To be honest I would be very careful taking this drug if you suffer from chest infections, or infections as a rule. I say this because there has been fatalities in trials for people taking DMD’s and this, and one of the drugs is plaquenil that was used in the trials - hydroxychloroquine (plaquenil). Not sure which DMD’s were implicated in the fatalities but would be wanting to read the research paper first before I considered it. But that’s just me as I am more cautious when it comes to medications because I have had some serious adverse reactions to medications in the past.
What is also interesting is that musculoskeletal pain is a common side effect, yet you are being prescribed this to lessen it? I have attached the full presribing information for you, but have copies and pasted some information that is of importance.
Do you take high strength fish oil? If you don’t and are not on blood thinning medications, consider taking high strength (no less than 1gram EPA content) of fish oil. Fish oil is broken into EPA/DHA. The EPA side is what is needed to be 1 gram or more to reduce inflammation. I would be more inclined to take fish oil for a good 8 weeks at a high dose (always read the bottle for content as most claim high strength and are far from it. Usually liquid fish oil is better) and see how your inflammation is then before trying a fairly new drug that has some pretty serious adverse reactions, especially if already on DMD (disease modifying drugs).
Infections. Serious infections, including sepsis and pneumonia, have been reported in patients receiving Orencia.
Some of these infections have been fatal. Many of the serious infections have occurred in patients on concomitant immunosuppressive therapy which in addition to their underlying disease, could further predispose them to infections. Doctors should exercise caution when considering the use of Orencia in patients with: a history of recurrent infections; underlying conditions which may predispose them to infections; or chronic, latent or localised infections.
Patients who develop a new infection while undergoing treatment with Orencia should be monitored closely. Administration of Orencia should be discontinued if a patient develops a serious infection. A higher rate of serious infections has been observed in adult RA patients treated with concurrent TNF blocking agents and Orencia.
In placebo controlled clinical studies in adults, of 1955 Orencia patients and 989 placebo patients, two cases of tuberculosis were reported, one each in the Orencia and placebo groups.
When treating patients with therapies that modulate the immune system, it is appropriate to screen for tuberculosis infections, as was the case with patients in these clinical trials. Orencia has not been studied in patients with a positive tuberculosis screen, and the safety of Orencia in individuals with latent tuberculosis is unknown. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy with Orencia.
Antirheumatic therapies have been associated with hepatitis B reactivation. Therefore, screening for viral hepatitis should be performed in accordance with published guidelines before starting therapy with Orencia.
Interactions: Formal drug interaction studies have not been conducted with Orencia.
The majority of patients in the RA placebo controlled clinical trials received concomitant DMARDs, NSAIDs and/or corticosteroids. Most patients were taking MTX. Other less frequently used concomitant DMARDs included chloroquine/ hydroxychloroquine, sulfasalazine and leflunomide. There is limited experience with abatacept in combination with other DMARDs such as azathioprine, gold and anakinra. Population pharmacokinetic analyses revealed that MTX, NSAIDs, corticosteroids and TNF blocking agents did not influence abatacept clearance (see Pharmacology, Pharmacokinetics).
Concurrent administration of a TNF blocking agent with Orencia has been associated with an increased risk of serious infections.Concurrent therapy with Orencia and TNF blocking agents is not recommended. There is insufficient experience to assess the safety and efficacy of Orencia administered concurrently with anakinra or rituximab, and therefore, such use is not recommended.
Orencia has not been studied in combination with agents which deplete lymphocyte count. Such combination therapy could potentiate the effects of Orencia on the immune system.