Infliximab

Aka: Infliximab, Remicade

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II. Indications

  1. Moderate to severe refractory Crohn's Disease
  2. Refractory Rheumatoid Arthritis
    1. Added to Methotrexate or with other agents

III. Contraindications

  1. Histoplasmosis
  2. Coccidioidomycosis
  3. Tuberculosis

IV. Mechanism

  1. Anti-TNF alpha Monoclonal Antibody
    1. Monoclonal Antibody binds Tumor Necrosis Factor alpha

V. Pharmacokinetics

  1. Half life of 5 mg/kg single dose: 10 days

VI. Disadvantages

  1. Cost: $2380/dose (cost to pharmacist)

VII. Dose: Crohn's Disease

  1. Initial: 5 mg/kg IV infusion over 2 hours
  2. Repeat at 2 weeks and 6 weeks for fistulas

VIII. Dose: Rheumatoid Arthritis

  1. Initial: 3 mg/kg IV at 0 weeks, 2 weeks and 6 weeks
  2. Maintenance: 3 mg/kg IV every 8 weeks (6x/year)
  3. Dosing range is 3-10 mg/kg (typically higher doses than 3 mg needed with longterm use)

IX. Efficacy: Crohn's Disease

  1. Significant response to remission even with fistulas
  2. Relapse may occur after 3 months

X. Adverse effects

  1. Safety of repeated use unknown
  2. Serum Sickness
  3. Lymphoma
  4. Opportunistic Infection
    1. Associated with Granulomatous infection
      1. Tuberculosis
      2. Histoplasmosis
    2. Higher risk of infection than with Etanercept
      1. Wallis (2004) Clin Infect Dis 38:1261-5 [PubMed]

XI. Drug Interactions

  1. Acetaminophen
  2. Benadryl
  3. Solu-Medrol
  4. Epinephrine

XII. References

  1. (1999) Med Lett Drugs Ther 41(1047): 19-20 [PubMed]
  2. Maini (2000) Lancet [PubMed]

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Related Studies

Cost: Medications

remicade (on 2/9/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
REMICADE 100 MG VIAL $1,130.59 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Ontology: infliximab (C0666743)

Definition (CHV) a drug used to treat autoimmune disorders
Definition (CHV) a drug used to treat autoimmune disorders
Definition (NCI_NCI-GLOSS) A monoclonal antibody that blocks the action of a cytokine called tumor necrosis factor alfa. It is being studied in the treatment and prevention of weight loss and loss of appetite in patients with advanced cancer. It belongs to the family of drugs called monoclonal antibodies.
Definition (NCI) A recombinant chimeric, mouse-human monoclonal antibody directed against tumor necrosis factor alpha (TNF-alpha), a protein involved in inflammation, cell survival, and apoptosis. Infliximab may be pro- apoptotic or anti-apoptotic, depending on cell type. (NCI04)
Definition (PDQ) A recombinant chimeric, mouse-human monoclonal antibody directed against tumor necrosis factor alpha (TNF-alpha), a protein involved in inflammation, cell survival, and apoptosis. Infliximab may be pro- apoptotic or anti-apoptotic, depending on cell type. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=38698&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=38698&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1789" NCI Thesaurus)
Concepts Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129) , Pharmacologic Substance (T121)
MSH C108577
SnomedCT 108675009, 386891004
LNC LP35095-6, MTHU018219
English infliximab (medication), monoclonal antibody cA2, MAb cA2, tumor necrosis factor alpha blockers infliximab, infliximab, infliximab [Chemical/Ingredient], monoclonal antibody ca2, inFLIXimab, Infliximab (product), Infliximab (substance), Infliximab, INFLIX, INF, cA2, INFLIXIMAB
Spanish infliximab (producto), infliximab (sustancia), infliximab
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Remicade (C0723012)

Definition (CHV) brand name of infliximab a drug used to treat autoimmune disorders
Definition (CHV) brand name of infliximab a drug used to treat autoimmune disorders
Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH C108577
LNC LA16782-7
English Remicade [brand name], Remicade, Centocor brand of infliximab, Essex brand of infliximab, Schering brand of infliximab, Schering-Plough brand of infliximab
Derived from the NIH UMLS (Unified Medical Language System)

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