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Abatacept (Orencia)

Important information about abatacept:

Abatacept, also known by the brand name Orencia®, is a medicine that treats autoimmune conditions such as juvenile arthritis. It limits the autoimmune response by interfering with how some cells interact with each other. It may be taken alone or with another disease-modifying drug (DMARD). Learn more about abatacept.

It may take up to 3 months for your child's symptoms to improve. Not every child who takes abatacept will see improvement. If the medicine does not help your child, your provider will discuss other options.

Abatacept can be given as an intravenous (IV) infusion in the Day Medicine Unit or as an injection under the skin (SQ, subcutaneously) at home. Your healthcare provider will prescribe the medicine. It can be filled at a specialty pharmacy.

Side effects from abatacept are not common in children but may include:

  • Infusion reactions may occur

  • Increased risk of infection

  • Headache or nausea with infusion

  • Irritation at the injection site

  • Changes in blood cell counts like anemia, low white blood cell count, or low platelet count

  • If a patient has undiagnosed and untreated tuberculosis (TB) or hepatitis B, these diseases could reactivate.

Patient instructions:

  • Your child will need blood tests before starting abatacept. Labs will be drawn every 6 months while taking the medicine. If your child takes other medicines, they may need labs more frequently. Your child must have a recent negative tuberculosis test (PPD) before starting abatacept.

  • Tell your other healthcare providers that your child is taking abatacept. Your child should not receive any live vaccines while taking etanercept. Live vaccines include MMR, varicella and the nasal flu mist. Your child should receive the flu shot, which does not contain live virus. The COVID vaccine is also recommended. Talk to your provider about when and how often your child should get this vaccine. When possible, your child should avoid contact with people who are sick.

  • Your child may receive an IV infusion of abatacept in the Day Medicine Unit at CHOP.

    • Call to schedule your infusion at (267) 426-0762. Day Medicine is located on the 3rd floor of the Buerger Center for Advanced Pediatric Care.

    • The first three infusions are 2 weeks apart from each other. Infusions are then spaced to every 4 weeks. The schedule will be weeks 0, 2, 4, 8 and so on.

    • Each infusion takes about 30 minutes, though your time at CHOP may be longer.

  • Abatacept can also be given as an injection under the skin into fatty tissue (subcutaneously).

Follow the instructions for the type of abatacept injection prescribed: How to Take or Administer ORENCIA® | ORENCIA® (abatacept)

Instructions for storage and disposal:

  • Store abatacept in the refrigerator until the expiration date on the package. Do not freeze.

  • Keep the medicine in the original carton to protect it from light or damage.

  • Handle the medicine gently. Do not shake.

  • Contact your local refuse department to learn the rules for needle and syringe disposal in your area. We cannot accept used syringes in our office. More information about this can also be found at

Contact your CHOP healthcare team with questions, concerns or if your child:

  • Has a fever on the day the day they usually take abatacept. Your team will help you to determine when to take it next

  • Has a fever or illness and the primary care provider is unsure of what next steps to take

  • Feels very tired or weak for more than 1-2 days after taking a dose of this medicine

  • Bruises easily or develops frequent nosebleeds or bleeding gums

  • Has swelling or pain at an injection site that does not go away after 2-3 days

  • Has been given too much medicine

Call 911 if your child has signs of an allergic reaction such as swelling of the face, lips, tongue or throat; trouble breathing, wheezing or chest tightness. If you are concerned the reaction is related to abatacept, call your healthcare team after symptoms resolve to discuss a plan moving forward.

Orencia Patient Information


Reviewed on April 20, 2023, by Kirsten Spichiger, DNP, CRNP; Melissa A. Lerman, MD, PhD, MSCE; Hannah Gustafson, PharmD

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