By Dr. Brian Bressler and Christina Pears, RN
What is it?
Remicade is a protein that partially inhibits the activity of the immune system by blocking the inflammatory molecules causing inflammation. By blocking its activity, inflammation is reduced.
Why do I need this medication?
This medication is used to treat ulcerative colitis and Crohn’s Disease. This medication will help stop and avoid the need for steroids.
How do I take it?
Remicade is given intravenously. Initially, you will receive one infusion at the start of treatment (Week 0). Your second infusion will be two weeks later (Week 2), and the third infusion will be six weeks after your first (Week 6). After the first 3 doses, you will receive an infusion approximately every eight weeks.
You can receive your Remicade dose at various infusion clinics. The infusion process will take approximately 3 hours. During this time, a health care professional will be monitoring you and checking your vital signs (blood pressure, heart rate, temperature, etc).
How long do I have to take this medication?
Remicade is used to induce remission (make you feel better) and is also an effective maintenance therapy to keep symptoms under control. This medication cannot be used as needed and must be continued once started. If you were to stop taking Remicade, your body can develop antibodies to it, thereby causing an allergic reaction and making the drug ineffective.
When will I start to feel better?
Remicade works relatively quickly, and while some people can begin to see benefits in as little as 7 days, results may take up to a few months.
What happens when I want to get pregnant?
This medication is relatively safe during pregnancy but family planning should be discussed with the doctor for more information.
Can I drink alcohol while on this medication?
What are the side effects/risks?
- Increased risk of infection
- Remicade suppresses the activity of the immune system which may increase your risk of developing infections from bacteria, viruses, and certain kinds of fungi. For example, this medication can reactivate tuberculosis (TB) if you’ve been exposed to it and it is dormant in the body. Therefore, it is necessary to undergo a TB skin test before starting therapy. Let the doctor know if you’ve been exposed to TB.
- Allergic/Hypersensitivity and Infusion Reactions
- These reactions may occur at the start of treatment, during the infusion, or even days after your Remicade treatment. These symptoms may include hives, difficulty breathing, pain, high or low blood pressure, or anaphylaxis. Some reactions can be treated by adding a single dose of an IV steroid, benedryl, and/or Tylenol prior to your infusion.
- Lupus-Like Syndrome
- This may include symptoms such as chest discomfort/pain that does not go away, shortness of breath, joint pain, or a sun- sensitive rash on the cheeks or arms.
- Multiple Sclerosis (MS)-Type Symptoms
- Signs and symptoms include numbness, weakness, tingling, or changes in your vision.
- Remicade may be associated with an increased risk of lymphoma, a cancer of the lymph nodes, but this risk is very low. For example, the risk of developing lymphoma in the general population on no medications is approximately 1 in 10000. This medication may increase that risk to about 4-6 in 10000.
Test your health: See how you compare to other people with Crohn’s disease or ulcerative colitis
- You may need to reschedule your infusion if you are ill and/or running a fever.
- It is recommended that your immunizations are up to date prior to starting therapy. While on Remicade, all live vaccines must be avoided.
- For women, it is important to receive annual pap tests, even if previous exams have been negative.
- Please speak to your doctor if you have a history of cancer or heart disease as this medication may be contraindicated.
Treatments: Humira (Adalimumab)
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