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Is it Possible to Decrease the Risk of an Allergic Reaction to Remicade?


Updated August 01, 2008

Question: Is it Possible to Decrease the Risk of an Allergic Reaction to Remicade?
Is it possible to develop an allergic or infusion reaction to Remicade at any time? Can a reaction occur in a patient who has been on Remicade for months or years? What can be done to minimize the risk of a reaction?

Allergic Reactions To Remicade

Antibodies to Remicade (infliximab) have been associated with immediate as well as delayed allergic reactions. These reactions most commonly occur during the third and fourth infusions and have ranged between:

  • mild urticaria (hives)
  • itching
  • low blood pressure
  • shock
  • Decreasing The Risk Of Adverse Reactions To Remicade

    Using Remicade (infliximab) intermittently (eg. treating flare ups of disease as opposed to regular infusions) has been associated with an increased incidence for development of antibodies to the drug, increasing the risk of reactions. The risk of antibody development and subsequent reactions is decreased by concomittant treatment with immunosuppressives such as:

  • steroids
  • methotrexate
  • azathioprine
  • In addition to combination therapy, the most effective method to help decrease the risk of a reaction is to slow the rate of infusion (intravenous or IV). It is recommended that the drug be infused over a two hour period, and in patients with severe reactions I infuse over four hours.

    Other measures that may help prevent reactions include pre-treatment with corticosteroids and antihistamines such as Allegra and Benadryl.

    Related Resources

  • Arthritis Medications - Test Your Knowledge
  • TNF Blockers (Enbrel, Remicade, Humira) - Test Your Knowledge
  • Biologic Response Modifiers
  • Answers provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle of TNF Blockers. The book is useful for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read our review of the book.

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