Remicade Interactions: Alcohol, Medications, and Others

Certain health conditions or other factors could raise your risk of harm if you take Remicade. In such cases, your doctor may not prescribe Remicade for you. These are known as contraindications. The list below includes contraindications of Remicade.

If you have moderate to severe heart failure. If you have moderate to severe heart failure, your doctor likely won’t prescribe Remicade above a certain dosage. This is because Remicade may worsen heart failure. The risk may be greater with higher doses of the drug.

If you have heart failure, talk with your doctor before starting Remicade treatment. They can tell you whether your condition is mild, moderate, or severe. Your doctor can also determine what your dosage should be.

For more information about Remicade’s dosage, see this article. You can also talk with your doctor or pharmacist to learn more.

If you’ve had an allergic reaction. If you have had an allergic reaction to Remicade or any of its ingredients, your doctor likely won’t prescribe Remicade. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start using Remicade, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Remicade is safe for you to take.

Remicade isn’t known to interact with alcohol.

However, both Remicade and alcohol can cause liver damage. So combining alcohol with Remicade could raise your risk of liver damage even more. (For more information about Remicade’s side effects, see this article.)

If you drink alcohol, talk with your doctor before starting Remicade treatment. They can tell you how much (if any) alcohol may be safe to drink with Remicade.

Before you start using Remicade, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Remicade interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Remicade?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Remicade. Keep in mind that this table does not include all drugs that may interact with Remicade. For more information about some of these interactions, see the “Drug interactions explained” section below.

* To learn more about Remicade’s side effects, see this article.
† Remicade is a biologic drug, which means it’s made from parts of living organisms.

Learn more about certain drug interactions that can occur with Remicade.

Interaction with immunosuppressant drugs

Immunosuppressant drugs lower the activity of your immune system. They’re used to treat autoimmune conditions, such as rheumatoid arthritis. They can also be used to make your body less likely to reject a transplanted organ, such as a heart, liver, or kidney.

Examples of immunosuppressant drugs include:

• azathioprine (Azasan, Imuran)
• cyclosporine (Gengraf, Neoral, Sandimmune)
• sirolimus (Fyarro, Rapamune)
• tacrolimus (Astagraf XL, Envarsus XR, Prograf)
• methotrexate (Otrexup, Rasuvo, others)

What could happen

Taking an immunosuppressant with Remicade can increase the risk of serious infection. This can happen because both Remicade and immunosuppressants lower your immune system’s ability to fight infection. Taking these medications together can raise your risk of serious infection even more.

In fact, Remicade has a boxed warning about the risk of serious infection. A boxed warning is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Boxed warnings” section at the beginning of this article.

In addition, taking Remicade with cyclosporine can affect how your body breaks down cyclosporine. This could change how effective cyclosporine will be for treating your condition.

What you can do

Before using Remicade, tell your doctor if you take an immunosuppressant. They can determine whether it’s safe to take these drugs together.

If you take Remicade with cyclosporine, your doctor will monitor you for symptoms of the condition you’re using cyclosporine to treat. They may also check the level of cyclosporine in your body more often than usual.

If you take Remicade with any immunosuppressant, your doctor will discuss your risk of infection. Be sure to tell them if you have any symptoms of infection, such as chills, fever, weight loss, or fatigue (low energy).

If you have these symptoms, your doctor may order tests to check for infection. They can also recommend what to do if you have an infection.

To learn more about taking Remicade with immunosuppressants, talk with your doctor. They may suggest ways to boost your immune system while using Remicade with an immunosuppressant. You can also see these articles about foods and other factors that may help strengthen your immune system.

Interaction with corticosteroids

Corticosteroids are used to reduce swelling. They can also be used to treat autoimmune conditions, such as ulcerative colitis and Crohn’s disease.

Examples of corticosteroids include:

• dexamethasone (Hemady)
• methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol)
• prednisone (Rayos)

What could happen

Using Remicade while taking a corticosteroid can raise your risk of serious infection. Both Remicade and corticosteroids can lower your immune system’s ability to fight infection. Your risk of infection increases if you take these medications together.

Remicade has a boxed warning about the risk of serious infection. To learn more, see the “Boxed warnings” section at the beginning of this article.

What you can do

Before starting Remicade treatment, tell your doctor about any corticosteroids you take. They can determine whether it’s safe to take these drugs together.

If you use Remicade while taking a corticosteroid, your doctor will discuss your risk of infection. They’ll likely have you watch closely for symptoms of infection. Examples include chills, fever, weight loss, and fatigue.

If you have symptoms of infection, your doctor may check for infection and can recommend what to do if you have one.

To learn more about taking Remicade with corticosteroids, talk with your doctor.

Interaction with other biologic drugs

Biologic drugs are made from parts of living organisms. They’re used to treat a variety of conditions, including cancers and autoimmune conditions.

Remicade is a biologic drug. Examples of other biologic medications include:

• abatacept (Orencia)
• adalimumab (Humira)
• anakinra (Kineret)
• etanercept (Enbrel)
• tocilizumab (Actemra)

What could happen

Using Remicade with other biologics raises your risk of serious infection. This is because Remicade and other biologics work by lowering the activity of your immune system. This keeps your immune system from fighting infection as well as it should.

Using other biologics with Remicade raises your risk of infection even more. In fact, Remicade has a boxed warning about the risk of serious infection.

To learn more about the risk of infection with Remicade, see the “Boxed warnings” section at the beginning of this article.

What you can do

Before using Remicade, tell your doctor if you take any biologic drugs. They’ll likely prescribe a drug other than Remicade for your condition.

Remicade may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Remicade.

Does Remicade interact with supplements?

Before you start using Remicade, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Remicade and herbs

There are currently no reports of Remicade interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Remicade.

Remicade and vitamins

There are currently no reports of Remicade interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Remicade.

Does Remicade interact with food?

There are currently no reports of Remicade interacting with food. If you have questions about eating certain foods during your treatment with Remicade, talk with your doctor.

Does Remicade interact with vaccines?

Your doctor will likely advise you to avoid receiving live vaccines during your Remicade treatment. (Live vaccines contain a weakened form of the infection they protect against.)

Remicade lowers your immune system’s ability to fight infection. Receiving a live vaccine while using Remicade could increase your risk of getting the infection the vaccine protects against.

Examples of live vaccines include:

• smallpox
• chickenpox
• yellow fever
• measles, mumps, rubella (MMR)

Before starting Remicade treatment, ask your doctor to review your vaccine history. If you need any live vaccines, your doctor may give you the vaccine before prescribing Remicade.

Your doctor can tell you whether it’s safe to receive any other vaccines while you’re using Remicade.

Does Remicade interact with lab tests?

There are currently no reports of Remicade interacting with lab tests. If you have questions about getting certain lab tests during Remicade treatment, talk with your doctor.

Does Remicade interact with cannabis or CBD?

There are currently no reports of Remicade interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Remicade.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Remicade. Before using Remicade, talk with your doctor about your health history. They’ll determine whether Remicade is right for you.

Health conditions or other factors that might interact with Remicade include:

Being older than age 65 years. If you’re older than age 65 years, you may have a higher risk of serious infection with Remicade. In fact, the drug has a boxed warning about the risk of serious infection. To learn more, see the “Boxed warnings” section at the beginning of this article.

Chronic obstructive pulmonary disease (COPD). If you have COPD and receive Remicade, you may have a high risk of cancer. In fact, the drug has a boxed warning about the risk of certain cancers. To learn more, see the “Boxed warnings” section at the beginning of this article.

Conditions that lower immune system activity. If you have a condition that lowers your immune system activity, such as diabetes, you may have a higher risk of infection with Remicade. In fact, the drug has a boxed warning about the risk of serious infection. To learn more, see the “Boxed warnings” section at the beginning of this article.

Heart failure. Before using Remicade, tell your doctor if you have heart failure. The drug may worsen heart failure in people who already have this condition. Your doctor can determine whether it’s safe for you to use Remicade.

If you have moderate to severe heart failure, your doctor likely won’t prescribe Remicade above a certain dosage. For details, see the “When should I avoid Remicade?” section above.

Infection, including hepatitis B or tuberculosis (TB). Before receiving Remicade, tell your doctor if you have an infection that’s causing symptoms. Also, tell your doctor if you have or have had hepatitis B or tuberculosis (TB).

Remicade may reactivate the hepatitis B virus in people who already have this virus in their bodies. The drug may also reactivate TB in people who already have this bacterium. With reactivation, the virus or bacterium becomes active again and causes symptoms.

If you have hepatitis B or TB, your doctor can recommend whether Remicade is right for you. If you have an infection that’s causing symptoms, they’ll likely delay the start of Remicade treatment until after your infection is cleared.

To learn more, see Remicade’s boxed warning about the risk of serious infection at the beginning of this article.

Liver problems. Remicade may cause liver damage. If you already have a liver problem, such as liver failure, this drug could worsen your condition. Talk with your doctor about whether Remicade is the right treatment for you.

For more information about Remicade’s side effects, see this article.

Nerve problems. Using Remicade may lead to conditions that affect your nervous system, such as multiple sclerosis (MS). This drug could worsen nerve problems in people who already have MS or another nerve problem.

If you have a condition that affects your nervous system, talk with your doctor before starting Remicade treatment. They can determine whether Remicade is right for you.

Pregnancy. It’s not known whether Remicade is safe to use during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor about whether this drug is safe for you.

Breastfeeding. It’s not known whether it’s safe to receive Remicade while breastfeeding. The drug passes into breast milk, but it isn’t known whether the drug may cause side effects in a child who’s breastfed. To learn more about using Remicade while breastfeeding, talk with your doctor.

Allergic reaction. If you’ve had an allergic reaction to Remicade or any of its ingredients, your doctor will likely not prescribe Remicade. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Taking certain steps can help you avoid interactions with Remicade. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Remicade treatment.

It’s also important to understand Remicade’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Remicade, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

If you still have questions about Remicade and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Do other drugs that could treat my condition have similar interactions?
• Does my dosage of Remicade affect my risk of interactions?
• Will I be monitored more closely during my Remicade treatment if I have certain health conditions?

To learn more about Remicade, see these articles:

• All About Remicade
• Side Effects of Remicade: What You Need to Know
• Dosage for Remicade: What You Need to Know
• Remicade and Cost: What You Need to Know
• Enbrel vs. Remicade: What You Should Know

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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 another 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.