Infliximab

What is infliximab?

Infliximab is used to treat some types of autoimmune conditions. These are conditions in which your body's defence (immune) system attacks healthy tissues, such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, bowel diseases such as Crohn's disease, ulcerative colitis and skin diseases such as chronic plaque psoriasis.

Infliximab is usually used when other treatments have not worked well. It is a type of medicine called a TNF inhibitor. It works by blocking natural inflammatory substances in your body called tumour necrosis factor-alpha (TNFa). This helps to reduce swelling (inflammation) and weaken your immune system, thereby slowing or stopping the damage from the disease. Read more about TNF inhibitors. 

How is infliximab given?

Infliximab is given by slow injection into a vein in your arm (called intravenous infusion), every 2–8 weeks. It usually takes about 2 hours for you to receive your entire dose of infliximab. Infliximab may cause serious allergic reactions during the infusion. Some people have reactions several hours or even days afterwards. A doctor or nurse will monitor you during the infusion and for 1 hour afterwards to be sure you are not having a serious reaction to the medicine. You may be given other medicines to treat or prevent reactions to infliximab.

Precautions – before taking infliximab

• Do you have any problems with your heart or lungs, such as heart failure, chest pain or difficulty breathing? 
• Do you have any problems with the way your kidneys or liver work?
• Are you pregnant or breastfeeding or planning to have a baby?
• Are you taking medicine for high blood pressure?
• Do you have an infection at the moment (including fungal infections)?
• Do you have hepatitis B?
• Are you due to have any vaccines?
• Do you have epilepsy or have you had any seizures?
• Do you have, or have you had, any type of cancer?

If so, it’s important that you tell your doctor before you start taking infliximab. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Side effects

Like all medicines, infliximab can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.

Increased risk of infections

Because infliximab weakens your body's immune system, it can make it more likely for you to get infections. These infections may be mild (such as a cold or sinusitis) or more severe, such as tuberculosis (TB) and septicaemia (infection of your blood).

• Before starting infliximab, you will need to:
  • have blood tests and a chest x-ray to check for infections
  • check with your doctor what vaccines you might need – you should not have a live vaccine while using infliximab.
• Tell your doctor immediately if you:
  • come into contact with someone who has an infection such as TB (tuberculosis) while you are taking infliximab
  • develop an ongoing cough, weight loss, fever, sore throat, bruising or bleeding.
• You will need to be monitored for infections during treatment and for several months after you have stopped taking it.
  • Before you start taking infliximab let your doctor know if you are pregnant or planning to become pregnant, and if you have TB or hepatitis B.

Learn more

Remicade Consumer Information Sheets, Medsafe, NZ
Infliximab Australian Rheumatology Association  
Infliximab RheumInfo

References

1. Biologic medicines for the treatment of inflammatory conditions: What does primary care need to know? BPAC, NZ, 2013
2. Infliximab NZ Formulary