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Remicade
Last reviewed: 04.07.2025
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Remicade is a drug with immunosuppressive activity. The drug interacts with soluble and transmembrane varieties of human tumor necrosis factor-α and weakens its activity, forming a stable complex.
Infliximab is a hybrid (IgGl) monoclonal antibody with strong affinity for transmembrane and soluble forms of the TNFα factor, but this drug component cannot neutralize the activity of lymphotoxin-α (TNFβ factor).
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Indications Remicade
It is used in the active stage of rheumatoid arthritis and regional enteritis. It can also be used in psoriasis, ankylosing spondylitis, ulcerative colitis and psoriatic arthritis.
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Release form
The drug is produced in the form of a lyophilisate used for the production of intravenous injection fluid - in 20 mg vials. There is 1 such vial in a pack.
Pharmacodynamics
When tested in vivo, the infliximab component quite quickly forms stable functioning complexes with human TNFα, resulting in a loss of bioactivity of the TNFα element.
Additional tests show that the active component of Remicade reduces inflammatory cell infiltration and reduces inflammation markers within the affected areas of the intestine. Endoscopic examination reveals healing of the intestinal mucosa.
Dosing and administration
The drug must be used under medical supervision; the physician must have successful experience in the treatment and diagnosis of arthritis (psoriatic or rheumatoid), ankylosing spondylitis or intestinal lesions of an inflammatory nature.
The substance must be administered via a dropper, intravenously, for at least 2 hours. The procedure must be performed at a maximum rate of 2 ml per minute - through an infusion system equipped with a built-in apyrogenic filter (sterile), which has weak protein-synthesizing activity.
In case of rheumatoid arthritis, it is necessary to first administer 3 mg/kg of Remicade. This dose should be repeated after 0.5 and 1.5 months. After that, the medication should be used at 2-month intervals. If the desired result is not achieved, it is necessary to determine the appropriateness of using this medication. The drug should be prescribed in combination with methotrexate.
In case of ulcerative colitis, 5 mg/kg of the drug is initially administered. The same dose is administered after the next 0.5 and 1.5 months. The procedure is then carried out at 2-month intervals. The dose can also be increased to 10 mg/kg. The development of clinically significant effects is noted within 3.5 months. If there is no effect, it is necessary to decide on whether to continue the treatment.
In psoriatic arthritis, 5 mg/kg of the drug is used at the initial stage, and then the procedure is repeated after 0.5 and 1.5 months. Later, the drug should be administered at 1.5-2-month intervals. It is allowed to combine the substance with methotrexate.
Use of the drug for active regional enteritis (severe or moderate) in adults - 1-time dose of 5 mg/kg. If there is no result from the first administration of the drug for 14 days, it should not be prescribed again. If a positive effect develops, the following therapeutic regimens can be used:
- after 0.5 and 1.5 months, a dose similar to the 1st infusion is used, and then the procedure is repeated at 8-week intervals. If necessary, the dosage can be increased to 10 mg/kg;
- administration of the drug only in case of relapses of the disease, if up to 4 months have passed since the first use.
Treatment of active regional enteritis (moderate or severe) in individuals under 18 years of age involves the use of the drug in an initial dose of 5 mg/kg. New procedures are performed after 0.5 and 1.5 months, and then the drug is administered with 8-week breaks. If necessary, the dose can be increased to 10 mg/kg. Remicade is combined with methotrexate, immunomodulators-6-mercaptopurine, and azathioprine. If the desired result is not achieved after 2.5 months, the use of the drug can be discontinued.
A single dose for regional enteritis with fistula formation (for adults) is 5 mg/kg. Repeated infusions are performed after 0.5 and 1.5 months. If there is no result after 3 procedures, further therapy should be abandoned. If the effect is positive, the following treatment regimens can be used:
- repeated infusions after 0.5 and 1.5 months, and then procedures with 8-week breaks;
- use in case of relapses of pathology, provided that the interval is up to 4 months.
In Bechterew's disease, a dose of 5 mg/kg is used first. Later, the drug is used after 0.5 and 1.5 months. After 3 such procedures, infusions are carried out with 6-8-week breaks. Treatment should not be continued if no result is observed after 1.5 months.
In case of psoriasis, 5 mg/kg of the substance is initially required. Repeated infusions are performed after 0.5 and 1.5 months, and then they are performed with a 2-month break. Further use is not recommended if there is no result within 3.5 months after 4 infusions.
In case of relapse of rheumatoid arthritis or regional enteritis, the medication can be administered again within 4 months after the last infusion.
In case of any disease with a positive effect of Remicade, the total duration of treatment should be selected by a doctor.
It is prohibited to mix the drug with other medications in one infusion system. If there are any particles in the solution, it is prohibited to use it. Unused remains of the drug must be destroyed.
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Use Remicade during pregnancy
It is prohibited to use the drug during pregnancy.
Side effects Remicade
Possible side effects of the medication include:
- CNS-related disorders: apathy, nervousness and drowsiness, severe anxiety, psychosis, depression and dizziness, as well as headaches and amnesia;
- dysfunction of the sense organs: endophthalmitis, conjunctivitis or keratoconjunctivitis;
- problems with respiratory activity: pulmonary edema, bronchitis, pleurisy, dyspnea, bronchial spasm, sinusitis and nosebleeds, as well as pneumonia, signs of allergy and infection affecting the upper respiratory tract;
- disorders of the urogenital system: swelling and infections in the area of the urinary tract;
- disorders associated with the function of the cardiovascular system: peripheral blood flow disorder, hematoma or ecchymosis, bradycardia, hot flashes, vascular spasms and fainting, as well as thrombophlebitis, petechiae, arrhythmia, palpitations, cyanosis and an increase or decrease in blood pressure;
- damage to the hematopoietic system: leukopenia, thrombocytopenia, neutro and lymphocytopenia, as well as anemia, lymphocytosis or lymphadenopathy;
- Gastrointestinal symptoms: diarrhea, indigestion, cheilitis, cholecystitis, diverticulitis and abdominal pain. In addition, gastroesophageal reflux, constipation, nausea and liver dysfunction;
- disorders affecting the epidermis: urticaria, seborrhea, rashes, warts, itching and dry skin. In addition, alopecia, hyperhidrosis and hyperkeratosis, as well as erysipelas, bullous rashes, fungal dermatitis, skin pigmentation disorders and furunculosis.
Along with this, the following negative signs may be noted: pain or infusion syndromes, myalgia, periorbital edema, drug-induced lupus, the appearance of infections, arthralgia, the formation of autoantibodies and negative manifestations in the infusion zone.
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Interactions with other drugs
It is prohibited to combine the drug with abatacept.
Plasma parameters of Remicade increase when combined with methotrexate. In addition, with such a combination, the formation of antibodies to the active component of the drug decreases.
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Storage conditions
Remicade must be kept in a place closed to children. It is forbidden to freeze the medicine. Temperature values are in the range of 2-8°C.
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Shelf life
Application for children
In pediatrics (children over 6 years of age), Remicade is prescribed only for ulcerative colitis and regional enteritis.
There are no data on whether the drug is safe and effective for use in pediatric patients with arthritis (psoriatic, idiopathic juvenile, or rheumatoid juvenile), psoriasis, or ankylosing spondylitis.
Analogues
The drug's analogues are Simponi, Enbrel with Humira and Enbrel Lio.
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Reviews
Remicade generally gets good reviews on medical forums. It is reported that after using it, pain disappears completely. Although some patients are concerned that the drug may cause addiction.
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Attention!
To simplify the perception of information, this instruction for use of the drug "Remicade" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.