Remicade

Remicade is a drug with immunosuppressive activity. The drug interacts with the soluble and transmembrane species of the human factor-α tumor necrosis and weakens its activity, forming a stable complex.

Infliximab is a hybrid (IgGl) antibody of a monoclonal nature, with strong affinity for transmembrane and soluble species of TNFα factor, but this drug component cannot neutralize the activity of lymphotoxin-α (TNFβ factor).

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Indications Remikejda

It is used in the active stage of rheumatoid arthritis and in regional enteritis. However, it can be used for psoriasis, ankylosing spondylitis, ulcerative colitis, and a psoriatic type of arthritis.

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Release form

The release of drugs is made in the form of a lyophilisate used for the manufacture of intravenous injection fluid - in bottles of 20 mg. In a pack - 1 such bottle.

Pharmacodynamics

When testing in vivo, the infliximab component rather quickly forms stably functioning complexes with human TNFα, resulting in a loss of the bioactivity of the TNFα element.

Additional tests show that the active component of Remicade weakens inflammatory cell infiltration and reduces the values of inflammatory markers within the affected areas of the intestine. Endoscopic examination reveals the healing of the intestinal mucosa.

[3], [4], [5], [6],

Dosing and administration

The drug must be used under medical supervision; A physician should have successful experience in treating and diagnosing arthritis (psoriatic or rheumatoid), ankylosing spondylitis, or inflammatory bowel lesions.

It is required to inject the substance through an IV drip, in / in a way, for at least 2 hours. The procedure should be performed at a speed of maximum 2 ml per minute - through an infusion system equipped with a built-in pyrogen-free (sterile) filter that has a weak protein-synthesizing activity.

For rheumatoid arthritis, 3 mg / kg Remicade should be administered first. Repeat this portion should be after 0.5 and 1.5 months. After that, the medication should be applied at 2-month intervals. In the absence of the desired result, the appropriateness of using this drug should be determined. Prescribed drugs need to be combined with methotrexate.

In case of ulcerative colitis, 5 mg / kg of the drug is first used. The same portion is administered after the next 0.5 and 1.5 months. In the future, the procedure is carried out with 2-month intervals. You can also increase the portion to 10 mg / kg. The development of a clinically significant effect is noted in the period up to 3.5 months. In the absence of an effect, it is necessary to resolve the issue of continuing treatment.

In case of arthritis of a psoriatic nature, at the initial stage, 5 mg / kg of drugs are used, and then the procedure is repeated after 0.5 and 1.5 months. Later, it is necessary to administer the drug with 1.5-2 month intervals. It is allowed to combine the substance with methotrexate.

The use of the drug in active regional enteritis (severe or moderate) in adults is a single dose of 5 mg / kg. In the absence of the result of the first injection of drugs for 14 days, it should not be prescribed again. With the development of a positive effect, the following therapeutic schemes can be used:

• after 0.5 and 1.5 months, the same portion of the first infusion is used, and then the procedure is repeated at 8-week intervals. When required, the size of the dosage can be increased to 10 mg / kg;
• the introduction of the drug solely in case of recurrence of the disease, if it has passed up to 4 months from the moment of its first use.

Treatment of the active form of regional enteritis (moderate or severe severity) in persons younger than 18 years of age involves the use of medication 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 intervals. If required, the portion can be increased to 10 mg / kg. Remicade is combined with methotrexate, immunomodulators-6-mercaptopurine, as well as azathioprine. In the absence of the necessary result after 2.5 months, you can cancel the use of the drug.

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. In the absence of a result after 3 procedures, further therapy should be abandoned. With a positive effect, you can use the following treatment regimens:

• repeated infusions after 0.5 and 1.5 months, and then carrying out procedures with 8-week intervals;
• use in case of recurrence of pathology, provided that the gap is up to 4 months.

In ankylosing spondylitis, a dose of 5 mg / kg is first used. Later, the drug is used after 0.5 and 1.5 months. After 3 such procedures, infusion is carried out with 6-8 weeks of interruption. Continue treatment should not be if after 1.5 months there is no result.

In the case of psoriasis, 5 mg / kg of substance is first required. Repeated infusions are performed after 0.5 and 1.5 months, and then they are carried out with a 2-month break. Further use is not recommended in the absence of a result for 3.5 months after 4 infusions.

With the recurrence of arthritis of rheumatoid nature or regional enteritis, it is possible to re-administer the medication for 4 months after the last infusion.

In the case of any disease with a positive impact of Remicade, the doctor should select the total duration of treatment.

It is forbidden to mix the drug with other medicines within a single infusion system. If any particles are present in the solution, it is forbidden to use it. Unused medicine residues are required to be destroyed.

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Use Remikejda during pregnancy

It is forbidden to use the drug during pregnancy.

Contraindications

The main contraindications:

• severe intolerance to drug elements;
• clinical manifestations of infectious lesions or abscesses;
• lactation period;
• sepsis.

[7], [8]

Side effects Remikejda

Among the possible adverse events of the drug:

• lesions associated with the work of the central nervous system: apathy, nervousness and drowsiness, great anxiety, psychosis, depression and dizziness, and in addition to this 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 bleeding from the nose, and in addition, pneumonia, signs of allergy and infection that affects the upper respiratory tract;
• disorders of the urogenital system: edema and infection in the urethra;
• disorders associated with CVS function: peripheral blood flow disorder, hematoma or ecchymosis, bradycardia, hot flashes, vascular spasms and syncope, and besides thrombophlebitis, petechiae, arrhythmia, palpitations, cyanosis and an increase or decrease in blood pressure;
• lesions of the hematopoietic system: leuko-, thrombocyto-, neutro, and lymphocytopenia, and in addition, anemia, lymphocytosis, or lymphadenopathy;
• symptoms associated with the work of the gastrointestinal tract: diarrhea, indigestion, cheilitis, cholecystitis, diverticulitis and pain, affecting the abdominal area. In addition, gastro-esophageal reflux, constipation, nausea, and impaired hepatic function;
• disorders affecting the epidermis: urticaria, seborrhea, rashes, warts, itching and dry skin. In addition, alopecia, hyperhidrosis and hyperkeratosis, as well as erysipelas, bullous eruptions, fungal dermatitis, skin pigmentation disorder and furunculosis.

Along with this, there may be such negative signs: pain or infusion syndromes, myalgia, periorbital edema, lupus drug, 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 forbidden to combine the drug with abatacept.

Plasma Remicade increases with combination with methotrexate. In addition, this combination reduces the formation of antibodies relative to the active component of drugs.

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Storage conditions

Remicade is required to keep in a place closed from the penetration of children. It is forbidden to freeze the medicine. Temperature values - in the range of 2-8 ° C.

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Shelf life

Remicade can be applied for a period of 3 years from the moment of sale of the medicine.

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Application for children

In pediatrics (children over 6 years of age), Remicade is prescribed only for ulcerative colitis and regional enteritis.

There is no evidence as to whether it is safe and effective to use the drug in pediatrics for arthritis (psoriatic, idiopathic juvenile or rheumatoid juvenile), psoriasis, or ankylosing spondylitis.

[14], [15]

Analogs

Analogues of the medication are drugs Simponi, Enbrel with Humira and Enbrel Lyot.

[16], [17], [18], [19], [20]

Reviews

Remicade basically gets good reviews on medical forums. It is reported that after his application of pain disappear completely. Although some patients fear that the drug may cause addiction.

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