WARNING

Infliximab is a medication used to treat various autoimmune diseases, including rheumatoid arthritis, Crohn’s disease, and psoriasis. While it can be effective, it comes with potential risks and side effects:

• Infections: Infliximab can increase the risk of serious infections, such as tuberculosis (TB), bacterial, fungal, or viral infections.
• Allergic Reactions: Some individuals may experience allergic reactions, including symptoms like rash, itching, or swelling.
• Infusion Reactions: Reactions to the infusion can occur, including fever, chills, and shortness of breath.
• Liver Issues: There is a risk of liver damage or liver failure, which may be indicated by symptoms like jaundice or dark urine.
• Heart Failure: Infliximab can worsen or cause heart failure in some patients.
• Cancer Risk: There may be an increased risk of certain types of cancer, including lymphoma.
• Autoimmune Disorders: Rarely, the medication can induce new autoimmune disorders or worsen existing ones.

It’s important to discuss these risks with your healthcare provider to ensure that the benefits of the medication outweigh the potential risks in your specific situation. Regular monitoring and follow-up can help manage and mitigate these risks.

Why is this medication prescribed?

Infliximab is prescribed for several conditions, primarily to manage autoimmune diseases where the immune system attacks the body’s own tissues. It works by targeting and inhibiting tumor necrosis factor-alpha (TNF-alpha), a substance involved in inflammation. Common conditions treated with infliximab include:

• Rheumatoid Arthritis: Reduces inflammation and slows the progression of joint damage.
• Crohn’s Disease: Helps control inflammation in the digestive tract, improving symptoms and inducing remission.
• Ulcerative Colitis: Similar to Crohn’s, it helps control inflammation in the colon and rectum.
• Psoriasis: Manages severe skin symptoms associated with psoriasis.
• Ankylosing Spondylitis: Reduces inflammation in the spine and pelvis.
• Hidradenitis Suppurativa: Treats this chronic skin condition that causes painful lumps under the skin.

By targeting TNF-alpha, infliximab helps reduce inflammation, relieve symptoms, and improve the quality of life for individuals with these conditions.

How should this medicine be used?

Infliximab is administered via intravenous (IV) infusion, typically in a healthcare setting. The general procedure for using infliximab involves:

• Dosage: The dosage and frequency of infliximab infusions depend on the condition being treated and the patient’s response. Common initial dosing might be at 0, 2, and 6 weeks, followed by maintenance doses every 8 weeks, but this can vary.
• Infusion: The drug is prepared and diluted according to the manufacturer’s instructions and administered by a healthcare professional.
• Infusion Rate: The infusion is usually given over a period of 1 to 2 hours. The rate may start slow and be increased gradually to minimize the risk of infusion reactions.
• Monitoring: Patients are monitored during and after the infusion for any immediate reactions or side effects.
• Pre-Medication: Some patients may receive pre-medication (e.g., antihistamines, corticosteroids) to help prevent or manage infusion reactions.
• Regular Dosing: Ongoing treatment usually requires regular follow-up visits for maintenance infusions.
• Monitoring: Regular monitoring may include blood tests and assessments to check for side effects or evaluate treatment effectiveness.

It’s important to follow the treatment plan and instructions provided by your healthcare provider to ensure the medication is used safely and effectively.

Other uses for this medicine

In addition to the primary conditions mentioned earlier, infliximab may also be prescribed for:

• Psoriatic Arthritis: Helps manage joint inflammation and skin symptoms associated with psoriasis.
• Giant Cell Arteritis: An inflammatory disease affecting the blood vessels, particularly those in the head.
• Behçet’s Disease: An autoimmune condition causing inflammation in multiple areas of the body.

What special precautions should I follow?

Special Precautions for Infliximab Injection:

• Infection Risk: Monitor for signs of infection. If you have a history of tuberculosis (TB) or other infections, inform your healthcare provider. Testing for TB may be required before starting treatment.
• Heart Conditions: Inform your healthcare provider if you have a history of heart failure or other heart conditions, as infliximab may exacerbate these issues.
• Liver Function: Regular liver function tests may be required to monitor for potential liver issues.
• Allergic Reactions: Be aware of the potential for allergic reactions, which can range from mild to severe. Report any symptoms like rash, itching, or difficulty breathing.
• Cancer Risk: Discuss any concerns about cancer risk with your healthcare provider. Regular screenings and monitoring may be advised.
• Autoimmune Disorders: Inform your healthcare provider if you have other autoimmune disorders, as infliximab might affect these conditions.
• Vaccinations: Some vaccinations should be avoided while on infliximab, particularly live vaccines. Consult your healthcare provider before receiving any vaccines.
• Pregnancy and Breastfeeding: If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the potential risks and benefits of infliximab with your healthcare provider.

Always follow your healthcare provider’s advice and report any unusual symptoms or side effects promptly. Regular follow-up appointments are important to manage and monitor your treatment effectively.

What special dietary instructions should I follow?

• No Specific Dietary Restrictions: There are no specific dietary restrictions associated with infliximab. However, maintaining a balanced diet and staying hydrated is always beneficial for overall health.
• Consult Healthcare Provider: If you have specific dietary concerns or conditions, discuss them with your healthcare provider or a nutritionist to ensure they do not interfere with your treatment.

What should I do if I forget a dose?

• Rescheduling: Contact your healthcare provider as soon as you realize you missed a dose. They will advise you on when to reschedule your next infusion.
• Do Not Double Dose: Do not try to compensate for a missed dose by taking a double dose or changing the schedule on your own.
• Continue with Regular Schedule: Follow the new schedule as advised by your healthcare provider. It’s important to stick to the treatment plan to achieve the best results.

What side effects can this medication cause?

Infliximab can cause a range of side effects, some of which may be serious. Common and serious side effects include:

Common Side Effects:

• Infusion Reactions: Fever, chills, nausea, headache, and rash during or after the infusion.
• Upper Respiratory Tract Infections: Symptoms like sore throat or cough.
• Gastrointestinal Symptoms: Abdominal pain, diarrhea, or nausea.
• Fatigue: Feeling unusually tired or weak.

Serious Side Effects:

• Infections: Increased risk of serious infections, such as tuberculosis (TB), bacterial, fungal, or viral infections.
• Allergic Reactions: Severe reactions including difficulty breathing, swelling of the face or throat, and severe rash.
• Liver Problems: Symptoms of liver issues include jaundice (yellowing of the skin or eyes), dark urine, or severe abdominal pain.
• Heart Failure: Worsening or new-onset heart failure, which can present with symptoms like shortness of breath, swelling of the legs, or fatigue.
• Cancer: Increased risk of certain types of cancer, including lymphoma.
• Autoimmune Conditions: Potential to trigger or worsen other autoimmune disorders.
• Neurological Issues: Symptoms like seizures, vision changes, or severe headache.
• Blood Disorders: Low blood cell counts, which can increase the risk of bleeding or infections.

It’s important to report any new or worsening symptoms to your healthcare provider promptly. Regular monitoring and follow-up appointments are crucial to manage and mitigate side effects.

What should I know about storage and disposal of this medication?

Storage and Disposal of Infliximab Injection:

• Storage:
  • Infliximab should be stored in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze.
  • Keep the vial or infusion bag in its original packaging to protect it from light.
  • Do not shake or stir the vial. If the solution is discolored or contains particles, do not use it.
• Disposal:
  • Dispose of any unused medication according to local regulations. Do not throw it in household trash or flush it down the toilet.
  • Check if your pharmacy has a take-back program or follow local guidelines for medication disposal.

In case of emergency/overdose

• Immediate Contact: Contact emergency services or go to the nearest emergency room if you experience severe symptoms like difficulty breathing, severe allergic reactions, or signs of infection.
• Report the Situation: Provide details about your infliximab treatment and any other medications you are taking.
• Contact Poison Control: Call poison control or seek medical attention immediately if you suspect an overdose.
• Symptoms: Be aware of symptoms that may indicate an overdose, though serious overdoses are rare.

What other information should I know?

• Regular Monitoring: Routine Tests: Regular blood tests and other monitoring may be required to assess the medication’s effectiveness and check for side effects.
• Inform Your Provider: Tell your healthcare provider about all other medications and supplements you are taking to avoid potential interactions.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of infliximab with your healthcare provider.
• Avoid Live Vaccines: Do not receive live vaccines while on infliximab without consulting your healthcare provider.
• Health Changes: Inform your healthcare provider of any significant health changes or new symptoms.

Always follow the specific guidance provided by your healthcare provider and the manufacturer’s instructions for your infliximab treatment.