthritis treatment or about 60 minutes if you’re receiving the drug for graft-versus-host disease.

If you receive Orencia by injection, you should talk to your doctor about self-injections. Your doctor will explain how to give you the injections, either with a prefilled syringe or the ClickJect autoinjector.

If you give yourself injections at home, you should change the injection sites. You can inject Orencia into certain areas.

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

It is important that you inject the full amount of Orencia. If you want to avoid giving injections, you should not.

“If you can’t make your appointment, call your doctor’s office or the infusion center to get a new one.”

“If you don’t know if you should give yourself a dose that you missed, call your doctor or the pharmacy.”

If you need help remembering to give yourself injections of Orencia on time, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

You should use less Orencia than your doctor prescribes. Doing so can cause serious side effects.

What to do in case you use too much Orencia

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

The drug manufacturer provides typical dosages. If your doctor recommends Orencia, they will prescribe the correct amount.

Remember, you shouldn’t change your dosage of Orencia without your doctor’s recommendation. Only use Orencia exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Some questions you may want to ask your doctor.

  • Can I switch from receiving Orencia through intravenous infusions to having subcutaneous injections?
  • Will my Orencia dose change if I change my weight?
  • How do I get myself a injection with the prefilled syringe or ClickJect?

If you have rheumatoid arthritis and want to stay informed about how to manage your condition, sign up for Healthline’s online newsletter. You can also read stories and advice from others in the Bezzy PsA and Bezzy RA communities.

Q:

Can children under 6 years receive Orencia by intravenous (IV) infusion?

Anonymous

A:

In some cases, yes. The Food and Drug Administration has approved Orencia IV infusions for children 2 to 6 years old to help prevent acute (sudden) graft-versus-host disease. (An IV infusion is an injection into a vein that’s given over a period of time.)

Clinical studies of Orencia infusions didn’t involve children younger than 6 years. But researchers have found that giving Orencia infusions for graft-versus-host disease prevention in children 2 to 6 years old is safe. This conclusion is based on models of how the drug works in the body and estimated dosing for children based on the recommendations for adults.

Orencia is also used to treat polyarticular juvenile idiopathic arthritis in children aged 2 years and older. It’s recommended that children younger than 6 years receive Orencia by subcutaneous injection (an injection under the skin) for this condition. But children 6 years and older can receive Orencia either by IV infusion or subcutaneous injection.

The “What is Orencia\’s dosage?” section above contains more information about the Orencia for children.

Talk to your doctor about the form of Orencia that is right for your child.

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.