Adult Dosing
Crohn’s disease or fistulizing crohn’s disease
- Induction regimen: 5 mg/kg IV for three doses at 0, 2, and 6 wks
- Maintenance regimen: 5 mg/kg q8 wks. May increase to 10 mg/kg if initial response is lost; if no response by 14 wks, discontinue
Ulcerative colitis
- Induction regimen: 5 mg/kg IV for three doses at 0, 2, and 6 wks
- Maintenance regimen: 5 mg/kg q8 wks
Rheumatoid arthritis
- 3 mg/kg IV for three doses at 0, 2 and 6 wks, then q8 wks thereafter. Should be given in comb with methotrexate
- May increase dose to 10 mg/kg or frequency to q4 wks if incomplete response
Ankylosing spondylitis
- 5 mg/kg IV for three doses at 0, 2, and 6 wks
- Maintenance regimen: 5 mg/kg q6 wks thereafter
Psoriatic arthritis, plaque psoriasis
- 5 mg/kg IV for three doses at 0, 2, and 6 wks
- Maintenance regimen: 5 mg/kg q8 wks
Kawasaki Syndrome [Non-FDA Approved]
- 5 mg/kg IV single dose infusion
Pediatric Dosing
Crohn’s disease
- >6 years old: Induction regimen: 5 mg/kg IV for three doses at 0, 2, and 6 wks
- Maintenance regimen: 5 mg/kg q8 wks
- Info: D/C if no response by week 14
Active moderate/severe ulcerative colitis
- >6 years old: Induction regimen: 5 mg/kg IV for three doses at 0, 2, and 6 wks
- Maintenance regimen: 5 mg/kg q8 wks
Kawasaki Syndrome [Non-FDA Approved]
- 5 mg/kg IV single dose infusion
- Serious and sometimes fatal infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have occurred with infliximab therapy. Patients should be closely monitored for the development of signs and symptoms of infection during and after treatment; do not start treatment if active infection is present [US Black Box Warnings]
- Lymphoma and other fatal malignancies have occurred with infliximab therapy in children and adolescent. Use cautiously in patients with a history of malignancy or in continuing treatment in patients who develop malignancy [US Black Box Warnings]
- Infliximab therapy can cause reactivation of hepatitis B virus (HBV) in patients who are chronic carriers of this virus mostly in patients receiving other immunosuppressant agents. Use cautiously and monitor HBV carriers during and several months after therapy in patients identified as carriers of HBV
- Severe hepatic reactions, including acute liver failure, jaundice, hepatitis and cholestasis have been reported rarely in patients receiving infliximab
- Consider other treatment options before starting infliximab therapy in patients with heart failure, as infliximab is associated with severe adverse outcomes and higher mortality rate in these patients
- Hematologic abnormalities such as leukopenia, neutropenia, thrombocytopenia, and pancytopenia have been reported with infliximab therapy, discontinue therapy if significant hematologic abnormalities develops and provide immediate medical attention
- Sever hypersensitivity reaction can occur after administration of infliximab, discontinue the drug and provide emergency treatment for hypersensitivity
- Consider empiric antifungal therapy for patients who reside or travel to regions where mycoses are endemic
- Monitor HBV carriers during and several months after therapy due to risk of hepatitis B reactivation; if reactivation occurs, stop treatment and start antiviral therapy
- Worsening of CHF and/or new onset CHF has been reported in patients treated with infiximab
- Rarely CNS manifestation of systemic vasculitis, seizure central and peripheral nervous system demyelinating disorder have been reported. Use cautiously in patients with these neurological disorders
- Do not use combination of infiximab and anakinra, as it cause toxicity reactions
- Do not use concomitantly with live vaccines
- Skin cancer (melanoma, Merkel cell carcinoma) have been reported in those being treated with TNF blockers, hence routine skin examination is advised
- Coadministration with other biological therapeutics used to treat the same conditions are associated with increased risk of serious infection
Cautions: Use cautiously in
- Latent and active tuberculosis
- Tuberculosis risk factors
- History of opportunistic infections
- History of chronic/recurrent infections
- Risk of infection
- History of malignancy
- Immunosuppressant use
- Myelosupression
- Hepatitis B carrier
- COPD
- History of CHF
- Neurological disorder
Pregnancy Category:B
Breastfeeding: Safety unknown; usually not detectable in breastmilk. As it is not absorbed orally, it is unlikely to adversely affect the breastfed infant. In a follow up study infants exposed to infliximab in utero and during maternal infliximab therapy showed normal development and no adverse effect. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 14 Jan 2011). As per manufacturer data as many drugs and immunoglobulins are excreted in human milk, and because of the potential for adverse reactions in nursing infants, decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Remicade 100 MG SOLR [Vial] (JANSSEN BIOTECH)
1 mg = $790.96
3 mg = $2320.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
