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Remicade (infliximab) - What You Need to Know

Second TNF Blocker Approved by FDA

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Updated March 26, 2014

Remicade (infliximab) - What You Need to Know Photo by Bonnie Jacobs (iStockphoto)

Remicade Is TNF Blocker:

Remicade (infliximab) is a biologic response modifier, specifically a monoclonal antibody which binds to and blocks tumor necrosis factor alpha (TNF-alpha). Tumor necrosis factor (TNF) alpha is a cytokine involved in the inflammatory process.Excess TNF-alpha has been blamed for inflammation and joint damage characteristic of rheumatoid arthritis and other forms of inflammatory arthritis.

Drugs Similar to Remicade:

Enbrel (etanercept) was the first anti-TNF drug approved by the FDA for rheumatoid arthritis and certain inflammatory types of arthritis in 1998. Remicade (infliximab) was the second TNF inhibitor to be approved by the FDA in 1999. Humira (adalimumab) was approved in 2002. Simponi (golimumab) was approved by the FDA on April 24, 2009.  Cimzia (certolizumab pegol) was FDA-approved on May 14, 2009.

Remicade uses human and mouse proteins to create a chimeric monoclonal antibody. Enbrel is derived by introducing human DNA into Chinese hamster ovary cells and creating a genetically engineered protein. Humira uses fully human proteins and phage display technology to produce monoclonal antibodies.

Administration of Remicade:

Remicade is administered as an intravenous infusion (I.V.). Usually a nurse administers the I.V. which takes about 1-2 hours to infuse. Remicade must be ordered by your doctor and requires insurance pre-authorization.

Indications for Remicade:

Remicade is approved alone or in combination with methotrexate to treat moderate to severe rheumatoid arthritis. Remicade is also approved for the treatment of active psoriatic arthritis.

Other conditions which have benefited from Remicade infusions include:

Recommended Dose of Remicade:

For the treatment of rheumatoid arthritis, the recommended dose of Remicade is 3 mg/kg. The initial dose of Remicade is followed by subsequent doses at two and six weeks. A maintenance dose of 3 mg/kg is infused every 8 weeks. Some patients who do not respond well with this regimen may shorten the interval between Remicade infusions or increase the dose. It is recommended that methotrexate be taken in combination with Remicade. The combination is effective, while minimizing side effects.

Special Concerns or Contraindications for Remicade:

Remicade is contraindicated in pregnant or nursing women. Remicade should not be given to people with a history of serious infection or people with uncontrolled diabetes. Remicade should not be given to patients with with moderate to severe congestive heart faiure. Also, a tuberculin skin test must precede treatment with Remicade.

Some patients can develop autoantibodies following treatment with Remicade. The autoantibodies can develop into a lupus-like condition, but it is rare.

Common Side Effects Associated with Remicade:

Common side effects associated with Remicade include:

  • upper respiratory infections
  • urinary tract infections
  • headache
  • nausea
  • cough
  • diarrhea
  • weakness
  • fever
  • back pain
  • skin conditions
  • infusion site reactions

Serious Adverse Reactions Associated With Remicade:

Discontinuation of Remicade:

If Remicade is discontinued and later re-started, there is a chance of allergic reaction. Following re-treatment with Remicade, some of the allergic reactions may be serious.

Sources:

Arthritis Without Pain, Scott J. Zashin, M.D., 2004

Arthritis - A Cleveland Clinic Guide, John D. Clough, M.D., 2006

The Pill Book, 10th Edition

Remicade - Patient Information Leaflet

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