What is Infliximab: Uses, Dosage, Side Effects and More

Infliximab is a powerful prescription medication that helps calm down your immune system when it's attacking your own body. It's given through an IV (intravenous) infusion at a hospital or clinic, where healthcare professionals can monitor you closely during treatment.

This medication belongs to a group called biologics, which are made from living cells rather than chemicals. Think of infliximab as a targeted helper that blocks specific signals in your immune system that cause inflammation and tissue damage.

What is Infliximab Used For?

Infliximab treats several autoimmune conditions where your immune system mistakenly attacks healthy parts of your body. Your doctor might prescribe it when other treatments haven't provided enough relief from your symptoms.

The medication is FDA-approved for these specific conditions:

• Rheumatoid arthritis (when combined with methotrexate)
• Crohn's disease and ulcerative colitis
• Ankylosing spondylitis
• Psoriatic arthritis
• Plaque psoriasis

Each of these conditions involves chronic inflammation that can cause significant pain and interfere with daily activities. Infliximab helps reduce this inflammation, which can lead to better symptom control and improved quality of life.

How Does Infliximab Work?

Infliximab works by blocking a protein called tumor necrosis factor-alpha (TNF-alpha) that plays a key role in inflammation. When your immune system produces too much TNF-alpha, it can cause the painful swelling and tissue damage seen in autoimmune diseases.

By binding to TNF-alpha and preventing it from working, infliximab helps break the cycle of inflammation. This is why it's called a TNF blocker or TNF inhibitor.

This medication is considered a strong, targeted treatment. It's typically reserved for moderate to severe cases where other medications haven't been effective enough. The effects usually become noticeable within a few weeks to months of starting treatment.

How Should I Take Infliximab?

Infliximab is only given as an IV infusion in a medical setting like a hospital, clinic, or infusion center. You cannot take this medication at home or by mouth.

The infusion process typically takes 2-3 hours, and you'll be monitored by healthcare professionals throughout. Most people receive their first three doses at weeks 0, 2, and 6, then continue with infusions every 8 weeks.

Before each infusion, your healthcare team will check your vital signs and ask about any symptoms or concerns. You don't need to fast before treatment, but it's helpful to eat a light meal and stay hydrated.

You might feel more comfortable bringing a book, tablet, or other quiet activities since you'll be sitting for several hours. Some people experience fatigue after treatment, so consider arranging for someone to drive you home.

How Long Should I Take Infliximab For?

The length of infliximab treatment varies greatly depending on your specific condition and how well you respond to the medication. Some people may need treatment for several months, while others might continue for years.

Your doctor will regularly assess how well the medication is working and whether you're experiencing any concerning side effects. They'll use blood tests, imaging studies, and your symptom reports to make these decisions.

It's important never to stop infliximab suddenly without discussing it with your doctor first. Stopping abruptly can cause your symptoms to return, sometimes more severely than before. Your healthcare team will create a plan that's right for your situation.

What Are the Side Effects of Infliximab?

Like all medications, infliximab can cause side effects, though not everyone experiences them. Understanding what to watch for helps you stay safe and get the most benefit from treatment.

Common side effects that many people experience include:

• Headache and fatigue
• Upper respiratory infections like colds
• Stomach pain or nausea
• Reactions at the infusion site
• Muscle or joint aches

These side effects are usually mild and often improve as your body adjusts to the medication. However, you should always report any new or worsening symptoms to your healthcare team.

More serious side effects require immediate medical attention, though they're less common:

• Signs of serious infection (fever, chills, persistent cough, flu-like symptoms)
• Unusual tiredness or weakness
• Skin changes including new growths or sores
• Persistent stomach pain or changes in bowel movements
• Difficulty breathing or chest pain

Because infliximab affects your immune system, you may be at higher risk for infections. Your doctor will monitor you closely and may recommend avoiding certain vaccines or crowded places during peak illness seasons.

Who Should Not Take Infliximab?

Infliximab isn't safe for everyone, and your doctor will carefully review your medical history before prescribing it. Certain health conditions or circumstances make this medication inappropriate or potentially dangerous.

You should not receive infliximab if you have:

• Active infections, especially tuberculosis or hepatitis B
• Heart failure (moderate to severe)
• Known allergy to infliximab or its components
• Certain types of cancer or a history of lymphoma

Your doctor will also use extra caution if you have diabetes, liver problems, or a history of recurring infections. They may require additional testing or monitoring before starting treatment.

Pregnancy and breastfeeding require special consideration. While infliximab may be used during pregnancy in certain situations, it's important to discuss the risks and benefits thoroughly with your healthcare team.

Infliximab Brand Names

The brand name for infliximab is Remicade, which is the original version of this medication. You might also encounter biosimilar versions, which are highly similar medications that work the same way.

Common biosimilar names include Inflectra, Renflexis, and Ixifi. These biosimilars have been proven to be just as effective and safe as the original Remicade, though your insurance coverage might vary between different versions.

Your doctor and pharmacist will work together to determine which version is best for you based on effectiveness, availability, and cost considerations.

Infliximab Alternatives

If infliximab isn't right for you or stops working effectively, several other treatment options are available. Your doctor can help you explore these alternatives based on your specific condition and medical history.

Other TNF blockers include adalimumab (Humira), etanercept (Enbrel), and certolizumab (Cimzia). These work similarly to infliximab but may be given as injections you can do at home.

Non-TNF biologics like rituximab, tocilizumab, or abatacept target different parts of the immune system. Traditional disease-modifying drugs like methotrexate, sulfasalazine, or hydroxychloroquine might also be options.

The choice depends on factors like your specific diagnosis, previous treatments, lifestyle preferences, and how your body responds to different medications.

Is Infliximab Better Than Adalimumab?

Both infliximab and adalimumab are effective TNF blockers, but they have different advantages depending on your situation. Neither is universally "better" than the other.

Infliximab is given as an IV infusion every 8 weeks, which means less frequent dosing but requires clinic visits. Adalimumab is a self-injection given every other week at home, offering more convenience but more frequent dosing.

Some people respond better to one medication than the other, and this can't be predicted in advance. Your doctor might choose one based on your specific condition, lifestyle, insurance coverage, or previous treatment history.

Both medications have similar effectiveness and side effect profiles. The decision often comes down to personal preference about clinic visits versus home injections.