Infliximab, Injectable Solution

Other warnings

• Liver damage warning: Infliximab may harm your liver. Tell your doctor if you have symptoms of liver damage, such as:
  • yellowing of your skin or the whites of your eyes
  • dark-colored urine
  • pain on the right side of your stomach area
  • fever
  • extreme tiredness
• Lupus-like symptom risk: Lupus is a disease that affects your immune system. Symptoms may include chest pain that doesn’t go away, shortness of breath, joint pain, and a rash on your cheeks or arms that gets worse in the sun. You doctor may decide to stop infliximab if you develop these symptoms.
• Vaccine warning: Don’t receive a live vaccine while taking infliximab. Wait at least three months after stopping infliximab to receive a live vaccine. Examples of live vaccines include the nasal spray flu vaccine, the measles, mumps, and rubella vaccine, and the chickenpox or shingles vaccine. A live vaccine may not fully protect you from the disease while you’re taking this drug. If you’re under the age of 18 years, make sure all vaccinations are up to date before starting infliximab.
• Serious reactions after infusion warning. Serious reactions affecting your heart, heart rhythm, and blood vessels can occur within 24 hours of the start of each infusion of this drug. These reactions can include heart attack, which can be fatal. If you have symptoms such as dizziness, chest pain, or palpitations within 24 hours of your infusion, call your doctor right away.

Infliximab is a prescription drug. It’s available as an injectable solution.

Infliximab is available as the brand-name drugs Remicade, Inflectra, and Renflexis. (Inflectra and Renflexis are biosimilars.*) Infliximab is not available in a generic version.

Infliximab may be combined with methotrexate when being used to treat rheumatoid arthritis.

* A biosimilar is a type of biologic drug. Biologics are made from a biological source, such as living cells. A biosimilar is similar to a brand-name biologic drug, but it’s not an exact copy. (A generic drug, on the other hand, is an exact copy of a drug made from chemicals. Most drugs are made from chemicals.)

A biosimilar may be prescribed to treat some or all of the conditions the brand-name drug treats, and is expected to have the same effects on a patient. In this case, Inflectra and Renflexis are biosimilar versions of Remicade.

Why it’s used

Infliximab is used to treat:

• Crohn’s disease (when you haven’t responded to other drugs)
• ulcerative colitis (when you haven’t responded to other drugs)
• rheumatoid arthritis (used with methotrexate)
• ankylosing spondylitis
• psoriatic arthritis
• long-term and severe plaque psoriasis (used when you need to treat your whole body or when other treatments aren’t right for you)

How it works

This medication works by blocking the action of a protein in your body called tumor necrosis factor-alpha (TNF-alpha). TNF-alpha is made by your body’s immune system. People with certain conditions have too much TNF-alpha. This can cause the immune system to attack healthy parts of the body. Infliximab can block the damage caused by too much TNF-alpha.

Infliximab injectable solution does not cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that can occur with infliximab include:

• respiratory infections, such as sinus infections and sore throat
• headaches
• coughing
• stomach pain

Mild side effects may go away within a few days or a couple of weeks. Talk to your doctor or pharmacist if they’re more severe or don’t go way.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Heart failure. Symptoms may include:
  • trouble breathing
  • swelling of your ankles or feet
  • rapid weight gain
• Blood problems. Symptoms may include:
  • bruising or bleeding very easily
  • fever that does not go away
  • looking very pale
• Nervous system problems. Symptoms may include:
  • vision changes
  • weakness of your arms or legs
  • numbness or tingling of your body
  • seizures
• Allergic reactions/infusion reactions. May occur up to two hours after the infusion of infliximab. Symptoms may include:
  • skin rash
  • itching
  • hives
  • swelling of your face, lips, or tongue
  • fever or chills
  • problems breathing
  • chest pain
  • high or low blood pressure (dizzy or feeling faint)
• Delayed allergic reaction. Symptoms may include:
  • muscle or joint pain
  • fever
  • rash
  • headache
  • sore throat
  • swelling of face or hands
  • difficulty swallowing
• Psoriasis. Symptoms may include:
  • red, scaly patches or raised bumps on the skin
• Infection. Symptoms may include:
  • fever or chills
  • cough
  • sore throat
  • pain or trouble passing urine
  • feeling extremely tired
  • warm, red, or painful skin

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Infliximab injectable solution can interact with other medications, herbs, or vitamins you might be taking. Your healthcare provider will look out for interactions with your current medications. Always be sure to tell your doctor about all medications, herbs, or vitamins you’re taking.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you’re taking.

This drug comes with several warnings.

Allergy warning

Infliximab can cause a severe allergic reaction. This reaction can happen while you’re getting treatment or up to two hours after. Symptoms may include:

• hives (red, raised, itchy patches of skin)
• trouble breathing
• chest pain
• high or low blood pressure. Signs of low blood pressure include:
  • dizziness
  • feeling faint
  • trouble breathing
  • fever and chills

Sometimes infliximab can cause a delayed allergic reaction. Reactions may occur 3 to 12 days after receiving your injection. Tell your doctor right away if you have any of these signs of delayed allergic reaction:

• fever
• rash
• headache
• sore throat
• muscle or joint pain
• swelling of your face and hands
• trouble swallowing

Warnings for people with certain health conditions

For people with infections: Tell your doctor if you have any kind of infection, even if it’s small, such as an open cut or a sore that looks infected. Your body may have a harder time fighting off the infection while you’re taking infliximab.

For people with tuberculosis (TB): Infliximab affects your immune system and may make it easier for you to get TB. Your doctor may test you for TB before starting the drug.

For people with hepatitis B: If you carry the hepatitis B virus, it can become active while you use infliximab. If the virus becomes active again, you’ll need to stop taking the drug and treat the infection. Your doctor may do blood tests before you start treatment, during treatment, and for several months following treatment with infliximab.

For people with blood problems: Infliximab may affect your blood cells. Tell your doctor about any problems you have with your blood before you start taking infliximab.

For people with nervous system problems: Infliximab may make symptoms of some nervous system problems worse. Use it with caution if you have multiple sclerosis or Guillain-Barre syndrome.

For people with heart failure: This medication may make heart failure worse. Call your doctor right away if you get symptoms of worsening heart failure. Symptoms may include shortness of breath, swelling of your ankles or feet, and sudden weight gain. You’ll need to stop taking infliximab if your heart failure gets worse.

Warnings for other groups

For pregnant women: Infliximab is a pregnancy category B drug. That means two things:

1. Studies of the drug in pregnant animals have not shown risk to the fetus.
2. There aren’t enough studies done in pregnant women to show if the drug poses a risk to the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Infliximab should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Call your doctor if you become pregnant while taking this drug.

For women who are breastfeeding: It is unknown if this drug passes into breast milk. If infliximab is passed to your child through your breast milk, it could cause serious side effects.

You and your doctor may need to decide whether you’ll take infliximab or breastfeed.

For seniors: You may be at higher risk for a serious infection while taking infliximab if you’re over the age of 65 years.

For children: Infliximab hasn’t been shown to be safe and effective for Crohn’s disease or ulcerative colitis in people younger than 6 years.

The safety and effectiveness of infliximab for other conditions haven’t been established in people younger than 18 years.

Your doctor will determine a dosage that’s right for you based on your condition and weight. Your general health may affect your dosage. Tell your doctor about all health conditions you have before your doctor or nurse administers the drug to you. You’ll be given infliximab through a needle placed in a vein (IV or intravenous infusion) in your arm.

You’ll receive your second dose two weeks after your first dose. Doses may become even more spread out after that.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Infliximab is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all: If you don’t take infliximab, your condition may not improve and it may get worse.

If you stop taking it: Your condition may get worse if you stop taking infliximab.

If you take too much: Only a healthcare provider should prepare the medication and give it to you. Taking too much of the drug is unlikely. However, make sure to discuss your dose with your doctor at each visit.

What to do if you miss a dose: It’s important not to miss your dose. Call your doctor if you’re unable to keep your appointment.

How to tell if the drug is working: Your symptoms should get better. For Crohn’s disease and ulcerative colitis, you may have fewer symptom flare-ups. For arthritis, you may be able to move around and do tasks more easily.

Keep these considerations in mind if your doctor prescribes infliximab for you.

Travel

Traveling may affect your dosing schedule. Infliximab is given by a healthcare provider in a hospital or clinic setting. If you plan to travel, talk to your doctor about your travel plans and see if they’ll affect your dosing schedule.

Clinical tests and monitoring

Before and during your treatment with this drug, your doctor may do tests to monitor your health. These tests may include:

• Tuberculosis (TB) test: Your doctor may test you for TB before starting infliximab and check you closely for signs and symptoms while you take it.
• Hepatitis B virus infection test: Your doctor may do blood tests to check you for the hepatitis B virus before you start treatment and while you’re receiving infliximab. If you have the hepatitis B virus, your doctor will do blood tests during treatment and for several months following therapy.
• Other tests: These tests may include:
  • blood tests to check for infections
  • liver function tests

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.