Dermatology (Skin conditions)

Infliximab

Contact: (0191) 282 5599 - Dermatology Dept

This information is designed to tell you about Infliximab, give you some important information about the drug, and to answer some of your questions. 

What are anti-TNF drugs?
Infliximab (trade name Remicade) is a type of drug known as anti-TNF. In people with psoriasis, a protein called TNF is present in the blood and skin in excessive amounts, where it increases inflammation. Anti-TNF drugs block the action of TNF and so can reduce inflammation. In this way they can help people with active psoriasis.

Why am I being prescribed Infliximab?
Infliximab has recently become available for people with rheumatoid arthritis and recent studies show benefit in patients with psoriasis. However Infliximab is not yet licensed for use in psoriasis. We have obtained permission to use Infliximab in a limited number of patients with severe psoriasis. It will only be prescribed if you have active psoriasis and you have already tried Methotrexate or other standard 'second-line' treatment (for example PUVA, phototherapy, Cyclosporin). It may also be prescribed if you cannot tolerate other treatments. Infliximab is available only on prescription from a consultant
dermatologist.

Infliximab will be not be prescribed if

  • Your psoriasis is not active
  • You have not tried standard treatments first
  • You are pregnant or breast-feeding
  • You have an infection

Your doctor may decide not to prescribe Infliximab if:

  • You have had tuberculosis (TB) in the past
  • You have had other repeated infections

When and how do I take Infliximab?
Infliximab is given by intravenous infusion (through a drip into a vein). You will need to go into hospital (on Ward 19) each time that you have an infusion.
You will be seen by a doctor and nursing staff. The infusion is given over two hours and you will have to wait for another one or two hours afterwards before you can go home. After the first infusion of Infliximab your response to this treatment will be monitored. Further infusions may be given at 2-16 week intervals.

When am I likely to feel better?
If you respond to Infliximab your psoriasis will show some improvement in 2-12 weeks.

What are the possible side effects?
Infliximab may cause a blocked or runny nose, headache, dizziness, flushing, rash, abdominal pain or indigestion. If you develop a fever, sore throat or other infection, you should see your GP or hospital doctor immediately. Rarely, people may be allergic to Infliximab. If this is the case with you, the drug will have to be stopped. Very rarely, people with Infliximab develop a condition called 'drug-induced lupus', which is usually mild. The symptoms are a rash, fever and increased joint pain. Your dermatologist will check for this with a blood test. If you develop drug-induced lupus, Infliximab will be stopped and the condition usually then disappears. No one knows the long-term side effects of Infliximab because it is a new drug.

What checks should I have while taking Infliximab?
You will have a chest X-ray and blood tests before starting treatment and then further blood tests while you are on Infliximab to monitor its effects.

Can I have immunisation injections while on Infliximab?
You should avoid immunisation injections involving any of the live vaccines such as polio and rubella (German Measles). Flu vaccines and pneumovax are safe and recommended.

Can I take other medicines along with Infliximab?
Some people who are on Infliximab will also be on prescribed Methotrexate. Some drugs interact with Methotrexate. You should discuss all your current
medications with your doctor and you should discuss any new medications with your doctor before starting them.

May I drink alcohol while taking Infliximab?
You can drink alcohol while taking Infliximab, but because you are likely to be taking Methotrexate as well, you should only drink it in small amounts. This is because Methotrexate and alcohol can interact and damage your liver.

What if I am thinking of getting pregnant?
No one knows the risk of Infliximab to an unborn baby. Women of childbearing age must use contraception while on Infliximab. Do not take Infliximab if you are thinking of becoming pregnant in the near future or if you are not using contraception. It is recommended that women do not become pregnant and men do not try for a baby with their partner for at least six months after the last dose of Infliximab.

And what about breast-feeding?
Do not breast feed while on Infliximab. The drug could pass in the breast milk and no one knows the risk to the baby.

Is Infliximab used for any other medical condition?
Infliximab can be given to people with severe rheumatoid arthritis and Crohn's disease (a bowel disease).

Where can I obtain further information?
If you would like any further information about Infliximab, of if you have any concerns about your treatment, you should discuss this with your doctor, nurse or pharmacist. If you have any queries or problems please contact the Dermatology Ward (open 24 hours) on 0191 282 5599.

More information is available at the following web site:
www.remicade.com


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