Remicade

1 What is Remicade?

Brand: Remicade

Generic: Infliximab

Remicade is a monoclonal antibody drug approved to treat moderate to severe cases of Crohn’s disease, rheumatoid arthritis, ankylosing arthritis, psoriatic arthritis, ulcerative colitis and plaque psoriasis, especially in cases that did not respond to previous treatments. Doctors also use Infliximab as an off-label treatment for refractory Takayasu disease, a disease of the blood vessels.

A monoclonal antibody is a type of antibody manufactured in a laboratory. These monoclonal antibodies are extracted from hybrid cells made from immune system cells and an antigen. The parent immune system cells were made to have affinity or target a very specific antigen. Therefore, monoclonal antibodies target a specific antigen in the body to cure a disease.

In the case of Infliximab, the antigen is the tumor necrosis factor-alpha or TNF. TNF plays an important role in inflammation and disease process of conditions like many types of arthritis, psoriasis and inflammatory bowel diseases (Crohn’s disease and ulcerative colitis). Therefore, Infliximab works against these conditions, especially on cases that resisted previous therapies or treatments.

Infliximab is a medication that is infused in your veins, so you can only have it in the hospital. Infliximab is a prescription medication.

2 What to Know Before Using

If you are about to start Remicade, speak with your doctor about what you need to know.

The doctor will consider the following before treating you with Remicade:

Infliximab is commonly used for disease cases that resisted previous treatments. You can only have Infliximab treatment if your condition did not improve with past treatments.

You must first tell your doctor all your allergies if any. That includes allergies to food, medications, animal products and preservatives.

Infliximab can be used in patients older than 6 years of age. The safety of Infliximab on populations below 6 years old is not yet known.

Elderly patients can use Infliximab. However, they must be carefully monitored because they have weaker immune systems that can put them at risk for infections.

Tell your doctor if you are pregnant or nursing a baby before using Infliximab. Infliximab is an FDA pregnancy category B drug. Consider stopping breastfeeding before having Infliximab treatment.

Infliximab is known to interact with several medicines, which can adversely affect its effect on the body or cause side effects. Make sure your doctor know all the medicines you take before using Infliximab.

In case the medications you take are very essential, the doctor may have to change doses or schedule when can you take them. Here are these medications:

  • Abatacept
  • Adenovirus Vaccine Type 4, Live
  • Adenovirus Vaccine Type 7, Live
  • Anakinra
  • Bacillus of Calmette and Guerin
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Cyclosporine
  • Fosphenytoin
  • Influenza Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Paclitaxel
  • Phenytoin
  • Poliovirus Vaccine, Live
  • Quinidine
  • Rilonacept
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Sirolimus
  • Smallpox Vaccine
  • Tacrolimus
  • Tocilizumab
  • Typhoid Vaccine
  • Varicella Virus Vaccine
  • Warfarin
  • Yellow Fever Vaccine

You may need to tell the doctor if you use tobacco or alcohol before having Infliximab treatment. Abusing alcohol or tobacco may affect your immune system or worsen symptoms of the disease you have. If you have problems controlling or stopping the abuse of these substances, call your doctor.

Before having Infliximab, you have to tell your doctor if you have other health conditions. Some health problems may worsen with Infliximab or cause additional side effects.

Remicade must be used with caution in the following health conditions:

3 Proper Usage

To use Remicade properly, you must follow all instructions given by your doctor. Remicade comes with a medication guide. Read and understand the guide first before using Remicade. Ask your doctor if you have questions.

The doctor bases Remicade dose on your body weight, and your health problem. Infliximab is a medication infused into your veins so the doctor or nurse will prepare and give the medication to you.

Remicade is usually infused in a schedule, at week 0, week 2 and week 6, and then every 4 weeks, 6 weeks or 8 weeks.

Infliximab treatment may be done concurrently with medicines such as methotrexate. The doctor may also give you medicines like antihistamines, acetaminophen or steroids first before giving Infliximab to reduce the incidence of adverse reactions. However, Infliximab must be infused alone and must not be mixed with other medications.

Infliximab must be infused over at least 2 hours. The doctor might slow down or stop infusion if you experienced adverse reactions (itching, difficulty breathing, rash, hives, fever, chills, dizziness, headache, etc.).

4 Precautions to Take

Before using Remicade, there are some precautions you must take. You need to see your doctor on a regular basis when having Remicade treatment. You may have to undergo physical examinations, blood and urine tests to make sure that the medication works and to check for early signs and symptoms of side effects.

Note that Infliximab may cause reaction during and after infusion. If you experience symptoms such as rash, hives, dizziness, lightheadedness, headache, fever, chills, difficulty swallowing or breathing, swelling of the tongue, face and mouth, call your nurse or doctor.

Infliximab treatment can lower your resistance to infections. Infections can cause serious effects on your condition. Wash hands frequently and avoiding large crowds of people can help. Call your doctor immediately if you experience fever, chills, sore throat, flu symptoms and weakness.

Infliximab may cause a serious side effect that causes inflammation in the liver (autoimmune hepatitis ) or cause symptoms similar to lupus. If you `have dark urine, fever, chills, feeling ill, weakness, joint pain, light-colored stools, pain in the upper right abdomen and yellowing of the eyes and skin, call your doctor immediately.

Although rare, Infliximab treatment is known to cause certain cancers especially in patients that have COPD, emphysema, those who smoked and psoriasis patients that underwent phototherapy treatment for long periods.

Teenage and young adult patients with Crohn’s disease and ulcerative colitis may develop a rare type of cancer called hepatosplenic T-cell lymphoma. Infliximab may also increase your risk of having certain skin cancers like melanoma and Merkel cell carcinoma.

Talk to your doctor about these risks before starting Infliximab treatment. Call your doctor if you have unusual bleeding or bruising, weakness, swollen lymph nodes, unexplained weight loss, the formation of red scaly patches and raised bumps on the skin.

Infliximab may cause changes in your immune system during treatment. This may cause a problem when you take live vaccines. Do not take live vaccines while having Infliximab treatment. If you are pregnant, tell the doctor you are having Infliximab because vaccines are often given to expecting mothers. Make sure the child completes his or her vaccines before having Infliximab treatment.

Patients taking Infliximab are more susceptible to tuberculosis infection, which can cause additional complications during treatment. You must have a tuberculosis skin test before starting Infliximab treatment. It is a very simple skin test accurate in determining if the patient has been exposed to tuberculosis bacteria or has an active infection.

The doctor may recommend close family members to get tested as well. Call your doctor if anyone in the family has tuberculosis.

Infliximab may cause adverse effects on the heart. Call your doctor if you experienced symptoms such as shortness of breath, swelling of the ankles, feet, and sudden weight gain.

Do not take any other medicine while having Infliximab treatment without doctor’s supervision.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Remicade. Remicade may cause the following side effects.

Call your doctor if you experienced these symptoms:

  • Pain in the abdomen
  • Chest pain
  • Chills
  • Cough
  • Dizziness
  • Lightheadedness or fainting
  • Fever
  • Headache
  • Hives or itching
  • Muscle pain
  • A runny nose or nasal congestion
  • Nausea
  • Sneezing
  • Sore throat
  • Tightness in the chest
  • Breathing difficulties
  • Unexplained fatigue or weakness
  • Vomiting
  • Back pain
  • Pink or cloudy urine
  • Cracks in the corners of the mouth
  • Diarrhea
  • Painful urination
  • Urgency to urinate
  • Pain
  • Pain or tenderness around the eyes and face
  • Rash
  • Soreness or irritation in the mouth or tongue
  • Soreness or redness around the fingernails and toenails
  • White patches in the mouth
  • Burning, itching or discharge in the vagina
  • Abscesses, or swollen, red and tender areas with pus
  • Back or side pain
  • Constipation
  • Black, tarry stools
  • Feeling of fullness
  • General feeling of illness
  • Having a hernia or bulge in the abdomen
  • Irregular or pounding heartbeat
  • Pain in the rectum
  • Pain in the abdomen or stomach spreading to the left shoulder
  • Pinpoint red spots on the skin
  • Severe stomach pain
  • Tendon injury
  • Unusual bleeding or bruising
  • Weight loss
  • Yellowing of skin and eyes
  • Blood in the nose
  • Burning, tingling or numbness in the hands, arms, feet or legs
  • Changes in consciousness
  • Light- or clay-colored stools
  • Frequent vomiting
  • Convulsions
  • Dark urine
  • Difficulty speaking and swallowing
  • Fast heartbeat
  • Heavier menses
  • Hoarseness of voice
  • Inability to move the arms and legs
  • Itching, puffiness or swelling of the face
  • Loss of appetite
  • Losing control of bladder
  • Muscle spasm or jerking
  • Noisy breathing
  • Painless swelling in the neck, armpits or groin
  • Pale skin
  • Red, scaling or crusted skin
  • Seizures
  • Sensation of pins and needles
  • Severe abdominal pain
  • Severe muscle weakness or numbness, especially if it is sudden or progressing
  • Slow and irregular breathing
  • Unpleasant odor of breath
  • Upper abdominal or stomach pain
  • Vomiting of blood or material that looks like coffee grounds
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