Medication Use and Facts
Remicade (infliximab) is an intravenous medication that is used to treat Crohn's disease, ulcerative colitis and rheumatoid arthritis (RA). Remicade is a monoclonal antibody that inhibits tumor necrosis factor alpha (TNFa). This protein is a potent proinflammatory agent. Inhibiting its function helps to decrease inflammation associated with inflammatory bowel disease and rheumatoid arthritis. In Crohn's disease Remicade can aid in healing fistulas, decreasing clinical symptoms, and achieving clinical remission in patients who have not adequately responded to other medical therapies.

Remicade is administered as an intravenous infusion. Infusions typically take 3 to 4 hours. An infusion center at Gastroenterology Consultants of Louisville allows for infusions to be administered conveniently under direct supervision by the doctors and nurse practitioners in the practice. Infusions are typically given at 8 week intervals. An induction infusion regimen at 0, 2 and 6 weeks is usually prescribed for patients when they begin receiving treatment with Remicade.

Remicade is a very potent drug and consequently, has the potential for side effects. Side effects may occur during the infusion of after the infusion. Remicade has the potential to increase an individual's susceptibility for infections. Severe infections including tuberculosis, pneumonia and sepsis have been reported in patients taking Remicade. Tell your doctor if you have had tuberculosis or been exposed to tuberculosis. Testing for tuberculosis is generally done before initiating treatment with Remicade.

Patients with heart failure generally should not be treated with Remicade. Tell your physician if you develop shortness of breath or new swelling of your ankles or feet. Rare reports of liver injury, blood disorders, lymphoma and other cancers as well as neurologic disease have occurred in patients receiving Remicade. Important additional information is available for patients at www.Remicade.com.

Infusion reactions are allergic responses to the protein in Remicade and may be seen at any time during treatment with Remicade.

Acute Reactions (<24 hours after infusion)
During the infusion some patients may experience an acute infusion reaction. Symptoms may include fever, chest pain, palpitations, sweating, nausea, flushing, itching, hypotension/hypertension, or difficulty breathing. Typically these resolve with slowing the rate of infusion, taking acetaminophen, anti-histamines, steroids, and/or epinephrine. Trained nurse practitioners and physicians are available in the infusion center at Gastroenterology Consultants of Louisville if an infusion reaction should occur. Your physician may recommend specific medications prior to your next infusion to decrease your possibility of having another reaction.

Delayed Reactions (>24 hours to 14 days after infusion)
These symptoms can occur after the infusion is completed. Symptoms generally include muscle or joint aches, itching, rash, fever, and fatigue. Usually these symptoms resolve with using acetaminophen, antihistamines, and steroids. If you experience these after your infusion, your physician may recommend specific medications prior to your next infusion to decrease your possibility of having a delayed reaction.

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