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Humira pen versus syringe?

My daughter (10 years) just failed Remicade, unfortunately. She developed high antibodies and has to move to Humira. She's going to be really upset since she's anxious about something new and loved the Remicade.

I know they are the pediatric formula available now, which I'm grateful for. With the new formulation is the syringe still less painful than the pen? I assume her GI will prescribe the pen unless I request the syringe.

Any advice would be welcome. The pen looks like it is easier, but I want to minimize her pain as much as possible. Thanks!

my little penguin

Staff member
Pen makes a click noise which can cause kids issues
And can misfire if they move
Kiddo is in control
They say stop or start
Some like to put their thumb over yours to push the meds
It’s all about control
We did humira for over five years
And used the syringe
Ds is now on Stelara (also a syringe )

Good luck
Thank you, my little penguin. I just got off the phone with a Humira nurse and it turns out that her dose is only available in a syringe so no choice anyway. But glad for the reassurance about the syringes.

my little penguin

Staff member
Watch for kiddie dose 20 mg
Vs adult dose 40 mg
There is a weight max for the kiddie dose
Ds was 9 and barely under the max for kiddie dose
We waited two months and humira did nothing
Adult dose was needed
It’s just a weight thing
He was on adult dose from age 9-13
Good luck


Staff member
It depends on the kid honestly. I have heard most parents say that the pen hurts more since you can't control the injection speed. But that was a plus for one of my daughters and a minus for the other.

My older daughter used the pen initially, with the old formulation of Humira than BURNED. She hated the shots, but refused to use the syringe because she didn't want to see the needle. She also starting doing her own shots soon after starting Humira and the pen was easier.

When she was older, at 19-20, I read on here that the syringe hurt less and got her to try it. It was still the burning formula of Humira but she loved the difference! Said going slower made it hurt less.

My younger daughter also started with the old formulation of burning Humira. Started with the pen and did her own shots at 12 (almost 13). She tried the syringe later and hated it. Said if you inject slower, it still burns and it prolongs the burning. I was shocked at her response since I'd always heard the syringe was less painful.

But now I have seen a number of parents on juvenile arthritis facebook groups say that their kids LOVE the new citrate free shot. That it's incredible compared to the old burning kind. Plus, I have also seen parents there say that their kids actually prefer the pen - usually for the same reason, it's over quicker and it gives the child control by doing the shot themselves.

I've seen kids as young as 7 giving themselves their own Humira shots (with supervision). The pen is much easier, but my older daughter says the syringe is pretty easy too once she got used to it.

So based on my two girls, I'd say it is trial and error. Ask your daughter what she'd prefer. If seeing the needle would bother her.

Also, my girls had no issue with the click when you press the pen button - it's not that loud. They never even mentioned it. I've also never seen any JIA parent mention it so far, but it does make a clicking noise and I could imagine it might bother a kiddo with a sensory processing disorder, for example.

But it's not something we ever had any issues with.

**Edited to add - just read your second message and it sounds like she's on the pediatric dose which is only available in the syringe. How much does she weigh?


Staff member
Pediatric Crohn‟s Disease (2.4):
• 17 kg (37 lbs) to < 40 kg (88 lbs):
• Initial dose (Day 1): 80 mg
• Second dose two weeks later (Day 15): 40 mg
• Two weeks later (Day 29): Begin a maintenance dose of 20 mg
every other week.

• ≥ 40 kg (88 lbs):
• Initial dose (Day 1): 160 mg
• Second dose two weeks later (Day 15): 80 mg
• Two weeks later (Day 29): Begin a maintenance dose of 40 mg
every other week.
So if she's under 88 lbs, they probably have her on 20 mg every other week. She'll have a loading dose of 80 mg at day 1 and then 40 mg on day 15. They make an 80 mg injection now so you don't have to worry about her being given multiple injections (they used to make kids do two 40 mg shots on day 1).

For the adult loading dose, they used to do 4 40 mg pens for a total of 160 mg on day 1 - it was brutal with the old Humira that burned a LOT. Now thankfully, they use two 80 mg shots that don't burn.

Icing before the shot helped both my daughters a lot.

my little penguin

Staff member
(2 years of age and older) Dose
10 kg (22 lbs) to <15 kg (33 lbs) 10 mg every other week
(10 mg Prefilled Syringe)
15 kg (33 lbs) to <30 kg (66 lbs) 20 mg every other week
(20 mg Prefilled Syringe)
≥30 kg (66 lbs) 40 mg every other week
(HUMIRA Pen or 40 mg Prefilled Syringe)
This is for jia dosing not crohns

But it’s the weight limits listed on the box you receive of humira
Not sure why the crohns dosing was lower (requires more weight for same amount of drug )

But Ds followed the box weights in terms of his response
At 67-68 lbs - he needed 40 mg