Pharm
Infliximab
search
Infliximab
, Remicade
See Also
Etanercept
(
Enbrel
)
Adalimumab
(
Humira
)
Indications
Moderate to severe refractory
Crohn's Disease
Refractory
Rheumatoid Arthritis
Added to
Methotrexate
or with other agents
Contraindications
Histoplasmosis
Coccidioidomycosis
Tuberculosis
Mechanism
Anti-TNF alpha
Monoclonal Antibody
Monoclonal Antibody
binds
Tumor Necrosis Factor
alpha
Pharmacokinetics
Half life of 5 mg/kg single dose: 10 days
Disadvantages
Cost: $2380/dose (cost to pharmacist)
Dose
Crohn's Disease
Initial: 5 mg/kg IV infusion over 2 hours
Repeat at 2 weeks and 6 weeks for fistulas
Dose
Rheumatoid Arthritis
Initial: 3 mg/kg IV at 0 weeks, 2 weeks and 6 weeks
Maintenance: 3 mg/kg IV every 8 weeks (6x/year)
Dosing range is 3-10 mg/kg (typically higher doses than 3 mg needed with longterm use)
Efficacy
Crohn's Disease
Significant response to remission even with fistulas
Relapse may occur after 3 months
Adverse effects
Safety of repeated use unknown
Serum Sickness
Lymphoma
Opportunistic Infection
Associated with
Granuloma
tous infection
Tuberculosis
Histoplasmosis
Higher risk of infection than with
Etanercept
Wallis (2004) Clin Infect Dis 38:1261-5 [PubMed]
Drug Interactions
Acetaminophen
Benadryl
Solu-Medrol
Epinephrine
References
(1999) Med Lett Drugs Ther 41(1047): 19-20 [PubMed]
Maini (2000) Lancet [PubMed]
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