Remicade (Infliximab)

Remicade (Infliximab) is an engineered biologic medication that is approved for use against rheumatoid arthritis, in combination with methotrexate. Methotrexate is the most commonly prescribed medicine against RA. It is known as a disease-modifying anti-rheumatic drug (DMARD).1

When given with methotrexate, Remicade reduces the signs and symptoms of RA and slows the structural damage that occurs in adults with moderately- to severely-active disease, resulting in improved physical functioning and increased quality of life.2,3

This medication is also prescribed for other autoimmune diseases, including adult and pediatric Crohn’s disease and ulcerative colitis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis.2

Remicade is not available in generic forms.

What are the ingredients in Remicade?

The active ingredient in Remicade is Infliximab.2

How does Remicade work?

Remicade is one of several monoclonal antibodies used to treat RA. Our bodies naturally produce antibodies, which are immune factors that act against bacteria, viruses, and other foreign organisms that invade and pose a threat to our health. Drug makers have engineered a variety of antibodies to target the mechanisms that cause certain diseases, including RA.

Remicade is partially derived from mouse antibodies. It blocks the action of tumor necrosis factor- α (TNF-α) and kills cells that express TNF-α on their surface. TNF-α is an important immune system signaling factor (called a cytokine) that plays a key role in swelling and inflammation. It is found in higher levels in the synovial fluid in the joints of patients with RA, and it is connected to inflammation as well as bone and cartilage damage. Blocking TNF-α helps tamp down the damage caused by the dysfunction of the immune system that is characteristic of RA.2,3

What are the possible side effects of Remicade?
Common side effects with Remicade include:2,4,5

  • Runny nose
  • Sore throat
  • Infections
  • Headache
  • Rash
  • Stomach pains
  • Upper respiratory infection
  • Infusion-related reactions, including:
    • Flu-like symptoms
    • Headache
    • Shortness of breath
    • Low blood pressure
    • Fever and chills
    • Stomach symptoms
    • Skin rash
    • Allergy

In some patients, Remicade can cause more harmful side effects. Patients who take Remicade are at increased risk for serious infections, including bacterial infections, tuberculosis, reactivation of hepatitis B, and invasive fungal infections.

Children, adolescents, and young adults taking Remicade are also at slightly higher risk for lymphoma and other cancers. Other rare but serious side effects include Hepatitis B reactivation, nerve diseases like multiple sclerosis, certain blood disorders, heart disease, liver problems, and lupus-type symptoms.2

This is not an exhaustive list of all potential side effects of Remicade. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects, contact your doctor or healthcare provider immediately.

Things to note about Remicade
Before taking Remicade, tell your doctor if you2,5:

  • Have a current infection or are prone to recurring infections, including open cuts
  • Lived in a region where fungal infections are common
  • Have HIV, diabetes, or a weakened immune system
  • Have tested positive for TB or have been in close contact with someone who has TB
  • Have or have had Hepatitis B
  • Have COPD, or chronic obstructive pulmonary disease or are at risk for cancer
  • Have or have had heart disease or heart failure
  • Have nervous system disorders like multiple sclerosis or Guillain-Barré syndrome
  • Are scheduled to receive a vaccine
  • Are pregnant or plan to become pregnant or are breastfeeding

With Remicade, there is an increased risk for serious infection. This is because Remicade can decrease the ability of the immune system to fight infections. If an infection develops while you are taking this medication, or if you have a severe allergic reaction, contact your doctor immediately. You may need to stop the medication.2

Remicade should not be used in patients with moderate to severe heart failure, since it can make heart symptoms worse. It is also not recommended for patients with nerve diseases like multiple sclerosis. Patients taking this medication should not receive live vaccines.2,5

Tell your doctor about any medications or supplements you are taking while on Remicade, because it doesn’t mix well with certain medicines, especially other biologics approved to treat RA and certain antibiotics. It is important for doctors to test you for TB before you take Remicade.2,4,5

Dosing information

Remicade is given through a vein in your arm via intravenous (IV) infusion and must be administered at a medical office. An infusion typically takes about 2 hours. It is always taken in conjunction with methotrexate. The exact does depends on your body weight, but the formula is 3 mg/kg to begin, at 0, 2 and 6 weeks, and then to continue with treatments once every 8 weeks after that. Increasing the dose of Remicade up to 10 mg/kg or getting treatments as frequently as every 4 weeks may benefit some patients.2

Written by: Sara Finkelstein | Last reviewed: June 2018.
View References
  1. Johnsen AK, Weinblatt M. Methotrexate: the foundation of rheumatoid arthritis therapy. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatoid Arthritis. Philadelphia, Penn: Mosby Elsevier; 2009:307-314.
  2. Prescribing Information. Janssen Pharmaceutical Companies. Horsham, PA. Revised October 2017. http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/REMICADE-pi.pdf Accessed June 12, 2018.
  3. Carolina Negrei, Violeta Bojinca, Andra Balanescu, et. al., Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches. Exp Ther Med. 2016 Apr; 11(4): 1177–1183. Published online 2016 Feb 2. doi: 10.3892/etm.2016.3045 Accessed May 26, 2018.
  4. Infliximab (Remicade). American College of Rheumatology. Updated January 2017. https://www.rheumatology.org/Learning-Center/Medication-Guides/Medication-Guide-Infliximab-Remicade Accessed June 12, 2018.
  5. Remicade. Janssen Biotech, Inc., Updated November 10, 2017. https://www.remicade.com Accessed June 12, 2018.