Orencia Dosages: Your GoodRx Guide

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Biologic medications have become more popular in recent years. These medications can be helpful for a number of health conditions, especially autoimmune disorders. Biologics typically come as injectable medications. Some are administered by a healthcare professional at a clinic or in a hospital setting. But many can be self-injected at home.

Orencia (abatacept) is a biologic that's used to treat rheumatoid arthritis (RA), psoriatic arthritis (PsA), and polyarticular juvenile idiopathic arthritis (pJIA). It can also help prevent acute (sudden) graft-versus-host disease - a possible complication of stem cell transplants.

For most uses, Orencia can either be self-injected subcutaneously (beneath the skin) or given as an IV infusion by a healthcare professional. Below, we review typical Orencia dosages for adults and children, plus more information about the dosage forms that are available.

What's the typical Orencia dosage for adults?

Your Orencia dosage will depend on why you're taking the medication and whether you're prescribed the injection or the IV infusion. If you receive IV Orencia, your dosage will be based on your body weight.

Good to know: Subcutaneous Orencia should be stored in the fridge until you're ready for a dose. Take doses out of the fridge about 30 minutes before you inject them. This can help make the injections more comfortable.

Orencia dosage for rheumatoid arthritis

If you're taking Orencia for RA, you may have the option of self-injecting or having it administered as an IV infusion.

The typical adult subcutaneous Orencia dosage for RA is 125 mg injected once weekly. (This dosage is not determined by body weight.) Your prescriber also has the option to give you a one-time IV infusion (a "loading dose") the day before or after your first subcutaneous injection. A loading dose can help raise Orencia levels in your body faster.

The typical adult IV Orencia dosage for RA is 500 mg to 1,000 mg infused over 30 minutes. Your specific dosage will depend on your body weight. After your first infusion, you'll receive your next IV Orencia doses in 2 and then 4 weeks. After that, your infusions will be administered once every 4 weeks.

The recommended weight-based dosages for IV Orencia can be seen in the table below.

If you're switching from IV Orencia to subcutaneous Orencia, your prescriber will likely recommend taking your first subcutaneous dose on the day you would have received your next IV dose.

Orencia dosage for psoriatic arthritis

Similar to treating RA, you may have the option to receive Orencia as a subcutaneous injection or an IV infusion when treating PsA.

The typical adult subcutaneous Orencia dosage for PsA is 125 mg injected once weekly. (This dosage is not determined by body weight.) Unlike with RA treatment, loading doses are not needed or recommended for PsA treatment.

The typical adult IV Orencia dosage for PsA is 500 mg to 1,000 mg infused over 30 minutes. Your specific dosage will depend on your body weight, as shown in the table above. After your first infusion, you'll receive IV Orencia again in 2 and then 4 weeks. After that, your infusions will be administered once every 4 weeks.

Orencia dosage for acute graft-versus-host disease prevention

IV Orencia is the only version of the medication that's FDA approved to prevent acute graft-versus-host disease.

The typical adult Orencia dosage for acute graft-versus-host disease prevention is 10 mg per kilogram of body weight, infused over 60 minutes. The maximum dosage is 1,000 mg per infusion.

You'll receive a total of 4 infusions during treatment. The recommended Orencia infusion schedule for acute graft-versus-host disease prevention is:

• First infusion: the day before the transplant

• Second infusion: 5 days after the transplant

• Third infusion: 14 days (2 weeks) after the transplant

• Fourth infusion: 28 days (4 weeks) after the transplant

What's the typical Orencia dosage for children?

Similar to adults, Orencia dosages for children vary depending on why they're receiving the medication. Orencia is approved to treat PsA and pJIA, as well as to prevent acute graft-versus-host disease, in children age 2 years and older. It's not approved for the treatment of RA in people under age 18.

Pharmacist tip: If your child is receiving IV Orencia, bring something like a book or mobile device to entertain them during the infusion. Orencia infusions take 30 to 60 minutes to administer. And your child's care team may want to observe them for infusion reactions afterwards.

Orencia dosage for polyarticular juvenile idiopathic arthritis

If your child is between the ages of 2 and 5 years old, they will receive subcutaneous Orencia injections. If your child is 6 or older, they can receive either the subcutaneous injections or the IV infusions.

For children weighing less than 165 lbs (75 kg), the typical IV Orencia dosage for pJIA is 10 mg per kilogram of body weight, infused over 30 minutes. Children weighing 165 lbs or more should follow the standard adult weight-based dosages discussed above. Children shouldn't receive more than 1,000 mg per infusion.

After your child's first infusion, they'll receive IV Orencia again in 2 and then 4 weeks. After that, their infusions will be administered once every 4 weeks.

For children, the typical subcutaneous Orencia dosage for pJIA is based on body weight, as outlined below:

• Children weighing 22-55 lbs (10-25 kg): 50 mg once weekly

• Children weighing 55-110 lbs (25-50 kg): 87.5 mg once weekly

• Children weighing 110 lbs (50 kg) or more: 125 mg once weekly

Orencia dosage for psoriatic arthritis

Subcutaneous Orencia is approved to treat PsA in children age 2 years and older. The typical children's subcutaneous Orencia dosage for PsA is based on body weight, as outlined below:

• Children weighing 22-55 lbs (10-25 kg): 50 mg once weekly

• Children weighing 55-110 lbs (25-50 kg): 87.5 mg once weekly

• Children weighing 110 lbs (50 kg) or more: 125 mg once weekly

IV Orencia is not approved for the treatment of PsA in children.

Orencia dosage for acute graft-versus-host disease prevention

IV Orencia is the only version of the medication that's FDA approved to prevent acute graft-versus-host disease in children. Subcutaneous Orencia is not approved for this use.

For the first infusion, the typical Orencia dosage for acute graft-versus-host disease prevention in children ages 2 to 5 years old is 15 mg per kilogram of body weight, infused over 60 minutes. The typical dosage for subsequent infusions is 12 mg per kilogram of body weight, infused over 60 minutes.

The typical dosage for children age 6 and older is 10 mg per kilogram of body weight, infused over 60 minutes. The maximum dosage is 1,000 mg per infusion.

Your child will receive a total of 4 infusions during treatment. For children, the recommended Orencia infusion schedule for acute graft-versus-host disease prevention is:

• First infusion: the day before the transplant

• Second infusion: 5 days after the transplant

• Third infusion: 14 days (2 weeks) after the transplant

• Fourth infusion: 28 days (4 weeks) after the transplant

What are the different dosage forms of Orencia?

Orencia comes in a few different dosage forms, as shown in the table below.

If you're receiving IV Orencia, your healthcare team will manage the vials. IV Orencia isn't a medication that you'd fill and pick up from a pharmacy. If you're taking subcutaneous Orencia, you'll manage the prefilled syringes or autoinjectors at home. But you'll likely need to fill the medication through a specialty pharmacy.

Subcutaneous Orencia comes in a box of 4 syringes or autoinjectors (about a 1-month supply). Store the medication in its original box and in the fridge at between 36°F and 46°F. Don't freeze Orencia.

What happens if you miss a dose of Orencia?

If you miss a dose of Orencia, contact your prescriber as soon as you realize you missed it. They can help you get back on track. Missing doses can cause symptoms of RA, PsA, or pJIS to worsen or return. Or it could put you at risk of developing acute graft-versus-host disease (if that's why you're taking the medication).

There are tools available to help you remember to take your doses. For example, you can set up a calendar alert or use a medication reminder app on your smartphone to stay on track.

How to save on Orencia

There are ways to save on Orencia, which is only available as a reference ("brand-name") biologic. GoodRx can help you navigate between copay savings cards and patient assistance programs to save money on your prescription:

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $5 per month for Orencia using a savings card from the manufacturer.

• Save with a patient assistance program. If you're uninsured or underinsured and meet certain income requirements, you may be eligible for Orencia's patient assistance program, which offers the medication at no cost.

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