Remicade

Infliximab

RA; ankylosing spondylitis; psoriatic arthritis; psoriasis; Crohn's disease; paed Crohn's disease; fistulizing Crohn's disease; ulcerative colitis; paed ulcerative colitis.

Adult RA In combination w/ MTX: Initially 3 mg/kg IV infusion over 2 hr, followed by additional 3 mg/kg at 2 & 6 wk after 1st infusion, then 8 wkly thereafter. May be increased up to 10 mg/kg after 22 wk of therapy. Ankylosing spondylitis/psoriatic arthritis 5 mg/kg IV infusion over 2 hr, followed by additional 5 mg/kg at 2 & 6 wk after 1st infusion, then 6-8 wkly thereafter. Psoriasis/ulcerative colitis 5 mg/kg IV infusion over 2 hr, followed by additional 5 mg/kg at 2 & 6 wk after 1st infusion, then 8 wkly thereafter. Moderate to severe Crohn's disease 5 mg/kg as single IV infusion over 2 hr as an induction regimen at 0, 2 & 6 wk. Maintenance: 5 mg/kg 8 wkly thereafter, may be adjusted up to 10 mg/kg. Fistulizing Crohn's disease 5 mg/kg IV over 2 hr, followed by additional 5 mg/kg at 2 & 6 wk after the 1st infusion. Re-administration for Crohn's diseases & RA Re-administer w/in 16 wk following last infusion. Ped Crohn's disease 5 mg/kg IV infusion followed by additional 5 mg/kg at 2 & 6 wk after 1st infusion, then 8 wkly thereafter, may be adjusted up to 10 mg/kg. 6-17 yr Ulcerative colitis 5 mg/kg IV infusion followed by additional 5 mg/kg at 2 & 6 wk after 1st infusion, then 8 wkly thereafter.

Hypersensitivity to infliximab & other murine proteins. TB or other severe infections eg, sepsis, abscesses & opportunistic infections; moderate or severe heart failure (NYHA class III/IV).

Infusion reactions & hypersensitivity, pretreatment w/ antihistamine, hydrocortisone &/or paracetamol to prevent. Infections, monitor for infections including TB, caution in patients w/ chronic infection or history of recurrent infections, including concomitant immunosuppressive therapy, patients taking TNF-blockers. Hepatitis B reactivation, test for HBV infection before initiating treatment. Hepatobiliary events. Concurrent administration of TNFα inhibitor & anakinra/abatacept w/ other biological therapeutics. Switching between biological DMARDS. Vaccinations, patients on infliximab may receive concurrent vaccinations, except for live vaccines. Live vaccines/therapeutic infectious agents, use not recommended. Autoimmune processes. Neurological events. Malignancies & lymphoproliferative disorders, caution treated w/ TNF-antagonist, heavy smoking, psoriasis, medical history of extensive immunosuppressant therapy or prolonged PUVA treatment. Heart failure. Haematologic reactions. May affect ability to drive & use machines. Hepatic dysfunction. Women of childbearing potential should use effective contraception. Pregnancy & lactation. Ped patients. Elderly ≥65 yr.

Viral infection; headache; URTI, sinusitis; abdominal pain, nausea; infusion-relation reaction, pain. Bacterial infections; neutropenia, leucopenia, anaemia, lymphadenopathy; allergic resp symptom; depression, insomnia; vertigo, dizziness, hypoaesthesia, paraesthesia; conjunctivitis; tachycardia, palpitation; hypotension, HTN, ecchymosis, hot flush, flushing; lower resp tract infection, dyspnoea, epistaxis; GI haemorrhage, diarrhoea, dyspepsia, gastroesophageal reflux, constipation; abnormal hepatic function, increased transaminases; new onset or worsening psoriasis, urticaria, rash, pruritus, hyperhidrosis, dry skin, fungal dermatitis, eczema, alopecia; arthralgia, myalgia, back pain; UTI; chest pain, fatigue, fever, inj site reaction, chills, oedema.

Increased plasma conc w/ MTX & other immunomodulators. Not recommended in combination w/ other biological therapeutics eg, anakinra & abatacept. Not to be given concurrently w/ live vaccines; therapeutic infectious agents.

Disease-Modifying Anti-Rheumatic Drugs (DMARDs) / Immunosuppressants

L04AB02 - infliximab ; Belongs to the class of tumor necrosis factor alpha (TNF-alpha) inhibitors. Used as immunosuppressants.

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