{"id":628101,"date":"2024-05-08T18:47:24","date_gmt":"2024-05-08T22:47:24","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=628101"},"modified":"2024-10-25T09:58:14","modified_gmt":"2024-10-25T13:58:14","slug":"remicade-for-ulcerative-colitis","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/remicade-for-ulcerative-colitis\/","title":{"rendered":"Remicade for ulcerative colitis: Dosage, efficacy &#038; more"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Frequent bloody diarrhea is one of the hallmark symptoms of <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/ulcerative-colitis-vs-crohns\/\"><span style=\"font-weight: 400;\">ulcerative colitis<\/span><\/a><span style=\"font-weight: 400;\">, an inflammatory disease of the colon or large intestine. When disease symptoms escalate to a moderate or severe degree, healthcare providers may prescribe strong medications to douse the flames of inflammation. One such drug is <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/remicade\/what-is\"><span style=\"font-weight: 400;\">Remicade<\/span><\/a><span style=\"font-weight: 400;\"> (infliximab), a monoclonal antibody that blocks the biochemical cascade that fuels this autoimmune disease. As an intravenous infusion given to both halt flare-ups and maintain disease remission, Remicade has powerful potential but also very real risks.&nbsp;&nbsp;<\/span><\/p>\n<h2 id=\"the-role-of-remicade-for-ulcerative-colitis\"><span style=\"font-weight: 400;\">The role of Remicade for ulcerative colitis<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Infliximab is an antibody that intercepts one of the key messengers of the immune system&rsquo;s signaling pathway. It blocks tumor necrosis factor-alpha (TNF-alpha), which can cause inflammation. Ulcerative <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/colitis-symptoms\"><span style=\"font-weight: 400;\">colitis<\/span><\/a><span style=\"font-weight: 400;\"> (UC) is marked by high levels of TNF-alpha in the intestinal wall, where it stokes more inflammation. Remicade can put a stop to it.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Like many diseases, including the other well-known inflammatory bowel disease, Crohn&rsquo;s disease, UC has <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1856208\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">varying severities<\/span><\/a><span style=\"font-weight: 400;\">. Mild UC is typified by fewer than four bloody stools per day and no systemic symptoms, like anemia, weight loss, or elevated inflammatory markers (measured with blood tests). When the disease is more severe, bloody diarrhea intensifies, and anemia and abdominal pain may occur. At worst, these elements can be more profound, causing weight loss, fever, or <\/span><a href=\"https:\/\/www.heart.org\/en\/health-topics\/arrhythmia\/about-arrhythmia\/tachycardia--fast-heart-rate\"><span style=\"font-weight: 400;\">tachycardia<\/span><\/a><span style=\"font-weight: 400;\"> (a heart rate above 100 beats per minute). Healthcare providers call upon Remicade for patient care if they fall into the moderate to severe categories.<\/span><\/p>\n<h2 id=\"benefits-of-remicade-for-ulcerative-colitis\"><span style=\"font-weight: 400;\">Benefits of Remicade for ulcerative colitis<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Stopping the daily impact of frequent diarrhea and pain is a welcome benefit of Remicade. At another level, UC control boosts one&rsquo;s overall health. With the immune system not using resources to fight a war on its own body, our systems can devote more proteins and energy to daily living. A <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6979320\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">meta-analysis<\/span><\/a><span style=\"font-weight: 400;\"> of clinical studies has demonstrated the drug&rsquo;s effectiveness in inducing remission from a UC flare.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As an intravenous (IV) infusion, Remicade requires a healthcare professional to place an IV catheter and administer the medication in a medical clinic. Some people like the fact that Remicade isn&rsquo;t a self-injection. But on the flip side, it may be inconvenient to go to a clinic or infusion center to get Remicade infusions on a regular basis.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/remicade-infusions\/\"><b>Remicade infusions: What to expect<\/b><\/a><\/p>\n<h2 id=\"remicade-dosages-for-ulcerative-colitis\"><span style=\"font-weight: 400;\">Remicade dosages for ulcerative colitis<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Dosages of Remicade are established for the induction and maintenance of disease remission. It is weight-based, and the dose can be increased if needed to maintain control. Alternatively, the interval between doses can be adjusted, becoming more frequent if needed. Here&rsquo;s the typical Remicade dosing schedule:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Induction dose<\/b><span style=\"font-weight: 400;\">: 5 mg\/kg of body weight intravenously and repeated to and six weeks from the initial dose<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Maintenance dose<\/b><span style=\"font-weight: 400;\">: 5 mg\/kg of body weight intravenously every eight weeks<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Maximum dose<\/b><span style=\"font-weight: 400;\">: 10 mg\/kg of body weight intravenously every four weeks<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">You can anticipate a <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5643264\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">response to Remicade<\/span><\/a><span style=\"font-weight: 400;\"> within weeks but may have some relief within days. It is your symptoms that help to guide decision-making about whether to increase the dose or not. In addition, inflammatory markers and drug levels can be monitored with blood tests, providing more feedback to the treating healthcare provider. Gastroenterologists are generally the specialists who have the ultimate responsibility for UC treatment.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It is worth noting that subcutaneous infliximab injections can be an option for maintenance treatment of ulcerative colitis. The subcutaneous infliximab product is called Zymfentra and can be administered easily with a pen injector device.<\/span><\/p>\n<h2 id=\"remicade-side-effects-warnings\"><span style=\"font-weight: 400;\">Remicade side effects &amp; warnings<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Remicade has a host of side effects patients should be aware of so they are well-informed to inform their healthcare provider as soon as possible.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Common side effects of Remicade include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mild infusion reactions<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea or abdominal pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rash or itching<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Joint pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fever<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fatigue<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Adverse effects of Remicade can be much more severe, though&mdash;severe enough for the Food and Drug Administration (FDA) to issue multiple <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/black-box-warning\/\"><span style=\"font-weight: 400;\">boxed warnings<\/span><\/a><span style=\"font-weight: 400;\"> about the drug and its TNF-alpha blocker brethren. Because the drug suppresses the immune system, the FDA warns specifically about the risk of serious infections, such as tuberculosis and fungal infections. A warning about cancer risk was also highlighted, based on lymphoma cases in children.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other serious side effects of Remicade include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hepatitis B reactivation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Anaphylactic allergic reactions<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe infusion reactions<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe skin rashes, such as Stevens-Johnson syndrome<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Congestive heart failure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver toxicity<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lung disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Autoimmune disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heart attack or stroke<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Because of its effect on the immune system, Remicade may cause problems when mixed with other therapeutics. Live virus vaccines must be avoided when using infliximab for fear of infection, and inactive vaccines may not be as effective. Some other immunosuppressants can be used carefully alongside Remicade if needed to control UC, but doing so may increase the risks of infection.<\/span><\/p>\n<h3 id=\"who-should-not-take-remicade-for-ulcerative-colitis\"><span style=\"font-weight: 400;\">Who should not take Remicade for ulcerative colitis?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Anyone with a history of serious allergic reactions to Remicade should not take it again. Depending on the dose used, moderate to severe congestive heart failure may be a contraindication as well.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Even if those contraindications do not apply, a patient&rsquo;s pretreatment evaluation may detect a reason to hold off on Remicade. Testing for latent infections with tuberculosis, hepatitis C, and hepatitis B is typical; any of these may require treatment first before getting on an immunosuppressant. A healthcare provider may also ensure their patients are immune to varicella, the virus that causes chickenpox and shingles.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Maternal use of Remicade during pregnancy or breastfeeding may be continued after weighing the benefits of UC control versus the possible risks on an individual basis and getting expert medical advice. In some cases, it may be worth reducing the dose in the third trimester or scheduling the last Remicade dose further away from the estimated delivery date. After exposure during pregnancy, infants can be considered immunosuppressed temporarily after birth due to lingering infliximab. Live vaccines are typically withheld in early infancy after exposure, according to the <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=a0a046c1-056d-45a9-bfd9-13b47c24f257\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">drug&rsquo;s labeling<\/span><\/a><span style=\"font-weight: 400;\">, but fortunately, most infant vaccines are not live versions.<\/span><\/p>\n<h2 id=\"remicade-vs-other-treatments-for-ulcerative-colitis\"><span style=\"font-weight: 400;\">Remicade vs. other treatments for ulcerative colitis<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Remicade is <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/remicade-alternatives\/\"><span style=\"font-weight: 400;\">not your only option<\/span><\/a><span style=\"font-weight: 400;\"> for UC treatment. Other TNF-alpha blockers, specifically <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-humira\/\"><span style=\"font-weight: 400;\">Humira<\/span><\/a><span style=\"font-weight: 400;\"> (adalimumab) and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/simponi\/what-is\"><span style=\"font-weight: 400;\">Simponi<\/span><\/a><span style=\"font-weight: 400;\"> (golimumab), are alternatives. They can be given by subcutaneous injection, so they can be self-administered at home. There have not been <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/remicade-vs-humira\/\"><span style=\"font-weight: 400;\">comparison<\/span><\/a><span style=\"font-weight: 400;\"> studies showing the superiority of any of these, so the choice of which to use may come down to cost and convenience, aside from the prescriber&rsquo;s recommendation.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Infliximab is such a complex molecule that when patent expiration allowed generic versions to be made and sold, competing companies aimed for an extremely similar molecule that had the same actions. These biosimilars effectively are the generic versions of Remicade, although slight molecular differences in structure exist. Most importantly, they have shown their similar action and can be more affordable.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Anti-TNF alpha agents are only one variety of biologics for UC. Entyvio (vedolizumab) blocks integrin, a different link in the chain of immune system signaling. It is more specific to the intestine, meaning it may not suppress other actions of the immune system as much. Interleukin is another immune system protein that can be inhibited. Stelara (ustekinumab) and Omvoh (mirikizumab) have this action. Choosing between these biologics and a TNF-alpha blocker may come down to what other autoimmune diseases, such as rheumatoid arthritis or psoriatic arthritis, are present and whether additional risk factors for infection exist.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Oral medications are other options for UC treatment. The so-called small molecule medications include <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/xeljanz\/what-is\"><span style=\"font-weight: 400;\">Xeljanz<\/span><\/a><span style=\"font-weight: 400;\"> (tofacitinib), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/rinvoq\/what-is\"><span style=\"font-weight: 400;\">Rinvoq<\/span><\/a><span style=\"font-weight: 400;\"> (upadacitinib), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/zeposia\"><span style=\"font-weight: 400;\">Zeposia<\/span><\/a><span style=\"font-weight: 400;\"> (ozanimod), and Velsipity (etrasimod). Oral glucocorticoids, like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/prednisone\/what-is\"><span style=\"font-weight: 400;\">prednisone<\/span><\/a><span style=\"font-weight: 400;\">, can be used to treat UC as well, and their IV versions can be substituted in some situations.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Remember that more options than these exist for treating milder forms of UC. Remicade and its alternatives are aimed at moderate to severe cases. TNF-alpha blockers and biologics, in general, can be classified under the umbrella drug category called <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/antirheumatics\"><span style=\"font-weight: 400;\">antirheumatics<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2 id=\"how-much-does-remicade-cost\"><span style=\"font-weight: 400;\">How much does Remicade cost?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Remicade&#8217;s disease-modifying and life-changing capability can be appealing despite its serious risks. The drug&rsquo;s price can be another deterrent, unfortunately. Depending on the dose, a single Remicade infusion can <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/remicade-without-insurance\/\"><span style=\"font-weight: 400;\">cost between $4,000 and $7,000<\/span><\/a><span style=\"font-weight: 400;\">. If this becomes a barrier to treatment, you can ask your healthcare provider about a lower-cost biosimilar to Remicade. You may even be able to lower the cost of more affordable biosimilars with a <\/span><a href=\"https:\/\/www.singlecare.com\/prescription-discount-card\"><span style=\"font-weight: 400;\">SingleCare prescription discount card<\/span><\/a><span style=\"font-weight: 400;\">. Such efforts can make a big difference in controlling ulcerative colitis.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Frequent bloody diarrhea is one of the hallmark symptoms of ulcerative colitis, an inflammatory disease of the colon or large intestine. When disease symptoms escalate to a moderate or severe degree, healthcare providers may prescribe strong medications to douse the flames of inflammation. One such drug is Remicade (infliximab), a monoclonal antibody that blocks the [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":628102,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[4343,16414],"coauthors":[20732],"class_list":["post-628101","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-brand-name-drugs","tag-digestive-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Remicade for ulcerative colitis: Dosage, efficacy &amp; more<\/title>\n<meta name=\"description\" content=\"Doctors may prescribe Remicade for ulcerative colitis in patients with severe cases of the inflammatory bowel disease.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.singlecare.com\/blog\/remicade-for-ulcerative-colitis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Remicade for ulcerative colitis: Dosage, efficacy &amp; 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