Remicade

Generic Name: infliximab (in FLIX ih mab)
Brand Names: Remicade

What is infliximab?

Infliximab reduces the effects of a substance in the body that can cause inflammation.

Infliximab is used to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, Crohn's disease, and ankylosing spondylitis. Infliximab is also used to treat severe or disabling plaque psoriasis (raised, silvery flaking of the skin).

Infliximab is often used when other medicines have not been effective.

Infliximab may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about infliximab?

Before you start treatment with infliximab, your doctor may perform tests to make sure you do not have tuberculosis or other infections.

Serious and sometimes fatal infections may occur during treatment with infliximab. Contact your doctor right away if you have signs of infection such as: fever, chills, sore throat, flu symptoms, easy bruising or bleeding, pale skin, or unusual weakness.

Infliximab can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. It is important that you not miss any scheduled visits to your doctor.

Do not receive a "live" vaccine while you are being treated with infliximab.

Using infliximab may increase your risk of developing certain types of cancer such as lymphoma (cancer of the lymph nodes) or autoimmune disorders (such as a lupus-like syndrome). This risk may be greater in children and young adults. Talk to your doctor about your specific risk.

What should I discuss with my healthcare provider before using infliximab?

You should not use this medication if you have heart failure, or if you are also being treated with anakinra (Kineret).

Before using infliximab, tell your doctor if you are allergic to any drugs, or if you have:

an active or recent infection;
a history of tuberculosis;
hepatitis B;
congestive heart failure;
epilepsy or other seizure disorder;
chronic obstructive pulmonary disease (COPD);
a history of cancer; or
a disease that affects the nerves or muscles, such as multiple sclerosis, myasthenia gravis, Guillain-Barre syndrome.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use this medication.

FDA pregnancy category B. Infliximab is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether infliximab passes into breast milk. Do not use infliximab without first talking to your doctor if you are breast-feeding a baby. Infliximab is not for use in children younger than 6 years old.

Treatment with infliximab may increase your risk of certain types of cancer, such as breast, colon, skin cancer, or lymphoma (cancer of the lymph nodes). This risk may be greater in children and young adults. You may also develop an autoimmune disorder (such as a lupus-like syndrome). Talk with your doctor about your specific risk.

How should I use infliximab?

Before you start treatment with infliximab, your doctor may perform tests to make sure you do not have tuberculosis or other infections.

Infliximab is given as an injection through a needle placed into a vein. Your doctor, nurse, or other healthcare provider will give you this injection. This medicine is usually given at intervals of 2 to 8 weeks.

Infliximab must be injected slowly, over about 2 hours. Your doctor may wish to observe you after the injection to make sure the medicine has not caused any serious side effects.

You may be given instructions on how to use your injections at home. Do not use this medicine at home if you do not fully understand how to give the injection and properly dispose of needles and other items used in giving the medicine.

If you store infliximab at home, keep it in the refrigerator. Do not allow the medicine to freeze and do not use it beyond the expiration date.

What happens if I miss a dose?

Contact your doctor if you miss a dose of infliximab.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of infliximab is not expected to produce life-threatening symptoms.

What should I avoid while using infliximab?

Avoid contact with people who have colds, the flu, or other contagious illnesses. Contact your doctor immediately if you develop signs of infection.

Do not receive a "live" vaccine while you are being treated with infliximab.

Infliximab side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Serious and sometimes fatal infections may occur during treatment with infliximab. Contact your doctor right away if you have signs of infection such as:

fever, chills, sore throat, flu symptoms weight loss;
chest pain, ongoing cough, coughing up blood; or
easy bruising or bleeding, pale skin, unusual weakness.

Call your doctor at once if you have any of these other serious side effects:

feeling short of breath, even with mild exertion;
swelling of your ankles or feet;
red, purple, or scaly skin rash, hair loss, joint or muscle pain, mouth sores;
numbness or tingling;
weak feeling in your arms or legs; or
problems with vision;
seizure (convulsions);
pain or burning when you urinate; or
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

stuffy nose, sinus pain;
stomach pain;
mild skin rash; or
headache.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect infliximab?

There may be other drugs that can interact with infliximab. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about infliximab.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.