Key takeaways

  • Orencia (abatacept) is a prescription drug with several uses, including treating certain kinds of arthritis in adults and some children.
  • Mild side effects of Orencia include headache, nausea, and dizziness. Serious side effects include serious infection and a possible risk of cancer.
  • Certain health factors, including a weakened immune system or a history of tuberculosis (TB), may raise your risk of side effects from Orencia. Before starting treatment, talk with your doctor about your health history.

Orencia is an injection that’s used to treat the following conditions:

It’s also used with certain other drugs to help prevent acute (sudden) graft-versus-host disease with hematopoietic stem cell transplantation. Orencia can be used in adults and some children for this purpose.

The active ingredient in Orencia is abatacept. This is a biologic medication, which means it’s made from parts of living organisms.

This article covers the common, mild, and serious side effects that Orencia can cause.

Orencia may cause mild or serious side effects in some people. The following lists contain some common side effects that could occur.

Common side effects of Orencia may vary depending on the condition it’s being used to treat.

In people prescribed Orencia for rheumatoid arthritis, common side effects can include:

For those receiving Orencia to help prevent acute graft-versus-host disease (aGVHD), common side effects may include:

These lists do not include all the possible side effects. If you have concerns about side effects of Orencia, talk with your doctor. They’ll only prescribe Orencia if they feel that the possible benefits outweigh your risk for side effects.

Orencia may cause mild side effects. These may include:

For more information about some of these side effects, see the “Side effects explained” section.

The list doesn’t include all the mild side effects that Orencia may cause. To learn about all the possible side effects of Orencia, see the drug’s prescribing information.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect during treatment with Orencia and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

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Serious side effects of Orencia are rare, but they can occur. These may include:

Note: Orencia’s role in the risk of cancer is not fully known.

For more information about some of these side effects, see the “Side effects explained” section.

Allergic reaction

For some people, Orencia can cause an allergic reaction. In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue your Orencia treatment.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Orencia, they may have you switch to a different treatment.

The following are answers to commonly asked questions about Orencia’s side effects. If you have other questions, talk with your doctor or pharmacist.

How do Orencia side effects differ when given by infusion vs. injection?

You may experience different side effects of Orencia depending on how you receive the drug.

Orencia can be given in two ways: by subcutaneous injection (an injection under the skin) or by intravenous (IV) infusion (an injection into a vein). An IV infusion is administered over time.

If you receive Orencia infusions, you’ll get your treatment at your doctor’s office. Orencia infusions last about 30 minutes each for arthritis treatment. For prevention of acute (sudden) graft-versus-host disease, infusions last about 60 minutes each.

Side effects are more common when Orencia is given by IV infusion than by subcutaneous injection. Infusion-related side effects generally occur within 1 hour of the start of the infusion and may include:

If you receive Orencia by subcutaneous injection, you or your caregiver will be trained on how to inject the medication. If you give yourself the injections, you can inject into your thigh or certain areas of your belly. A caregiver may inject into your upper arm.

Injection site reactions are more common when Orencia is given by subcutaneous injection than by infusion. These side effects can be mild to moderate and may include:

  • pain
  • swelling
  • skin discoloration
  • itching

Your doctor will talk with you about which form of Orencia best fits your needs.

Does Orencia cause hair loss?

No, Orencia shouldn’t cause hair loss. In studies of the drug, hair loss wasn’t a reported side effect. However, hair loss may happen in people with certain kinds of arthritis, including those that Orencia treats.

If you’re concerned about hair loss while taking Orencia, talk with your doctor. They may suggest testing to find the reason for it. They may also recommend ways to help reduce it.

Is depression a side effect of Orencia?

No, Orencia is not known to cause depression. This side effect wasn’t seen during studies of the drug. However, people with certain kinds of arthritis, including those that Orencia treats, may be at risk for depression.

If you think you have untreated depression or another mental health condition, talk with your doctor about your treatment options.

Could using Orencia make me gain weight?

No, Orencia doesn’t cause weight gain. This side effect wasn’t seen during studies of the drug.

In fact, nausea is a common side effect of Orencia, and it may reduce your appetite. This could lead to weight loss in some people.

If you have unexplained weight changes during your Orencia treatment that concern you, talk with your doctor. They may be able to recommend tips for maintaining a weight that’s healthy for you.

Does Orencia cause neurological side effects?

No, Orencia shouldn’t cause neurological (brain and nervous system) side effects. Neurological side effects weren’t seen in studies of Orencia.

During your Orencia treatment, call your doctor right away if you experience seizures, changes in vision or hearing, or feelings of numbness or weakness. Your doctor may order tests to find the cause.

Are there any long-term side effects of Orencia?

Orencia, like most medications, can cause short- or long-term side effects. Serious long-term side effects are rare but may include:

Note: Orencia’s role in the risk of cancer is not fully known.

Talk with your doctor if you’re concerned about long-term side effects of Orencia. And to learn more about those in this list, see the “Side effects explained” section.

In studies, children with polyarticular juvenile idiopathic arthritis who used Orencia were more likely to experience certain side effects than adults using the drug. These side effects included:

  • diarrhea
  • cough
  • fever
  • belly pain

Other side effects seen in children during studies were similar to those seen in adults. To learn more, see the sections above that describe the mild and serious side effects of Orencia.

Learn more about some of the side effects that Orencia may cause.

Infection

Taking Orencia might raise your risk of infection. This is because Orencia may make it harder for your immune system to protect against germs.

Infections seen with Orencia are usually mild. Examples include a sinus infection or the common cold. In rare cases, Orencia may cause a serious infection, such as sepsis or pneumonia.

Symptoms of an infection can include:

  • fever
  • fatigue
  • cough
  • skin changes (warmth, pain, or pus)

Note: Certain other infections are also possible if you’re receiving Orencia for graft-versus-host disease prevention. See the “Epstein-Barr virus and cytomegalovirus” section for details.

What might help

Let your doctor know if you have any symptoms of an infection. They may want to do tests to find out what kind of infection you have. They may also prescribe medication to treat it.

If necessary, your doctor may stop the Orencia treatment until your infection is gone. This is because Orencia may make serious infections harder to treat.

One way to help prevent getting an infection during your treatment is to avoid people who may be sick. Also, washing or sanitizing your hands often can help prevent the spread of infection.

You can help support your immune system and possibly lower your risk for infection by:

For other suggestions on preventing infection during your treatment, talk with your doctor.

Epstein-Barr virus and cytomegalovirus

If you’re receiving Orencia to help prevent acute graft-versus-host disease, certain serious viral infections are possible. Examples of these include cytomegalovirus and Epstein-Barr virus. If you’ve had either of these viruses in the past, Orencia can cause them to reactivate (cause symptoms). Symptoms may include:

What might help

For graft-versus-host disease prevention, your doctor will likely prescribe drugs for you to take with Orencia. These drugs are to help prevent cytomegalovirus and Epstein-Barr virus infections. Your doctor will also monitor you for signs of these and other infections.

Headache

A headache is one of the most common side effects of Orencia. In most cases, headaches caused by Orencia are mild.

What might help

If you get headaches from Orencia, there are several natural headache remedies you can try to help get rid of them. A few examples include:

  • drinking plenty of water each day
  • using a cold or warm compress
  • massaging the painful area

Over-the-counter pain relievers are another option. These include acetaminophen (Tylenol) or anti-inflammatory drugs such as ibuprofen (Motrin). If you’re not sure whether you can safely take over-the-counter pain relievers, talk with your doctor.

Possible risk of cancer

Orencia may affect how your cells function and grow, which could possibly lead to cancer. In rare cases, certain kinds of cancer were seen in people using Orencia in studies.

However, it’s not known if Orencia was the cause of cancer in people using this drug. And people who received a placebo (a treatment with no active drug) in these studies had similar rates of cancer as people using Orencia.

Symptoms of cancer can vary, depending on the area of your body that’s affected. They may include:

  • changes to your senses (vision or hearing problems, feelings of numbness)
  • headache
  • fatigue
  • lumps, growths, or other changes in the appearance of your skin
  • unexplained weight loss or gain

What might help

Talk with your doctor right away if you think you have symptoms of cancer. Also, keep up with your routine blood tests and preventive screenings (like mammograms and colonoscopies). If you develop cancer, your doctor will prescribe treatment for it. They’ll also discuss whether you should continue taking Orencia.

Orencia may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you use Orencia. Factors to consider include:

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.