infliximab, Remicade

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GENERIC NAME: infliximab

BRAND NAME: Remicade

DRUG CLASS AND MECHANISM: Infliximab is an antibody administered intravenously that is used for treating several chronic inflammatory diseases. Infliximab works by blocking the effects of tumor necrosis factor alpha (TNF alpha), a substance made by cells of the body which has an important role in promoting inflammation. There are two other injectable drugs that block TNF alpha--adalimumab (Humira) and etanercept (Enbrel). Specifically, infliximab is used for treating the inflammation of Crohn's disease, rheumatoid arthritis, psoriasis, ankylosing spondylitis, and psoriatic arthritis. By blocking the action of TNF-alpha, infliximab reduces the signs and symptoms of inflammation. Infliximab does not cure Crohn's disease, psoriatic arthritis, or rheumatoid arthritis. Infliximab can retard the destruction of joints by rheumatoid arthritis. The FDA approved infliximab in August 1998.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Powder for intravenous injection, 100 mg

STORAGE: Infliximab should be refrigerated at 2-8 C (36-46 F)

PRESCRIBED FOR: Infliximab is approved for use alone or combined with methotrexate (Rheumatrex, Trexall) for treating moderate to severe rheumatoid arthritis.

Infliximab is used for reducing the signs and symptoms of inflammation in moderate to severe Crohn's disease and Crohn's disease in which there are fistulas (passageways created when the inflammation penetrates beyond the wall of the intestine).

It also is approved for the treatment of active psoriatic arthritis. Infliximab is helpful in reducing the joint inflammation of juvenile rheumatoid arthritis, ankylosing spondylitis, plaque psoriasis, and psoriatic arthritis.

It also has been found to be helpful in treating the inflammation of uveitis and sarcoidosis that is not responding to traditional therapies.

Infliximab is approved for use in pediatric patients with moderately to severely active Crohn's disease who have had an inadequate response to conventional therapy.

DOSING: Infliximab is administered intravenously. The recommended dose is a 5 mg/kg infusion at 0, 2, and 6 weeks and then 5 mg/kg every 8 weeks for moderate to severe active Crohn's disease or fistulizing Crohn's disease in adult or pediatric patients. Adults who initially responded then lost response may be treated with 10 mg/kg.

The recommended dose for the treatment of moderately to severely active rheumatoid arthritis is 3 mg/kg at 0, 2, and 6 weeks followed by 3 mg/kg every 8 weeks. Infliximab should be combined with methotrexate. If response is incomplete, up to 10 mg/kg or treating every 4 weeks may be tried.

Ulcerative colitis, psoriatic arthritis, and plaque psoriasis are treated with a 5 mg/kg infusion at 0, 2, and 6 weeks and then 5 mg/kg every 8 weeks.

Ankylosing spondylitis is treated with a 5 mg/kg infusion at 0, 2, and 6 weeks then 5 mg/kg every 6 weeks.

DRUG INTERACTIONS: Because infliximab may reduce the response of the immune system, it should not be administered with vaccines containing live bacteria or viruses. Combining infliximab with anakinra (Kineret), abatacept (Orencia) or tocilizumab (Actemra), drugs that also reduce the response of the immune system, may increase the risk of serious infections.




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