Infliximab

Drug Name
Infliximab

Brand Name(s)
Remicade®, Inflectra®

Drug Class
Biologic

Infliximab is used to treat inflammatory types of arthritis, such as rheumatoid arthritis (RA), psoriatic arthritis and ankylosing spondylitis.

  • What types of arthritis is infliximab used for?

    Infliximab is used to treat inflammatory types of arthritis, such as rheumatoid arthritis (RA), psoriatic arthritis and ankylosing spondylitis.

    When infliximab is used to treat RA, methotrexate is always used in combination. This helps to optimize your therapy with infliximab. Infliximab may be used as monotherapy to treat psoriatic arthritis and ankylosing spondylitis.

  • How is infliximab administered?

    Infliximab is delivered by infusion.

  • What is the typical dose and when do I take it?

    The dose of infliximab depends on your body weight. Infliximab is given by infusion initially, then again at week two and week six. Following this, an infusion is given every four to eight weeks depending on the condition you are being treated for and your response to treatment.

  • How long will it take to work?

    As with all of the biologics, you may not feel the effects of the infliximab right away. Some people begin to feel the effects of the medication fairly quickly; however, it may take three to six months to feel its full effect. It is important to be patient and keep taking your medication.

    To provide symptom relief while you are waiting for infliximab to take effect, your health-care provider may recommend taking a steroid, such as prednisone, or a non-steroidal anti-inflammatory drug (NSAID).

  • When should I not take infliximab and call my doctor?

    Infliximab can make it more difficult for your body to fight infections. Therefore, people with active infections should not take infliximab. If you have a fever, think you have an infection or have been prescribed an antibiotic, contact your health-care provider. People who have had frequent infections in the past or a history of tuberculosis should discuss the use of infliximab with their health-care provider. 

    Also contact your provider if you are having surgery as you may need to stop infliximab until you are healed and there is no sign of infection.

    Infliximab has not been studied in pregnant women or nursing mothers so its effect(s) on pregnant women or nursing babies are unknown. You should tell your doctor if you are pregnant, or are planning to become pregnant. Because of the potential for adverse reactions in nursing infants, a decision should be made with your health-care provider on whether or not to discontinue nursing or the medication, taking into account the importance of the drug to the mother.

    Anyone who has had a previous allergic reaction to infliximab should avoid the medication.
    People with a history of cancer or nervous system problems, such as multiple sclerosis, should discuss the use of infliximab with their health-care provider before starting the medication.

    Infliximab may make a condition called congestive heart failure worse. Tell your doctor if you have congestive heart failure.

    Ideally, your vaccinations should be up to date prior to starting infliximab. If you have already started therapy with infliximab, your health-care provider will likely recommend most inactive vaccines (e.g., influenza, pneumococcal). Live vaccines are not recommended due to risk of causing infection. Before receiving any vaccinations while taking infliximab, you should speak with your health-care provider.

  • What are the side effects of infliximab?

    Like all medications, taking infliximab carries some risk of side effects, which must be balanced with the potential benefits. In general, the risk of joint damage and permanent disability (resulting from arthritis) is much greater than the risks of side effects from infliximab. When monitored properly the vast majority of side effects are rare and most improve over time and are reversible.

    Firstly, infliximab can increase your risk of infections.

    Infliximab can in rare cases cause an allergic reaction during the infusion (flushing, itching, changes in heart rate and blood pressure, etc.). A health-care professional will monitor for this reaction during the infusion. 
    In rare cases, people experience headaches, nausea, abdominal pain and diarrhea with infliximab. If this becomes severe please consult your health-care provider.

    Some people have developed lupus-like symptoms that disappeared after the medication was stopped. If you have chest pains that do not go away, shortness of breath or a rash on your cheeks or arms that gets worse in the sun, call your doctor right away.

    There have been rare cases of disorders that affect the nervous system of people taking infliximab or other TNF-blockers. Signs that you could be experiencing a problem affecting your nervous system include: numbness or tingling, problems with your vision, weakness in your legs, and dizziness.

    Infliximab very rarely can cause a drop in drop in the number of certain types of blood cells or problems with the liver.

  • What helps to reduce side effects?

    Take infliximab as prescribed and contact your health-care provider if you have any concerns while taking the medication.

    If you experience an infusion reaction while taking infliximab, prior to your next infusion your health-care provider may recommend a medication pre-treatment to prevent this. Your prescriber may also recommend a longer infusion time.

  • Do I need any monitoring while taking infliximab?

    Your health-care provider may order periodic blood tests to check your blood count and liver function and to follow the activity of your arthritis.


This information was last updated November 2017, with expert advice from:

Jason Kielly, B.Sc. (pharm.), Pharm.D.
Assistant Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health

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