- Crohn’s disease in adults and some children
- ulcerative colitis in adults and some children
- psoriatic arthritis in adults
- plaque psoriasis in adults
- rheumatoid arthritis in adults taking methotrexate
- ankylosing spondylitis in adults
To learn more about these conditions and how Remicade is used for them, see the “What is Remicade used for?” section below.
Remicade comes as a solution. You’ll receive it from a healthcare professional as an injection directly into your vein that’s given over a period of time. This is known as an intravenous infusion.
Infliximab is classified as a biologic, which means it’s made from parts of living organisms. It comes in several biosimilar forms. Biosimilars are like generic drugs. Unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.
The biosimilar forms of Remicade include:
- infliximab-axxq (Avsola)
- infliximab-dyyb (Inflectra)
- infliximab (Renflexis)
Read on to learn about Remicade’s uses, side effects, and more.
As with most drugs, Remicade may cause mild or serious side effects. The lists below describe some of the more common side effects that Remicade may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you may have
- other medications you may be taking
Your doctor or pharmacist can tell you more about the potential side effects of Remicade. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a short list of some of the mild side effects that Remicade can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Remicade’s medication guide.
Mild side effects of Remicade that have been reported include:
* For more information on this side effect, see the “Side effect focus” section below.
Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Remicade can occur, but they aren’t common. If you have serious side effects from Remicade, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Remicade that have been reported include:
- infusion-related reactions, such as trouble breathing, skin discoloration or warming, headache, and rash
- liver problems, such as cholestasis (a condition that lowers or blocks the flow of bile from the liver) and liver failure
- heart failure
- heart attack
- nervous system conditions, such as seizures and multiple sclerosis
- lupus-like syndrome, a disorder that causes symptoms similar to lupus, an autoimmune disease*
- reactivation of hepatitis B virus or tuberculosis
- sarcoidosis, a disease that causes inflammation in some of your body organs
- boxed warnings:†
- serious infections, including tuberculosis, bacterial infections (which can cause a severe complication called sepsis), and fungal infections
- allergic reaction†
* Autoimmune diseases cause your immune system to attack your own body.
† For more information on this side effect, see the “Side effect focus” section below.
Side effect focus
Learn more about some of the side effects Remicade may cause.
Remicade has boxed warnings. A
Serious infections. Remicade may increase your risk for serious infections. Examples include tuberculosis (TB), fungal infections, and bacterial infections. A severe complication called sepsis can result from bacterial infections.
Cancer. There have been reports of people who received Remicade developing a certain type of cancer called lymphoma. This cancer affects the lymphatic system. Other types of cancer have also been reported in people using Remicade. Cancers have occurred more often in children than in adults using Remicade.
A rare form of lymphoma called hepatosplenic T-cell lymphoma (HSTCL) may also occur. This type of lymphoma can be fatal. It occurred in people using Remicade with other drugs that lower immune system activity, including azathioprine (Imuran) and 6-mercaptopurine (Purinethol). It was reported that most people who developed HSTCL were male* children or young adults with Crohn’s disease or ulcerative colitis.
* In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
What might help
Before starting Remicade treatment, your doctor may give you a TB test to check for latent TB. With latent TB, you have the TB bacteria in your body, but it’s not making you ill.
If you test positive for latent TB, your doctor may prescribe treatment for this infection. You’ll have to complete this treatment before you start using Remicade. Your doctor will also regularly check you for TB while you’re using Remicade.
If you get a serious infection during Remicade treatment, your doctor may tell you to stop using the drug.
If you have Crohn’s disease or ulcerative colitis, your doctor will weigh the benefits and risks of using Remicade. They may also be cautious about prescribing Remicade if you’re taking 6-mercaptopurine or azathioprine.
Joint pain is a side effect of using Remicade. But it can also be a symptom of an allergic reaction, hepatitis B virus reactivation, or lupus-like syndrome (a disorder that causes symptoms similar to lupus). And these are all possible side effects of the drug.
What might help
If you have joint pain while using Remicade, talk with your doctor immediately. They’ll make note of your symptoms to see if your joint pain might result from a more serious side effect.
You may be able to take an over-the-counter pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil). But talk with your doctor before taking any other medication with Remicade. They must first make sure that your joint pain isn’t a symptom of a more serious side effect.
Long-term side effects
Also keep in mind that Remicade lowers immune system activity. If your immune system is suppressed for a long time, you might develop certain autoimmune diseases.
Autoimmune diseases cause your immune system to attack your own body. Examples include certain demyelinating diseases, such as multiple sclerosis and Guillain-Barré syndrome, which affect the protective layer of cells surrounding your nerves. Another example is lupus-like syndrome, a disorder that causes symptoms similar to lupus.
Alopecia, a condition that causes hair loss, is another possible long-term effect of Remicade. People with alopecia may lose the hair on their scalp, face, and other areas of the body.
What might help
If you need to use Remicade long term, your doctor will test you for serious infections. They will continue to do so throughout treatment.
Examples of infections include hepatitis B and tuberculosis. And you may have other infections while using Remicade. Talk with your doctor immediately if you develop symptoms of infection, such as fever, cough, or flu-like symptoms.
Before you start Remicade treatment, your doctor will ask about your medical history. Tell your doctor if you’ve had any type of cancer. Your doctor will let you know if the benefits of using Remicade outweigh your risks for developing cancer. If you develop cancer while using Remicade, your doctor may adjust or stop your medication.
If you have hair loss while receiving Remicade, stopping the medication may decrease this side effect. But do not stop using Remicade if you develop long-term side effects. Talk with your doctor if the side effects become bothersome. They may be able to suggest treatments to decrease the side effects.
Some people may have an allergic reaction to Remicade.
Symptoms of a mild allergic reaction can include:
- skin rash
- flushing (temporary warmth, redness, or deepening of skin color)
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
People who are allergic to Remicade may also develop serum sickness. Symptoms of serum sickness include:
- sore throat
- muscle pain
- joint pain
- fluid buildup in the hands and face
- trouble swallowing
Call your doctor right away if you have an allergic reaction to Remicade. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Find answers to some commonly asked questions about Remicade.
Does Remicade cause hair loss, issues with teeth, or weight gain?
It’s unclear. Remicade wasn’t reported to cause hair loss or teeth issues. And more research needs to be done on whether Remicade can cause weight gain. But effects the drug has on your body might in turn lead to these side effects.
Remicade wasn’t reported to cause hair loss. But Remicade lowers immune system activity. In rare cases, this could result in the body attacking hair cells, causing hair loss. This is a condition called alopecia areata. Stopping Remicade use may stop this hair loss.
But do not stop using Remicade without talking with your doctor first. If you’re concerned about hair loss during Remicade treatment, talk with your doctor or pharmacist.
It also isn’t clear if Remicade affects your teeth. But Remicade can increase your risk of infection, so you may develop dental infections after certain dental procedures. Tell your dentist which medications you’re taking before any dental procedure.
Your dentist can recommend ways to avoid dental infections. Keeping your mouth clean can also help you avoid needing procedures that can lead to infections.
Remicade may affect your weight. If you develop an infection, it’s possible for you to lose weight. People with heart failure may also see changes in their weight while using Remicade.
If you’re concerned about changes in your weight, talk with your doctor immediately.
How does Remicade work? Is it a chemotherapy drug?
No, Remicade isn’t a chemotherapy drug. Chemotherapy drugs stop the growth of cancer cells by killing them or stopping them from multiplying (making more cells). Remicade acts on the immune system to lower its activity. It targets a protein responsible for certain immune functions.
Some autoimmune diseases, such as Crohn’s disease and rheumatoid arthritis, are caused by an overactive immune system. By blocking factors involved in immune function, Remicade can help reduce symptoms of some autoimmune diseases.
What’s the half-life of Remicade? How long does it stay in your system?
The half-life of a medication is the time it takes for your body to get rid of half of the medication. Doctors use a drug’s half-life to find out how long the drug stays in your blood. Usually after about 4 to 5 half-lives, your body will have rid itself of the medication.
It takes between 7 to 9 days for the body to get rid of half of a dose of Remicade. This means Remicade can stay in your system for 28 to 45 days.
What should I know about Remicade vs. Stelara?
Your doctor may prescribe either Stelara or Remicade if you’re an adult and have any of the following conditions:
But doctors may also prescribe Stelara for some children with plaque psoriasis. Some children may also receive Remicade for ulcerative colitis and Crohn’s disease.
While both Remicade and Stelara can treat the same diseases, they work on different parts of the immune system.
Stelara blocks immune factors called interleukin-12 and interleukin-23. These immune factors may also play a role in certain autoimmune diseases. These are diseases that cause your immune system to attack your own body. Remicade works by blocking the activity of a type of immune system protein called tumor necrosis factor.
To learn more about these drugs and find out which might be best for you, talk with your doctor.
Will my body make antibodies to Remicade?
Yes, it’s possible for your body to make antibodies (immune system proteins) to Remicade. This would affect how well the medication works.
Since Remicade is a biologic medication, your body could identify it as a foreign substance. (Biologic drugs are made from parts of living organisms.) Your body may then try to remove the drug by making antibodies. If this happens, your doctor may need to switch your medication.
Some people may have a higher risk for making antibodies to Remicade, such as those with Crohn’s disease.
Taking other immunosuppressants with Remicade may lower the risk of your body making antibodies against Remicade. If you’re concerned about producing antibodies to this drug, talk with your doctor.
If I stop using Remicade, will I have withdrawal symptoms?
No, you won’t have withdrawal symptoms if you stop using Remicade. But symptoms of your disease may come back or worsen. If you want to stop using Remicade, talk with your doctor first to avoid making your symptoms worse.
If you have a certain type of arthritis or disease related to inflammation, your doctor may recommend Remicade. Doctors may prescribe Remicade to treat the conditions below. Remicade doesn’t cure these conditions, but it does help manage them by easing the symptoms they cause.
- Crohn’s disease (CD). Remicade is used to treat moderate to severe CD in adults and in children ages 6 years and older. CD is a condition that causes inflammation in your intestines.
- Ulcerative colitis (UC). Adults and children ages 6 years and older may use Remicade to treat moderate to severe UC. This is a condition that causes inflammation in your lower intestine.
- Psoriatic arthritis (PsA). Remicade is used to treat PsA in adults. With PsA, you have swelling in your joints. Some people may also have plaques, which are thick, scaly patches of skin.
- Plaque psoriasis (PsO). For adults who have long-lasting and severe PsO, Remicade may be a treatment option. With PsO, you may have plaques on the skin of your scalp or torso, and around your joints.
- Rheumatoid arthritis (RA). Remicade is used to treat moderate to severe RA. RA is a condition that causes swelling in your joints. Joint pain and swelling usually occurs on both sides of the body. But RA may also cause problems in other areas of your body, such as your heart, eyes, and skin.
- Ankylosing spondylitis (AS). Adults with AS may use Remicade to treat their condition. AS is like RA, but people with AS usually have long-lasting back and hip pain. Arthritis in other joints, like with RA, occurs in some people with AS. But unlike with RA, the joint pain usually occurs on one side of the body.
Remicade works by blocking the activity of a type of immune system protein called tumor necrosis factor (TNF). This protein helps your body fight infections. But with some diseases, such as arthritis and Crohn’s disease, the body makes too much TNF, or TNF is too active. Blocking TNF’s activity may help treat these diseases.
Your doctor will explain how Remicade will be given to you. They’ll also explain how much you’ll be given and how often. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.
Remicade comes as a powder that a healthcare professional mixes with the provided liquid. Next, they add the Remicade solution to a bag of saline. You then receive the medication as an injection directly into your vein over a period of time. This is known as an intravenous infusion. The infusion time for Remicade is at least 2 hours.
Depending on the condition you’re being treated for, you’ll receive Remicade based on a schedule determined by your doctor. After you receive your first infusion, you’ll have another one 2 weeks later. You’ll have your third dose 6 weeks later.
After the first three doses, you’ll likely receive Remicade every 8 weeks, unless you’re being treated for ankylosing spondylitis. For this condition, you’ll receive a dose every 6 weeks.
Some people with rheumatoid arthritis (RA) may need a dose every 4 weeks.
Receiving Remicade with other drugs
If you have RA, your doctor can only prescribe Remicade with methotrexate.
Flare-ups of inflammatory diseases may require taking corticosteroids.
People using Remicade with methotrexate or corticosteroids have a higher risk for developing a serious infection. This is because Remicade, methotrexate, and corticosteroids are all immunosuppressants. They reduce the activity of the immune system, decreasing the ability of your body to fight infections.
Other medications you may need to take with Remicade include:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen (Aleve) and celecoxib (Celebrex)
- folic acid
- narcotics, such as morphine (Kadian) and hydromorphone (Dilaudid)
- antibiotics, including metronidazole (Flagyl)
- antivirals, such as valganciclovir (Valcyte)
- 6-mercaptopurine (Purinethol)
- azathioprine (Imuran)
- aminosalicylates, including mesalamine (Pentasa) and sulfasalazine (Azulfidine)
Questions about receiving Remicade
Here’s a list of questions and answers related to receiving Remicade.
- What if I miss a dose of Remicade? You’ll receive doses of Remicade from a healthcare professional. If you miss an appointment to receive your next dose of Remicade, reschedule immediately. Missing doses of Remicade may affect how well the medication works.
- Will I need to use Remicade long term? You might. Ask your doctor how long you’ll need to use Remicade to treat your condition. Your doctor will assess how well the medication is working for you. Sometimes Remicade can stop working, in which case your doctor may need to switch your medication.
- Should I receive Remicade with food? Remicade is injected directly into your vein. Receiving Remicade with or without food won’t affect its absorption.
- How long does Remicade take to work? Depending on the condition you’re using Remicade for, it may take several weeks to several months before you feel the drug easing your symptoms. Talk with your doctor to find out how long it might be before the medication starts working.
Questions for your doctor
You may have questions about Remicade and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions like:
- How will Remicade affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and where you receive your infusions.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Remicade manufacturer’s website to see if it has support options.
- rheumatoid arthritis
- psoriatic arthritis
- ankylosing spondylitis
- Crohn’s disease
- ulcerative colitis
- plaque psoriasis
But doctors can also prescribe Humira for certain other autoimmune diseases, such as juvenile idiopathic arthritis and hidradenitis suppurativa. Ask your doctor which TNF blocker is best for your condition.
To see a detailed breakdown of these drugs, check out this drug article. And be sure to talk with your doctor about which medication is right for you.
Inflectra is a biosimilar version of Remicade.* It contains the active ingredient infliximab-dyyb, whereas Remicade’s active ingredient is infliximab. Biosimilars aren’t identical to the original drug, but they’re close enough to be used for the same conditions.
Your doctor may prescribe either Remicade or Inflectra for the same medical conditions. These two medications also have the same safety concerns, including risk of serious infections and possible risk of cancer.
If you’d like to learn more about these two medications, see this side-by-side comparison. And let your doctor know if you have questions about the best option for you.
A doctor may prescribe either Remicade or Entyvio for adults with Crohn’s disease or ulcerative colitis. Remicade works by blocking the activity of an immune system protein called tumor necrosis factor. Entyvio is an integrin receptor blocker. Integrin is another immune system protein that plays a role in ulcerative colitis and Crohn’s disease.
To find out whether Remicade or Entyvio may be better for treating your condition, talk with your doctor.
For more information about Remicade and Entyvio, view this detailed breakdown. And ask your doctor if you’d like to know more about how these drugs compare with each other.
When considering Remicade treatment, discuss your overall health and any medical conditions you have with your doctor. And tell your doctor if you’re taking any medications. Some drugs can interfere with Remicade.
These and other considerations to discuss with your doctor are described below.
Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.
Before receiving Remicade, be sure to tell your doctor about all medications you take (including prescription and over-the-counter types). Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Remicade.
Interactions with drugs or supplements
Remicade can interact with several types of drugs. These drugs include:
- other biologics, such as anakinra (Kineret), abatacept (Orencia), and tocilizumab (Actemra)
- other tumor necrosis factor blockers, such as etanercept (Enbrel)
- drugs that need close monitoring of their dosage, including warfarin (Coumadin), cyclosporine (Neoral), and theophylline (Theo-24)
This list does not contain all types of drugs that may interact with Remicade. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Remicade.
While using Remicade, you cannot receive live vaccines. This type of vaccine contains a weakened form of the germ that causes an infection or disease. Since Remicade lowers the activity of the immune system, live vaccines may cause the disease they’re designed to prevent.
Examples of live vaccines include:
Before starting Remicade, ask your doctor to review your immunization history. If you’re missing any vaccines, get them before starting Remicade. If you need a vaccine while using Remicade, talk with your doctor first.
Boxed warnings include:
- Serious infections. Remicade may increase your risk for serious infections. Examples include tuberculosis, fungal infections, and bacterial infections. A severe complication called sepsis can result from bacterial infections.
- Cancer. There have been reports of people who received Remicade developing a certain type of cancer called lymphoma. This cancer affects the lymphatic system. Other types of cancer have also been reported in people using Remicade. Cancers have occurred more often in children than in adults using Remicade.
For more information about the boxed warnings for Remicade, see the “Side effect focus” section above.
Remicade may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you receive Remicade. Factors to consider include those in the list below.
- Hepatitis B virus reactivation. Before starting Remicade treatment, your doctor will test you for hepatitis B. Remicade treatment may reactivate the hepatitis B virus because the drug lowers the activity of your immune system. With hepatitis B, it’s possible for you to have the virus in your body, but it’s not making you ill. If you have hepatitis B, you may need to have it treated before receiving Remicade. Your doctor may tell you to stop Remicade treatment if you contract the hepatitis B virus.
- Heart failure. If you have moderate to severe heart failure, your doctor may not prescribe Remicade. If you need to use Remicade, they may prescribe a lower dose. Your doctor will monitor your heart function if you need to use Remicade. For people with heart failure, higher doses of Remicade may increase the risk of hospitalization or death. Remicade may cause heart failure in people who don’t have risk factors for heart problems. Seek emergency medical attention if you develop symptoms of heart failure while using Remicade. Symptoms include sudden weight gain, swelling of the ankles or feet, and shortness of breath.
- Demyelinating diseases. Remicade may cause or worsen demyelinating diseases, which affect the protective layer of cells surrounding your nerves. Examples of this type of disease include multiple sclerosis and Guillain-Barré syndrome. If you have a nervous system disorder, your doctor will weigh the benefits and risks of using Remicade. If you develop any nervous system condition while you’re using Remicade, your doctor may have you stop treatment.
- Allergic reaction. If you’ve had an allergic reaction to Remicade or any of its ingredients, you should not use Remicade. Ask your doctor which other medications are better options for you.
Use with alcohol
Some medications interact with alcohol, though Remicade isn’t one of them. But
Pregnancy and breastfeeding
Remicade doesn’t affect pregnancy. But if you’re pregnant or considering becoming pregnant while receiving Remicade, let your doctor know. Remicade may cross the placenta during the last trimester of pregnancy. Exposure to Remicade may lower the function of an infant’s immune system and increase their risk for getting an infection.
Infants exposed to Remicade during the third trimester of pregnancy should not receive live vaccines until they’re older than 6 months.
Remicade is also present in breast milk. Children breastfed from someone using Remicade may be exposed to low levels of the drug. Remicade is digested in the stomach and intestines, so children aren’t at risk for absorbing Remicade.
If you’re breastfeeding or considering breastfeeding during Remicade treatment, talk with your doctor. They’ll help you decide whether the benefits of Remicade outweigh any risks to your infant.
* Autoimmune diseases cause your immune system to attack your own body.
If you have questions about Remicade, talk with your doctor or pharmacist. Your doctor can tell you about other treatments you can use for your condition. Here’s a list of articles that you may find helpful.
- Crohn’s Disease Medications and Treatments
- 12 Things to Know About Ulcerative Colitis Treatment
- Treatment Options for Moderate to Severe Psoriatic Arthritis
- All You Need to Know About the Latest Psoriasis Treatments
- Rheumatoid Arthritis Medication List
- Treatment for Ankylosing Spondylitis
Some questions to ask your doctor about Remicade may include:
- Can I drive after receiving Remicade infusions?
- Which natural remedies can I use along with Remicade for rheumatoid arthritis flare-ups?
- How can I reduce my child’s anxiety about their Remicade infusions?
Can I switch to Inflectra after starting Remicade?Anonymous patient
Yes, you can. Inflectra is a biosimilar of Remicade. Biosimilars aren’t identical to their parent biologics, but they are highly similar. So a biologic and its biosimilar can treat the same conditions. Because of this, Inflectra works in the same way as Remicade.
Switching to Inflectra may help reduce the cost of treatment. However, you should talk with your doctor if you have questions about switching medications. They can work with you to determine the best drug for treating your condition.Victor Nguyen, PharmD, MBAAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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.