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Remicade overview
BRAND NAMES:
Remicade
Generic Names:
Avsola
Inflectra
Ixifi
Renflexis
Zymfentra (this medication contains infliximab, but is injected subcutaneously, or under the skin, rather than by IV infusion)
Uses:
Remicade is used to treat:
Crohn’s disease
Ulcerative colitis
Rheumatoid arthritis
Ankylosing spondylitis
Psoriatic arthritis
Plaque psoriasis
Therapeutic Classes:
TNF blockers
Forms:
Injectable
How it’s taken:
By intravenous infusion (infusion into a vein)
What is Remicade used for?
Remicade is generally used after other treatments have not been effective. Remicade is often used along with other medications, and is FDA-approved to treat:
Crohn’s disease in adults and children 6 years and older
Ulcerative colitis in adults and children 6 years and older
Rheumatoid arthritis in adults (in combination with the medication methotrexate)
Ankylosing spondylitis in adults
Psoriatic arthritis in adults
Plaque psoriasis in adults
Key takeaways
Expert tips for using Remicade
Remicade contains the active ingredient infliximab and is used to treat various autoimmune conditions such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and others.
Before taking Remicade, make sure your healthcare provider knows your full medical history, any medical conditions you currently have, and all the medications you take.
Remicade is given by a healthcare provider by intravenous infusion (infusion into a vein) over a period of at least 2 hours.
There are potential serious side effects associated with this medication, so familiarize yourself with possible side effects and be alert to symptoms that may signal a serious side effect.
Keep all appointments for your infusions as well as follow-up appointments with your healthcare provider and appointments for bloodwork
What form(s) does Remicade come in
Single-dose vial
100 mg
What are common Remicade doses?
The dose varies by indication and weight:
Crohn’s disease (adults): 5 mg/kg by IV infusion at 0, 2, and 6 weeks. Then, 5 mg/kg is given every 8 weeks. For individuals who respond to treatment, but then stop responding, a higher dose of 10 mg/kg every 8 weeks may be required.
Crohn’s disease (pediatric patients 6 years and older): 5 mg/kg by IV infusion at 0, 2, and 6 weeks. Then, 5 mg/kg is given every 8 weeks.
Ulcerative colitis (adults): 5 mg/kg by IV infusion at 0, 2, and 6 weeks. Then, 5 mg/kg is given every 8 weeks.
Ulcerative colitis (pediatric patients 6 years and older): 5 mg/kg by IV infusion at 0, 2, and 6 weeks. Then, 5 mg/kg is given every 8 weeks.
Rheumatoid arthritis in combination with methotrexate: 3 mg/kg by IV infusion at 0, 2, and 6 weeks. Then, 3 mg/kg is given every 8 weeks. For patients who do not respond completely, a higher dose (of up to 10 mg/kg every 8 weeks) or more frequent dosing (as often as every 4 weeks) may be required, taking into consideration the higher risk of serious infections with higher doses or more frequent dosing.
Ankylosing spondylitis: 5 mg/kg by IV infusion at 0, 2, and 6 weeks. Then, 5 mg/kg is given every 6 weeks.
Psoriatic arthritis (with or without methotrexate): 5 mg/kg by IV infusion at 0, 2, and 6 weeks. Then, 5 mg/kg is given every 8 weeks.
Plaque psoriasis: 5 mg/kg by IV infusion at 0, 2, and 6 weeks. Then, 5 mg/kg is given every 8 weeks.
Common Remicade prescriptions
Remicade
100mg solution reconstituted
How to take Remicade
Before you take Remicade, your healthcare provider will test you to make sure you do not have an infection.
Your doctor will prescribe your dose and schedule. Keep all appointments. This medicine is given by infusion placed in a vein. This medicine must be given slowly, over a period of at least 2 hours. You will be watched closely after your infusion, to make sure you do not have any serious reactions.
A nurse or other health provider will give you this medicine.
Your doctor may also give you other medicines (including allergy medicine, fever medicine, steroid medicine) before or during your infusion.
Because Remicade affects your immune system, you can get infections more easily. Your doctor will monitor you closely and test you for infection. Keep all appointments.
If you have ever had hepatitis B, Remicade can cause the infection to become active or worsen. Your healthcare provider will order liver function tests while you take Remicade and for some time after you stop.
What to do if you miss a dose of Remicade
If you miss an appointment for your Remicade infusion, call your healthcare provider right away for instructions.
Remicade contraindications
This medicine is not right for everyone. You should not receive Remicade if you have ever had an allergic reaction to infliximab, murine (mouse) proteins, or any inactive ingredients in the medication.
People with moderate or severe heart failure should not receive Remicade doses of more than 5 mg/kg.
Remicade warnings
Before taking Remicade, tell your doctor about any medical conditions you have. Tell your doctor if you are pregnant or breastfeeding, or if you have liver disease, heart or blood vessel disease, a bleeding disorder, blood or bone marrow problems, cancer, diabetes, or any type of infection. Tell your doctor if you have a history of seizures, multiple sclerosis, Guillain-Barre syndrome or a similar nervous system disease, or frequent or serious infections (including tuberculosis or hepatitis B).
This medicine may cause the following problems:
Increased risk for infections, which may be life-threatening
Increased risk of certain cancers (including lymphoma, skin cancer, cervical cancer)
Liver problems (be alert to stomach pain, fatigue, dark urine, clay-colored stools, yellowing of the skin and whites of the eyes)
Infusion reaction (including rash, hives, fever, chills, chest pain, heart attack, stroke, changes in blood pressure, or heart rhythm problems)
New or worsening heart failure (symptoms may include shortness of breath, swollen legs/feet, and sudden weight gain)
Lupus-like syndrome (be alert to symptoms such as rash on the arms or cheeks, shortness of breath, chest pain, joint pain)
Nervous system problems (symptoms may include seizures, numbness, tingling, problems with vision, speech, or walking)
You will need to have a test for tuberculosis (TB) before you start receiving Remicade, as well as during treatment. Tell your doctor if you or anyone in your home has ever had a positive TB skin test or been exposed to TB.
This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
Remicade interactions
Tell your healthcare provider about any medications you take, including prescription and OTC drugs, vitamins, and supplements.
You should not take Remicade along with other biologics that treat the same medical conditions as Remicade, such as Kineret (anakinra), Orencia (abatacept), Enbrel (etanercept), or Actemra (tocilizumab).
Tell your doctor if you have recently received or are scheduled to receive a vaccine. You should not get a live vaccine while taking Remicade (such as MMR, varicella, rotavirus, or the nasal flu vaccine).
Some medicines may affect how infliximab works. Tell your doctor if you are using any of the following: cyclosporine, theophylline, or warfarin.
Tell your doctor if you have had light treatment (phototherapy) for psoriasis.
Remicade side effects
Serious side effects may occur. Contact your healthcare provider right away if you experience a serious side effect, or get emergency medical help if your symptoms feel dangerous or life-threatening.
If you have symptoms of an allergic reaction or infusion reaction, you should get emergency medical attention. Symptoms may include:
Hives
Difficulty breathing
Chest pain
Fever or chills
High or low blood pressure
Some people have a delayed allergic reaction, which may occur between 3 and 12 days after your infusion. Get medical help if you have any of the following symptoms:
Fever
Rash
Headache
Sore throat
Muscle pain
Joint pain
Difficulty swallowing
Facial and/or hand swelling
Serious side effects
Any type of rash, patches, or bumps on the skin
Chest pain
Irregular heartbeat
Pain in the arms, back, neck, jaw, or stomach
Swelling of the feet, ankles, lower legs, or abdomen
Sudden weight gain
Shortness of breath
Changes in vision
Sudden weakness of an arm or leg
Muscle or joint pain
Numbness and tingling
Confusion
Problems with thinking or walking
Dizziness and lightheadedness; balance problems
Sudden and severe headache
Seizures
Liver problems: appetite loss, dark urine, stomach pain, yellowing of the skin or whites of the eyes
Unusual bruising or prolonged bleeding; nosebleeds; blood in the stools or gums
Less serious side effects
Stomach problems like heartburn or nausea
Headache
Runny nose
Flushing
White patches in the mouth
Vaginal yeast infection
Sources:
Remicade, National Library of Medicine DailyMed (2022)
Infliximab injection, National Library of Medicine MedlinePlus (2021)
Remicade, Prescriber’s Digital Reference
Infliximab injection, Cleveland Clinic
Infliximab (Rx), Medscape
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