Drug Interactions Of Remicade Vs Humira
Remicade or Humira should not be combined with other biological products used to treat the same conditions, due to an increase in serious infections and other complications. Examples of interacting drugs include anakinra, abatacept, or tocilizumab.
Remicade or Humira also can interact with drugs that have a narrow therapeutic index. This means a drug has a small window between being safe and effective, and being toxic. These drugs include Coumadin , cyclosporine, and theophylline.
People taking Remicade or Humira should not receive live vaccines.
This is not a full list of drug interactions and other drug interactions may occur. Before taking Remicade or Humira, tell your healthcare provider about all of the medications you take, including Rx and OTC drugs, vitamins, and supplements.
Measurement Of Serum Levels Of Infliximab And Human Anti
There is insufficient scientific evidence regarding the clinical value of measurements of serum levels of infliximab and/or HACA for patients receiving infliximab therapy.
The protocol in the study by Maini et al pre-specified that pharmacokinetic data would be analyzed in the first 200 subjects. However, the number of subjects with human anti-chimeric antibodies formation was not stated. Because of the murine component of the antibody, patients receiving infliximab can develop HACA that are associated with an increased rate of infusion reactions. Pharmacokinetic measurements were actually performed in 197 patients and results were consistent with the previously defined half-life of 8 to 12 days. It should be noted that HACA formation could not be measured in patients receiving infliximab since the drug interferes with the assay. However, 27 patients who discontinued treatment before 30 weeks were tested for HACA formation, and 3 patients tested positive for HACA . The rate of HACA formation in patients with Crohn’s disease treated with infliximab is reported to be 13 %, but this rate appears to be less if a patient is on concurrent immunosuppressive therapy . It is unclear whether serum infliximab levels may decline more rapidly in the presence of HACA resulting in reduced effectiveness of infliximab therapy.
Similarly, tests for serum drug concentration levels of infliximab and adalimumab have been proposed to determine dosing and guide infusion intervals .
Drug Forms And Strengths
Remicade comes as a vial of powder, and each vial contains 100 mg of infliximab . Your healthcare professional will add a liquid to the vial to make a solution.
Then the healthcare professional will give you the Remicade solution as an infusion. This is an injection into your vein thats given over a period of time.
Remicade infusions are typically about 2 hours long.
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Who Needs This Medication
Some doctors recommend biologics before trying prednisone because of the risk of becoming “steroid dependent”unable to stop prednisone without a flare-up in symptoms. But other doctors point out that not enough is known about the long-term benefits and side effects of starting out with a biologic.
It is the case that most studies of biologics have involved people who didn’t find relief with other medication, so we don’t know very much about the pros and cons of starting on a biologic before other medications. Biologics and prednisone provide quick relief, but biologics can be used for longer periods of time, whereas prednisone should only be used for short periods.
One strategy that doctors sometimes use is to have a patient begin using a biologic or prednisone for immediate relief and start azathioprine or mercaptopurine at the same time to prevent recurrent symptoms. In studies, the combination of the biologic infliximab and azathioprine provided better clinical symptoms relief than either medication alone, although patients reported that their quality of life was similar with combination or single medication use.
How Is Remicade Given
Before you start treatment with Remicade, your doctor may perform tests to make sure you do not have tuberculosis or other infections.
Remicade is given as an infusion into a vein. A healthcare provider will give you this injection.
This medicine must be given slowly, and the infusion can take at least 2 hours to complete.
You may be watched closely after receiving infliximab, to make sure the medicine has not caused any serious side effects.
Infliximab affects your immune system. You may get infections more easily, even serious or fatal infections. Your doctor will need to examine you on a regular basis, and you may need frequent TB tests.
Serious infections may be more likely in older adults.
If you need surgery, tell the surgeon ahead of time that you are using Remicade.
If you’ve ever had hepatitis B, using infliximab can cause this virus to become active or get worse. You may need frequent liver function tests while using this medicine and for several months after you stop.
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Receiving Remicade With Other Drugs
If you have RA, your doctor can only prescribe Remicade with methotrexate.
Flare-ups of inflammatory diseases may require taking corticosteroids.
People using Remicade with methotrexate or corticosteroids have a higher risk for developing a serious infection. This is because Remicade, methotrexate, and corticosteroids are all immunosuppressants. They reduce the activity of the immune system, decreasing the ability of your body to fight infections.
Other medications you may need to take with Remicade include:
- aminosalicylates, including mesalamine and sulfasalazine
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Will My Body Make Antibodies To Remicade
Yes, its possible for your body to make antibodies to Remicade. This would affect how well the medication works.
Since Remicade is a biologic medication, your body could identify it as a foreign substance. Your body may then try to remove the drug by making antibodies. If this happens, your doctor may need to switch your medication.
Some people may have a higher risk for making antibodies to Remicade, such as those with Crohns disease.
Taking other immunosuppressants with Remicade may lower the risk of your body making antibodies against Remicade. If youre concerned about producing antibodies to this drug, talk with your doctor.
When To Get Treatment
An increase in inflammation causes a flare, and the nature of inflammation means that you should treat it as quickly as you can. Inflammation grows exponentially, because inflammation itself causes an increase in inflammation. The longer you leave it untreated, the worse it will get. In addition, untreated inflammation not only leads to the symptoms associated with ulcerative colitis, it can also increase your risk of developing complications such as colorectal cancer down the line. Pay attention to your symptoms, and visit your physician if you notice that they change or increase even a small amount.
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Remicade Vs Humira: Differences Similarities And Which Is Better For You
Remicade and Humira are two brand-name medications used for inflammatory bowel disease rheumatoid arthritis, and various other autoimmune diseases. You may have heard of these drugs in the news. Humira is made by AbbVie, and has been the worlds top-selling drug since 2012. Remicade is made by Janssen Biotech, Inc.
Both Remicade and Humira are prescription drugs approved by the U.S. Food and Drug Administration . They are known as biologics and are monoclonal antibodies. Remicade and Humira are in a drug class called tumor necrosis factor blockers, or TNF blockers. They work by blocking the activity of tumor necrosis factor, or TNF. TNF is a substance in the body that can cause inflammation and lead to various diseases related to the immune system. TNF blockers, also called TNF inhibitors, suppress the immune system, blocking the activity of TNF.
Although both Remicade and Humira are both TNF blockers, they do have some differences. Continue reading below to learn about Remicade and Humira.
Key Points About Entyvio
- Entyvio is approved for ulcerative colitis and Crohn’s disease.
- Entyvio is given by infusion in three starting doses, and then every eight weeks.
- Common side effects include infections pain in the joints, back, throat or extremities symptoms of nausea, fever, fatigue, cough, or itching and a rash.
- If you are pregnant or plan to become pregnant, you and your doctor should decide if you should take Entyvio.
- It’s not currently known if Entyvio passes into breastmilk.
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If You Take More Than The Recommended Amount Of Remicade
Call your doctor right away if you believe youve received too much Remicade. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
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Can Remicade Cause Cancer
Its not clear whether Remicade causes cancer.
There have been reports of new or unusual cancers* with the use of Remicade and other drugs in the tumor necrosis factor-alpha blockers class.
However, in a review of multiple studies, the evidence for cancer risk was conflicting. Analyses of studies and registries that collect information from larger populations have also had conflicting results.
If you have concerns about cancer, talk with your doctor about your medical history and your risk for cancer. Theyll explain the benefits and risks of taking Remicade. For more information about Remicade and cancer, see the Remicade side effects section above.
for cancer. A boxed warning is the most serious warning from the Food and Drug Administration . For more information, see FDA warnings at the beginning of this article.
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Safety And Side Effects
The risk of experiencing side effects is an important factor to consider when choosing to take a biologic drug.
The mild side effects associated with these medications can include:
- multiple sclerosis
You must get a test for tuberculosis and hepatitis before you can start a biologic.
Also notify your doctor if you have been around a person with chicken pox, shingles, or tuberculosis, or if you are scheduled to receive a vaccine or have surgery.
The risk of biologics to unborn babies is unknown. Women of child-bearing age should use contraception while on biologics. Your doctor may ask you if you are thinking of becoming pregnant before you start a biologic. If you are planning to become pregnant, talk with your doctor about when to stop using contraception and biologics. The labeling of biologics advises these medications not be used by pregnant women unless necessary. If you do become pregnant while taking a biologic, your doctor may tell you to continue to take the biologic while monitoring you and your baby closely. Large international registries have not shown an increase in the risk of birth defects in women on biologic therapy.
Side Effects And Risks
Because Inflectra is a biosimilar of infliximab , Inflectra and Remicade have the same side effects. Examples of common and serious side effects for each drug are listed below.
More common side effects
This list contains more common side effects that can occur with both Remicade and Inflectra :
for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration . For more information, see FDA warnings at the beginning of this article.
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Questions About Receiving Remicade
Heres a list of questions and answers related to receiving Remicade.
- What if I miss a dose of Remicade? Youll receive doses of Remicade from a healthcare professional. If you miss an appointment to receive your next dose of Remicade, reschedule immediately. Missing doses of Remicade may affect how well the medication works.
- Will I need to use Remicade long term? You might. Ask your doctor how long youll need to use Remicade to treat your condition. Your doctor will assess how well the medication is working for you. Sometimes Remicade can stop working, in which case your doctor may need to switch your medication.
- Should I receive Remicade with food? Remicade is injected directly into your vein. Receiving Remicade with or without food wont affect its absorption.
- How long does Remicade take to work? Depending on the condition youre using Remicade for, it may take several weeks to several months before you feel the drug easing your symptoms. Talk with your doctor to find out how long it might be before the medication starts working.
Other Experimental And Investigational Indications
Aetna considers infliximab, infliximab-abda, infliximab-axxq, and infliximab-dyyb experimental and investigational for all other indications because its effectiveness for these indications has not been established:
- Takayasus arteritis
Infliximab products include Avsola , Inflectra , Remicade , and Renflexis brands, which are considered tumor necrosis factor blockers. Infliximab neutralizes the biological activity of tumor necrosis factor-alpha by binding to the soluble and transmembrane forms of TNF therefore effectively inhibiting the binding of TNF with its receptors. Infliximab does not neutralize TNF , a related cytokine that utilizes the same receptors as TNF. TNF is a cytokine that plays an important role in various inflammatory processes including: induction of proinflammatory cytokines such as interleukins 1 and 6, enhancement of leukocyte migration by increasing endothelial layer permeability and expression of adhesion molecules by endothelial cells and leukocytes, activation of neutrophil and eosinophil functional activity, induction of acute phase reactants and other liver proteins, as well as tissue degrading enzymes produced by synoviocytes and/or chondrocytes.
In addition to risk of serious infections, malignancies and heart failure, other labeled warnings and precautions include the following:
Most common adverse reactions infections , infusion-related reactions, headache, and abdominal pain .
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Rated For Osteoarthritis Report
I have been an Remicade about a year now. I have scleritis which is inflammation in my eyes. This condition could have caused vision loss for me. I was on prednisone for over two years to help with the inflammation and severe headaches. Remicade allowed me to get off the prednisone . I gained a lot of weight being on the prednisone. Remicade has helped me tremendously with hardly any side effects. I get infusions every 8 weeks.
What Does Remicade Cost
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and where you receive your infusions. To find current prices for Remicade in your area, visit GoodRx.com.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Remicade manufacturers website to see if it has support options.
But doctors can also prescribe Humira for certain other autoimmune diseases, such as juvenile idiopathic arthritis and hidradenitis suppurativa. Ask your doctor which TNF blocker is best for your condition.
To see a detailed breakdown of these drugs, check out this drug article. And be sure to talk with your doctor about which medication is right for you.
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How Does Infliximab Work
Crohns disease and ulcerative colitis have been linked to an increase in certain proteins – including one called tumor necrosis factor . Your bodys immune system naturally produces TNF.
An increase in TNF is linked to an increase in inflammation in the bodys digestive system – which can lead to a worsening of inflammatory bowel disease symptoms.
Remicade is one of a group of medications which target TNF proteins, bind to them and block them. This helps to prevent inflammation in the body which is hoped will reduce IBD symptoms. The immune system is also suppressed. This can mean that people taking Remicade are more prone to picking up illnesses and infections.
Express Ii Study Design16
EXPRESS II evaluated 835 patients with moderate to severe plaque psoriasis. These patients had â¥10% body surface area involvement, a Psoriasis Area and Severity Index score of â¥12, and were candidates for systemic therapy or phototherapy. Patients were randomized to placebo or REMICADEÂ® at doses of 3 mg/kg IV or 5 mg/kg IV at Weeks 0, 2, and 6 . At Week 14, patients in the REMICADEÂ® arms continued on their original dose but were randomized to either an every 8 week scheduled maintenance therapy or an as needed maintenance therapy through Week 46. Patients randomized to the PRN maintenance therapy group received their original REMICADEÂ® dose when baseline improvement in PASI was < 75% and received placebo if PASI improvement was â¥75%. Maintenance visits occurred monthly. At Week 16, the placebo group crossed over to REMICADEÂ® induction therapy , followed by a maintenance therapy every 8 weeks. The primary endpoint was proportion of patients achieving PASI 75 at Week 10.
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Is It Important To Treat A Flare Early Or Is It Ok To Wait A Bit
Inflammation typically does not resolve without treatment and early intervention has a better outcome than waiting to treat. At an early stage of a flare, a more optimal baseline treatment is often enough to get the inflammation under control. If you wait, there is a greater risk that you might need drugs with greater side effects, such as oral steroids. By waiting, you will have to manage longer with your symptoms before getting relief. Living with constant or longer periods of inflammation might increase your risk for future complications, as inflammation might cause damage to the gut wall that accumulates in severity with each flare.
If you are experiencing worsening symptoms, you have probably already had the flare for some time without symptoms. Evidence shows that a stool test for inflammation in the colon, called fecal calprotectin, is often elevated for two to three months before any symptoms appear. Your colon might also start to show visual evidence of inflammation before you have symptoms, or at least indicate an increased risk for a flare.