Remicade (infliximab)
How this therapy is used at Arthritis Care of Texas in Corpus Christi, TX — what it is, how it is taken, side effects, and safety checks.
- Treats
- Rheumatoid arthritis · Psoriatic arthritis · Ankylosing spondylitis
- How given
- IV infusion in our office
- How often
- Every 8 weeks, after starter doses
Remicade does both jobs: it relieves pain and swelling and helps protect joints and tissue from damage. Many people feel improvement within the first few infusions — sometimes within 2–6 weeks — with full effect judged over 3 months. It is a long-term controller, not a painkiller; skipping infusions lets inflammation return.
What it is: An anti-TNF biologic (brand name Remicade). It blocks TNF to reduce inflammation in rheumatoid arthritis, psoriatic arthritis, and occasionally ankylosing spondylitis. It is not a painkiller — it modifies the disease, with improvement over 2–12 weeks.
Before starting: It is not prescribed if your arthritis isn't active, you have an infection, or other appropriate drugs haven't been tried. It may not be prescribed with a history of repeated or serious infections, MS, cancer, a serious heart condition, or lung fibrosis. A chest x-ray and TB check are done before starting, plus hepatitis screening.
How it's taken: By intravenous infusion into the arm, usually in our infusion suite, taking about 2 hours plus 1–2 hours of observation. The schedule: a first infusion, another at 2 weeks, another 4 weeks after that, then every 8 weeks. Infusions may get shorter (and possibly move home) once you are established on treatment. If treatment is interrupted for more than 16 weeks, there is a higher allergic-reaction risk on restarting, so closer monitoring is needed. It is a long-term treatment — keep taking it even if it is slow to work, and even when you improve.
Side effects: Most common: blocked or runny nose, headache, dizziness, flushing, rash, and stomach pain or indigestion. Infection risk is increased, and it can rarely affect blood-cell production — report a sore throat, fever, unexplained bruising, bleeding, or paleness promptly; stop if severe. Chickenpox and shingles can be severe. Anti-TNFs are linked to some skin cancers (treatable when caught early); there is no confirmed increased risk of other cancers. Very rarely, drug-induced lupus (rash, fever, joint pain — diagnosed by blood test; mild and clears on stopping).
Pregnancy: Current guidelines say it can be used during pregnancy, and by men trying to father a child. It is usually stopped after four months of pregnancy; if continued, there is a possible (unproven) newborn infection risk, and the baby should not have live vaccines (e.g. BCG) until seven months old. Breastfeeding data is limited; small amounts may pass into milk but it doesn't appear harmful. Don't restart methotrexate until breastfeeding stops.
Why the checks: Each step has a reason: TB and hepatitis screening find dormant infections that TNF blockade could reactivate, so they can be treated first; checks before each infusion (symptoms, infections, temperature) make sure that day is a safe day to treat; and periodic blood tests follow counts and liver values over the course of therapy.
Used for Rheumatoid arthritis · Psoriatic arthritis · Ankylosing spondylitis
Common worries
Why the TB test before my first infusion?
Remicade blocks TNF, a signal that keeps dormant TB contained. Screening finds hidden infection so it can be treated first — the routine safety step that makes TNF blockers safe to use.
Why do I need someone to watch me during infusions?
Infusion reactions — flushing, itching, fever, blood-pressure changes — are possible, mostly during early infusions. They are usually mild and manageable on the spot, which is exactly why infusions happen with the team present.
I feel great between infusions. Can I stretch the interval?
Feeling great is the drug holding levels steady. Stretching intervals lets levels fall, symptoms return, and the body may form antibodies against the drug. Keep the schedule; changes are made at reviews, with reasons.
Ready to be seen? New patients are seen within 2–4 weeks.