What Is Remicade Infusion?

Remicade is a medication used to treat inflammatory bowel disease(IBD), which includes Crohn’s disease and ulcerative colitis (UC). It is not a first-line treatment method for IBD but instead a medication given to patients who haven’t responded to more common IBD treatments. Patients require infusions approximately six times a year, which means an infusion once every eight weeks. Remicade works well at arresting symptoms and reducing disease severity, sometimes putting IBD into remission.

What Is Inflammatory Bowel Disease?

Inflammatory bowel disease is a term used to describe two disorders: Crohn’s disease and ulcerative colitis, both of which cause inflammation of the digestive tract. However, the two diseases differ in location. Ulcerative colitis develops in the large intestine (colon) and rectum, presenting with inflammation and ulcers. Crohn’s disease can affect the entire digestive tract, often in patchy spots that penetrate the deeper layer of the GI tract. 

Both Crohn’s disease and ulcerative colitis share many of the same symptoms, and patients may experience:

• Poor appetite
• Unintended weight loss
• Diarrhea 
• Blood in the stool
• Abdominal pain
• Chronic fatigue

If you experience any of the symptoms above for more than a few days or notice a significant change in bowel habits, you should consult your physician. Additionally, you should always consult with your provider if you discover blood in the stool. 

What Are Treatments for Crohn’s Disease and Ulcerative Colitis?

Typical medication therapy for both Crohn’s disease and ulcerative colitis include:

• Anti-inflammatory medications, such as 5-aminosalicylates (sulfasalazine, balsalazide)
• Corticosteroids, such as prednisone and budesonide
• Immunosuppressant drugs, such as azathioprine, mercaptopurine, and methotrexate

Corticosteroids are primarily used to quickly control active disease in patients who are having frequent symptoms. Remicade infusion is used when first-line treatments with anti-inflammatory medications fail, patients rely on corticosteroids to control IBD, or the disease is severe enough to lead to hospitalizations or surgery..

Why Is Remicade Infusion Used?

Some patients don’t respond well to other treatments because their IBD is severe. IBD can cause your immune system to become overactive, which in turn causes excess amounts of a protein called TNF-alpha (tumor necrosis factor-alpha). The excess TNF-alpha causes the immune system to attack healthy cells in the gastrointestinal tract. Regular Remicade infusions prevent excessive amounts of TNF-alpha, remedying the inflammation in the digestive tract.

How Do I Prepare for a Remicade Infusion?

You will first consult with your gastroenterologist or physician to discuss your medical history and any medications you are taking. There are some conditions your doctor needs to be informed of prior to an infusion. These include:

• Blood problems
• Liver injury
• Cancer
• History of heart failure
• Infections
• Nervous system disorders, such as epilepsy and multiple sclerosis (MS)
• Hepatitis B
• Tuberculosis

Also inform your doctor if you have any allergies, as it is possible to be allergic to one or more of the ingredients in Remicade. 

Unlike other procedures where fasting is typically a requirement, before a Remicade infusion, it’s best if you have breakfast or lunch before your procedure, as well as plenty of fluids. A nurse will monitor your vital signs prior to administration, and then the physician begins the procedure. 

What Happens During a Remicade Infusion?

A Remicade infusion takes about two hours to complete. A nurse will prep an area on your arm in order to administer an intravenous (IV) needle. Once the needle is inserted, the doctor begins the infusion. You’ll be constantly monitored by your provider during the infusion, and vital signs are taken every 30 minutes. Once the infusion is complete, the needle is removed. Because there is no sedation or invasive procedures, you can typically resume normal activities immediately after receiving the infusion. 

Are There Any Side Effects of Remicade?

You may experience some possible side effects after receiving the transfusion. The most common side effects patients experience after a Remicade infusion include:

• Sore throat 
• Sinus infections
• Abdominal pain
• Coughing
• Headache

It is also possible to have a reaction to the infusion, which can occur for up to two hours post-procedure. Some patients may experience:

• Chest pain
• Fever
• Chills
• Low blood pressure
• High blood pressure
• Itching
• Shortness of breath
• Rash

These are common reactions and should resolve on their own. However, let your physician know if the side effects are very bothersome or do not go away within 24 hours.  

How Often Are Remicade Infusions Given?

Every Remicade infusion will take approximately two hours to administer. The first three doses are considered starter doses, and are given at weeks zero, two, and six. After you receive your first three starter doses, then you will receive maintenance Remicade infusions. The maintenance infusions are scheduled every eight weeks. In addition to being a treatment for inflammatory bowel disease, Remicade is also administered to patients who suffer from moderate to severe rheumatoid arthritis, active psoriatic arthritis, active ankylosing spondylitis, and chronic severe plaque psoriasis. Remicade can also be administered to children who have moderate to severe Crohn’s disease or ulcerative colitis.