Digestive Health Inflammatory Bowel Disease Treatment What You Need to Know About Remicade (Infliximab) By Amber J. Tresca facebook twitter linkedin Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16. Learn about our editorial process Amber J. Tresca Medically reviewed by Medically reviewed by Robert Burakoff, MD, MPH on July 17, 2020 linkedin Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases. Learn about our Medical Review Board Robert Burakoff, MD, MPH Updated on August 05, 2020 Print Table of Contents View All Table of Contents How It's Taken Indications Contraindications Side Effects Interactions Use in Pregnancy Financial Aid Remicade (infliximab) is a type of drug known as a monoclonal antibody. TNF-alpha (tumor necrosis factor alpha) is found in higher amounts in people with Crohn's disease than it is in people who do not have any form of inflammatory bowel disease (IBD). Remicade stops TNF-alpha from being used by the body. TNF-alpha is actually a cytokine, which plays a role in the inflammatory process in the body. IBD is an inflammatory condition and TNF-alpha is believed to play a role in the way the disease affects the gastrointestinal system. A cytokine goes between cells in the body delivering chemical "messages." DragonImages / Getty Images How Is Remicade Taken? Remicade is given as an infusion through an IV line, often in a hospital or doctor's office setting. The infusion is given slowly over several (usually two or more) hours. The physician who prescribes Remicade will provide any special instructions that patients should follow before the infusion appointment. Why Is Remicade Prescribed? Remicade may be prescribed for adults and children over the age of 6 who have a moderate to severe case of ulcerative colitis or Crohn's disease, the main forms of IBD. Remicade binds to TNF-alpha, preventing it from causing inflammation in the body. With the TNF-alpha unable to cause inflammation, a person with IBD may experience an inactive time in the disease process, also called remission. For Crohn's disease, Remicade is approved for use in cases that are not responding to other drug therapies. It may also be given for people with Crohn's disease who have fistulas and to treat certain forms of rheumatoid arthritis. With moderate to severe ulcerative colitis, 2020 guidelines recommend that a biologic medication (such as Remicade) be used first-line—i.e., right away, rather than waiting for other treatments to fail or stop working. Remicade is used both for the induction of remission and maintenance of remission; it should not be stopped when remission occurs. According to these guidelines, combining Remicade with an immunomodulator medication is preferred over using Remicade alone. Who Should Not Take It? Tell your doctor if you have ever had any of the following conditions: Allergic reactions to any medicationCurrent pregnancyCancerInfectionsLupusRecent vaccination Potential Side Effects Common side effects of Remicade include: Abdominal painNauseaFatigueVomiting Tell your doctor if any side effects are bothersome or don't go away. Rarely other, more serious side effects can occur, such as: Difficulty urinatingInfection,Irregular heartbeatRectal pain These side effects should be reported to your physician immediately. Medication Interactions Remicade has not been extensively studied for drug interactions. During clinical trials of Remicade, some patients were already taking antibiotics, antivirals, corticosteroids (such as prednisone), 6-MP/AZA, and aminosalicylates. These patients did not experience a greater amount of infusion reactions than those who were not taking any other drugs. However, people receiving Remicade should not receive any vaccines containing live viruses or bacteria (note: the seasonal influenza shot does not contain a live virus). Remicade suppresses the immune system, and taking other drugs that suppress the immune system at the same time could increase the possible risk of infection. A physician should be consulted about any other medications being taken at the same time as Remicade. Is Remicade Safe During Pregnancy? The FDA has classified Remicade as a type B drug. The effect that Remicade has on an unborn child has not been studied extensively. Remicade should only be used during pregnancy if clearly needed. Notify the prescribing doctor if you become pregnant while taking Remicade. It is thought that Remicade does not pass into breast milk. Women should check with their physicians, but it is currently thought that women who are receiving Remicade should not be discouraged from breastfeeding their babies, particularly given the widespread benefits of breast milk for an infant. How Can I Get Help for the Cost? Janssen Pharmaceuticals has a Patient Assistance Program to help in getting medical coverage for Remicade. Help may also be available from local IBD organizations. Was this page helpful? Thanks for your feedback! We're providing tips on how to take better care of your gut. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Papamichael K, Lin S, Moore M, Papaioannou G, Sattler L, Cheifetz AS. Infliximab in inflammatory bowel disease. Ther Adv Chronic Dis. 2019;10:1-15. doi:10:2040622319838443. Melsheimer R, Geldhof A, Apaolaza I, Schaible T. Remicade (infliximab): 20 years of contributions to science and medicine. Biologics. 2019;13:139-178. doi:10.2147/BTT.S207246 Feuerstein JD, Isaacs KL, Schneider Y, et al. AGA Clinical Practice Guidelines on the Management of Moderate to Severe Ulcerative Colitis. Gastroenterology. 2020;158(5):1450-1561. doi:10.1053/j.gastro.2020.01.006 Ali T, Kaitha S, Mahmood S, Ftesi A, Stone J, Bronze MS. Clinical use of anti-TNF therapy and increased risk of infections. Drug Healthc Patient Saf. 2013;5:79-99. doi:10.2147/DHPS.S28801 Chaparro M, Gisbert JP. How safe is infliximab therapy during pregnancy and lactation in inflammatory bowel disease?. Expert Opin Drug Saf. 2014;13(12):1749-62. doi:10.1517/14740338.2014.959489 Additional Reading Janssen Pharmaceuticals. What You Need to Know About Remicade. Remicade.com. 28 Jan 2016. Kane S, Ford J, Cohen R, Wagner C. Absence of infliximab in infants and breast milk from nursing mothers receiving therapy for Crohn's disease before and after delivery. J Clin Gastroenterol. 2009 Aug;43:613-616. doi:10.1097/MCG.0b013e31817f9367 Wilhelm SM, McKenney KA, Rivait KN, Kale-Pradhan PB. A review of infliximab use in ulcerative colitis. Clin Ther. 2008 Feb;30:223-230. doi:10.1016/j.clinthera.2008.02.014