Infliximab

uses

What is infliximab used for?Infliximab is commonly used for the following inflammatory or immune conditions.Certain gut conditions, such as Crohn’s disease and ulcerative colitisCertain autoimmune conditions, such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitisPlaque psoriasisInfliximab may also be used for other conditions as determined by your health care provider.How does infliximab work (mechanism of action)?Tissue necrosis factor (TNF) is a natural chemical in your body that is involved in normal inflammatory and immune activity. In certain types of arthritis, gut conditions, and plaque psoriasis, you may have higher-than-normal TNF levels. Infliximab works by blocking some forms of TNF. By blocking TNF, infliximab may reduce inflammation and immune activity, to provide relief in these conditions.How is infliximab supplied (dosage forms)?Brands and other namesAvsolaInflectraIxifiRemicadeRenflexisZymfentraDosage forms and strengths120 mg/mL prefilled syringes or prefilled pensInfliximab is also available in injectable forms.How should I store infliximab?Infliximab should be stored in the carton, to protect it from light, in the refrigerator, between 36 F and 46 F (2 C and 8 C). If needed, such as when traveling, the medicine can be stored (protected from light) at room temperature, between 68 F and 77 F (20 C and 25 C) for up to 14 days. If stored at room temperature and not used within 14 days, infliximab should be thrown away. Once stored at room temperature, infliximab should not be put back in the refrigerator. Ask your pharmacist if you have any questions about how to store infliximab.

how to use

liquid that is injected into a blood vessel, liquid that is injected under the skin

drug interactions

Does infliximab interact with foods or drinks?There are no known interactions between infliximab and foods or drinks.It is unknown if drinking alcohol will affect infliximab.Does infliximab interact with other medicines (drug interactions)?Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.In particular, make sure that you discuss if you are using or have recently used any of the following before using infliximab.Azathioprine (Imuran, Azasan), which is a medicine used for rheumatoid arthritisMercaptopurine (Purinethol, Purixan), which is a medicine used for certain types of cancerCyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune systemAbatacept (Orencia), which is a medicine used for certain types of arthritisAnakinra (Kineret), which is a medicine used for rheumatoid arthritis and other conditionsWarfarin, which is a blood thinnerTheophylline (Elixophyllin, Theo-24), which is a medicine for asthma or certain other breathing problemsBacillus Calmette-Guerin (TICE BCG), which is a treatment for bladder cancerInfliximab may alter the blood levels of some other medicines. Tell your health care provider about all medicines that you take or have recently taken.This may not be a complete list of medicines that can interact with infliximab. Always check with your health care provider.

side effects

What are the most common side effects of infliximab?The most common side effects of infliximab are listed below. Side effects may vary based on your age, the reason you are using infliximab, or how you receive it. Tell your health care provider if you have any of these side effects that bother you.Infections (see below)Infusion-related reactions (see below)Bruising, swelling, pain, itching, or redness where the needle went inJoint painDiarrheaHigh blood pressureDizzinessBlood disorders (see below)HeadacheFlushingStomach painLiver damage (see below)Increased creatine phosphokinase (CPK) levelsThere may be other side effects of infliximab that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.What are the serious side effects of infliximab?While less common, the most serious side effects of infliximab are described below, along with what to do if they happen.Severe Allergic Reactions. Infliximab may cause allergic reactions, which can be serious. Some of these reactions can happen even days after your dose. Stop using infliximab and get help right away if you have any of the following symptoms of a serious allergic reaction.Breathing problems or wheezingRacing heartFever or general ill feelingSwollen lymph nodesSwelling of the hands, face, lips, mouth, tongue, or throatSore throat, trouble swallowing, or throat tightnessItching, skin rash, or pale red bumps on the skin called hivesNausea or vomitingDizziness, feeling lightheaded, or faintingStomach crampsJoint or muscle painHeadacheInfections. Infliximab can increase your risk of infections, including serious infections. Some of these infections can lead to death. Call your health care provider right away if you have an infection or any of the following symptoms.Burning or stinging when you pee Cough or coughing up bloodFever, sweats, chills, or muscle achesShortness of breathDiarrhea or stomach painWeight lossWarm, red, or painful skinCancer. A small number of people who used infliximab have developed cancer. Children, teenagers, and young adults may have an increased risk of developing cancer. People with severe conditions or who use infliximab for a long time may be at a higher risk of cancers, especially lymphomas. Let your health care provider know if you or your family has a history of cancer. Tell your health care provider about any new symptoms that you may get.Hepatitis B Virus Reactivation. If you have hepatitis B virus in your body or have had hepatitis B in the past, infliximab could make the virus active again. Keep all appointments for bloodwork before starting infliximab and during treatment. Call your health care provider right away if you have any of the following symptoms of hepatitis.Unusual tirednessYour skin or the whites of your eyes turning yellowish in color (also called jaundice)Nausea, vomiting, or loss of appetiteDark-colored peeFever or chillsPain in your sideStool (poop) that is clay-coloredRashNerve Damage. In rare cases, infliximab may damage the protective covering that surrounds the nerves (demyelinating disease). Before starting infliximab, tell your health care provider if you already have a demyelinating disease such as multiple sclerosis or optic neuritis, or if you have seizures. Once you have started using infliximab, tell your health care provider right away if you have any of the following symptoms.Changes in mental functionMuscle weaknessNumbness or tinglingPoor coordination or dizzinessTrouble walkingVision changes or vision lossSeizuresBlood Disorders. Infliximab can cause blood disorders, such as pancytopenia, hemolytic anemia, low platelet levels (thrombocytopenia), and low white blood cell levels (leukopenia or neutropenia). These can sometimes lead to death. Stop using infliximab and get help right away if you have any of the following symptoms of blood disorders.FeverShortness of breathPale or yellowish skinEasy bruising or bleedingFrequent infectionUnusual weakness or tirednessDizziness, lightheadedness, or feeling like you are about to pass outHeadacheFast or abnormal heartbeatHeart Failure. Infliximab may lead to or worsen heart failure, especially at higher doses. Tell your health care provider right away if you have any of the following symptoms of heart failure.Shortness of breath or trouble breathing, especially while lying downSwelling in your feet, ankles, or legsUnusually fast weight gainUnusual tirednessImmune System Reactions. Infliximab can cause inflammation of your liver, blood vessels, or lymph vessels and cause symptoms that look like a condition called lupus. Stop using infliximab and call your health care provider right away if you get any of the following symptoms.Rash (may get worse in the sun)Joint painFeverWeakness or unusual tirednessLiver Damage. Liver damage, also called hepatotoxicity, can happen when using infliximab. Call your health care provider right away if you have any of the following symptoms of liver damage.Nausea or vomitingStomach or belly painFeverWeakness or unusual tirednessItchingLoss of appetiteLight-colored poopDark-colored urine (pee)Your skin or the whites of your eyes turning yellowish in color (also called jaundice)Heart Attack and Stroke. Infliximab can increase your risk of a heart attack or stroke that can lead to death. Get emergency help if you have any of the following symptoms of a heart attack or stroke.Chest pain or pressureFast or abnormal heartbeatTrouble breathingPain in your back, jaw, throat, or armSweating, upset stomach, vomiting, or dizzinessSudden weakness on one side of your bodySudden and severe headacheSlurred speech or trouble understanding speechHeart Effects. Infliximab may increase your risk of certain effects on the heart, such as causing an abnormal heart rhythm (arrhythmia). Get medical help right away if you have chest or arm pain, a fast or irregular heartbeat, or if you feel your heartbeat more than usual.Infusion Reactions. Infliximab can cause reactions that can be serious when it is given to you. Your infusion may need to be slowed or stopped if you have these reactions. Tell your health care provider right away if you have any of the following symptoms when you get your infusion or within a few hours.  Fever or chillsJoint or muscle painRedness of your face and neckTrouble breathingChest painHives or itchingNausea or vomitingSkin Problems. Infliximab may cause or worsen a skin condition known as psoriasis. Tell your health care provider if you have any of the following symptoms of psoriasis.Red patches that may be scalyPus-filled bumps on your skin

overdose and misseddose

What should I do if I accidentally use too much infliximab?If you or someone else has used too much infliximab, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.What should I do if I miss a dose of infliximab?Infusions. Infliximab infusions are usually given by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving infliximab as scheduled. If you miss an appointment to get your infliximab dose, call to make another appointment as soon as possible. Prefilled Syringes or Pens. If you miss a dose, use it as soon as you remember. Your next injection will be  two weeks later. Do not use double or extra doses.Â

warnings and Precautions

Who should not use infliximab?Allergies to Ingredients. People who are allergic to any of the following should not use infliximab.InfliximabAvsolaInflectraRemicadeRenflexisZymfentraMouse proteinsAny of the ingredients in the specific product dispensedYour pharmacist can tell you all of the ingredients in the specific infliximab products they stock.Heart Failure. Some doses of infliximab should not be used if you have moderate to severe heart failure. What should I know about infliximab before using it?Do not use infliximab unless it has been prescribed to you by a health care provider. Use it as prescribed. Do not share infliximab with other people, even if they have the same condition as you. It may harm them.Keep infliximab out of the reach of children. Since this medicine should be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.People who are 65 or older can be at a greater risk of serious side effects from infliximab. Talk to your health care provider about your risks if you are in this age group.When you first start using infliximab, it is usually given as an intravenous (IV) infusion in a hospital or clinic. You may get medicines before infliximab to reduce the chance you will have side effects from the infusion. Some people, depending on why they are using infliximab, may be able to change to giving themselves an injection under their skin instead of the IV infusions. Talk to your health care provider if you have any concerns about infliximab. If you will inject this medicine under your skin, make sure that you or a caregiver understands how to properly prepare and use infliximab. Read and follow the “Instructions for Use” that come with your infliximab. Do not inject infliximab in the exact same spot every time. You should rotate where you give infliximab shots. Do not inject it in areas that are bruised, red, hard, or tender. If you have any questions, talk to your pharmacist or other health care provider.What should I tell my health care provider before using infliximab?Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if infliximab is right for you.In particular, make sure that you discuss any of the following.Vaccines. Talk with your health care provider about any vaccines that you may need. You should not receive certain vaccines right before or while using infliximab. Tell your health care provider about any vaccines you have recently received or have scheduled.Current and Past Health Conditions. Tell your health care provider if you have any of the following.Think you have an infection, are being treated for an infection, or get infections oftenOpen sores or cutsHave or had cancerHeart problems, including having or ever had heart failureNerve problems, including numbness, tingling, seizures, multiple sclerosis, Guillain-Barre syndrome, optic neuritis, or other conditionsDiabetesBlood disordersLiver problemsUsed phototherapy in the pastImmune system problemsChronic obstructive pulmonary disease (COPD)Tuberculosis, or close contact with someone who has itTraveled to or lived in areas where the risk of tuberculosis is highLive or lived in areas (such as the Ohio or Mississippi River valleys) where there is an increased risk of certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis)Have or had hepatitis BOther Medicines and Supplements. Infliximab may interact with other medicines and supplements. Before using infliximab, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.Pregnancy. It is not known if or how infliximab could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use infliximab while you are pregnant or trying to get pregnant. If you were using infliximab while you were pregnant, tell your baby’s health care provider before your baby gets any vaccines.Breastfeeding. Small amounts of infliximab pass into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use infliximab while breastfeeding.

about

Infliximab is medicine used for many inflammatory or immune problems, such as certain types of arthritis, gut conditions, and skin conditions. Common side effects include infections, headache, or stomach pain. Contact your health care provider right away if you develop a rash or notice any signs of an infection or increased bleeding or bruising.