Infliximab (Remicade)

Patient Information

Infliximab use in the treatment of inflammatory bowel disease

Why am I being prescribed Infliximab?

Infliximab, also known as Remicade is an established treatment for Crohn’s disease. Currently doctors can only prescribe it for individual patients by request. It is used in the treatment of;

Moderate or severe active Crohn’s disease who have not been helped by standard treatments or, For the treatment of patients with ‘fistulating’ (an abnormal passage between loops of bowel and the skin or other organs) Crohn’s disease.

How does the medicine work?

Infliximab works to interrupt inflammation by neutralising a protein that naturally occurs in the body called tumour necrosis factor-alpha (TNF-alpha). TNF-alpha works with other proteins (cytokines) to control the immune system and patients with Crohn’s disease seem t produce too much at sites of inflammation. It may also cause damage to the cells lining the gut, causing diarrhoea and pain.

Infliximab reduces inflammation by neutralising the TNF-alpha, allowing the lining of the gut to heal and fistulas to close.

Does infliximab work for everyone?

In studies infliximab has been shown to improve symptoms for two thirds of patients, while on third achieve full remission. On average, benefits last up to 14 weeks.

How do I take the medicine?

Infliximab is given through a drip in your vein whilst you are in hospital. The treatment takes about 2 hours and you will need to stay in hospital for 1-2 hours after the treatment has finished. If the medicine works for you, a single treatment can have immediate benefits. Usually maintenance treatment with infliximab is scheduled for every 8 weeks.

If you have a fistula a further 2 treatments may be necessary 2 weeks and 6 weeks after the first dose.

What are the side effects of infliximab?

All drugs have side effects, and many patients have no complications at all. In studies in Crohn’s disease, approximately 5% of patients discontinued scheduled Infliximab infusions due to an adverse experience. The most common reasons for discontinuation of treatment were infusion reactions and infections. An infusion reaction may occur during an infusion or up to 2 hours post infusion. Nursing staff will monitor you carefully, and will stop the infusion should this occur. Reactions normally get better without any treatment. The main side effects of infliximab include; fever or chills, anaemia, fatigue, nervousness, headache, dizziness, nausea or vomiting, pain, rashes and upper respiratory tract infections. You may have an increased risk of infection following treatment, therefore be extra vigilant when coming into contact with people who are unwell, especially those with ‘flu or chicken pox. If you develop any signs of a temperature, infections, or ‘flu-like’ illness, please contact us on the number below.If you are having infliximab for the second time, you have some risk of developing a delayed reaction. If you develop any new or worrying symptoms, please contact us.

Does infliximab interact with my other medication?

Specific studies on drug interactions with infliximab have not been conducted. The majority of patients in Crohn’s disease clinical trials received one or more of the commonly used medications such as aminosalicylates, steroids and immunosuppressants.

Does infliximab affect fertility or pregnancy?

If you are male or female and are planning a family, or a woman who becomes pregnant whilst taking infliximab you must tell your doctor or nurse immediately. To date infliximab has not been used in pregnancy. Until studies are carried out pregnant women should not use infliximab.

Nursing mothers.

It is not known whether Infliximab is excreted in human milk. It is therefore not recommended due to the potential for serious adverse reactions in nursing infants from infliximab,

Can I drink alcohol with infliximab?

Yes, it is perfectly safe.

What if I have other questions?

If you have any other questions about your treatment, or if you have any problems or difficulties please ask your specialist nurse or Consultant:

Patient.co.uk is a useful website:

http://www.patient.co.uk/medicine/infliximab



 

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