Infliximab (Injection)

Introduction:

Infliximab (in-FLIX-i-mab)

Treats rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, plaque psoriasis, and ulcerative colitis.

Brand Name(s):

Remicade

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given through a needle placed in one of your veins.
• A nurse or other trained health professional will give you this medicine.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.
• This medicine needs to be given slowly. The needle will need to remain in place for at least 2 hours.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using anakinra (Kineret®), azathioprine (Imuran®), etanercept (Enbrel®), or methotrexate (Folex®, Rheumatrex®). Tell your doctor if you have received infliximab before. Make sure your doctor knows about all other medicines you are using, including nonprescription (over-the-counter) medicines and herbal products.
• Talk to your doctor before getting flu shots or other vaccines while you are receiving this medicine. Vaccines may not work as well, or they could make you ill while you are using this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have liver disease, kidney disease, heart problems, bleeding disorder, any type of infection or an infection that would not go away or keeps coming back, diabetes, a weakened immune system, or if you have ever been treated with medicines that weaken your immune system (such as steroids or cancer medicines). Tell your doctor if you have a history of seizures, multiple sclerosis, Guillain-Barre syndrome, or a similar nervous system disease. Make sure your doctor knows if you have lung disease (such as chronic obstructive pulmonary disease or COPD), a history of cancer, hepatitis B infection, psoriasis, or if you have recently received a vaccine.
• Serious skin reactions can occur during treatment with this medicine. Check with your doctor right away if you have any of the following symptoms while taking this medicine: blistering, peeling, or loosening of the skin; chills; cough; diarrhea; fever; itching; joint or muscle pain; red skin lesions; sore throat; sores, ulcers, or white spots in your mouth or lips; or unusual tiredness or weakness.
• You will need to have a skin test for tuberculosis before you start using this medicine. Tell your doctor if you or anyone in your home has ever had a positive reaction to a tuberculosis test.
• A small number of people (including children and teenagers) who have used this medicine have developed certain types of cancer. This is more common among patients who have lung diseases or are heavy smokers, and in psoriasis patients who have had phototherapy treatment for a long time. Some patients with Crohn's disease or ulcerative colitis also developed a rare type of cancer called lymphoma. Talk with your doctor if you have unusual bleeding, bruising, or weakness; swollen lymph nodes in the neck, underarms, or groin; or unexplained weight loss. Also, check with your doctor right away if your skin has red, scaly patches, or raised bumps that are filled with pus.
• This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
• Call your doctor right away if you start to have signs of infection such as persistent cough, fever, chills, weight loss, night sweats, shortness of breath, unusual tiredness or weakness, or flu-like symptoms such as a runny or stuffy nose, headache, or feeling generally ill. Tell your doctor if you have been exposed to chickenpox or any other virus.
• Your risk of getting an infection increases when you travel to places where certain organisms (such as fungi, bacteria, viruses, or parasites) are more common. Tell your doctor where you live and if you have any history of travel if you start to have any sign of infection.
• Do not change or stop using this medicine without checking with your doctor first. Your doctor may want you to gradually reduce the amount you are using before stopping it completely.
• If your symptoms do not improve or if they get worse, call your doctor.
• Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Blistering, peeling, or red skin rash.
• Bone pain.
• Change in how much or how often you urinate.
• Chest pain or shortness of breath.
• Cold or flu symptoms such as runny or stuffy nose, sore throat, fever, chills, or body aches.
• Dry mouth, increased thirst, or muscle cramps.
• Fast, slow, or irregular heartbeat.
• Joint pain or swelling.
• Lightheadedness, dizziness, or fainting.
• Nausea, vomiting, loss of appetite, or pain in your upper stomach.
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• Pain in your lower leg (calf).
• Pain when urinating, or dark-colored urine or pale stools.
• Raised bumps on the skin filled with pus.
• Red or black stools.
• Red, scaly patches on the skin.
• Severe confusion, or thoughts of hurting yourself or others.
• Sores or white patches on your lips, mouth, or throat.
• Stiff neck or seizures.
• Sudden or severe headache, problems with vision, speech, or walking.
• Swelling in your hands, ankles, or feet.
• Swollen lymph nodes in the neck, underarms, or groin.
• Trouble with breathing or swallowing.
• Unexplained weight loss.
• Unusual bleeding or bruising.
• Unusual tiredness or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Cough that does not go away.
• Diarrhea or upset stomach.
• Mild headache.
• Mild muscle or joint pain.
• Mild skin rash or itching.
• Redness, pain, or swelling where the needle is placed.
• Warmth or redness in your face, neck, arms, or upper chest.

If you notice other side effects that you think are caused by this medicine, tell your doctor: