Is Remicade effective? Instructions for use, patient reviews about this medicine will be presented below. Also from this article you will learn about the cases under which this drug is prescribed, whether it has contraindications and undesirable effects, what components are included in its composition and so on.
Form, composition
The drug "Remicade" is available in the form of lyophilized powder, intended for the preparation of an infusion solution. The active substance of this medication is infliximab. It also contains additional components in the form of polysorbate 80, sodium hydrogen phosphate dihydrate, sucrose and sodium dihydrogen phosphate monohydrate.
Basic properties
What is Remicade Medication? Instructions for use states that it is an immunosuppressive agent.
Entering the body, the drug begins to interact with the soluble and transmembrane forms of tumor necrosis alpha (TNFα), reducing their activity through the formation of a stable complex.
Studies by experts indicate that the active substance of the drug reduces cellular infiltration (inflammatory), as well as the number of inflammatory markers in the affected areas of the intestine. In this case, a rather rapid healing of its mucous membrane occurs.
Pharmacokinetics of the drug
What pharmacokinetic parameters does Remicade have? Instruction, reviews state that a single intravenous administration of infliximab in an amount up to 20 mg / kg is accompanied by a proportional increase in its maximum concentration.
Repeated use of the drug causes a small accumulation of the active substance in the blood serum.
Routes of excretion of this drug have not been determined.
Indications for use
For what purposes can the medicine "Remicade" be prescribed? The use of this medication is indicated in the following cases:
- Rheumatoid arthritis in active form (if the treatment of patients with basic anti-inflammatory drugs was ineffective). Therapy is carried out in combination with Methotrexate. This combination allows to reduce the signs of the disease, as well as improve the condition of the joints as a whole.
- Crohn's disease in adult patients. How does Remicade help in this case? The instruction states that therapy with this drug should be carried out in case of intolerance or inefficiency, as well as in the presence of contraindications to standard drugs. With such a diagnosis, “Remicade helps to eliminate all signs of the disease, maintain remission and quickly heal wounds, close fistulas and improve the patient's condition.
- Crohn's disease in adolescents. Treatment with this drug is carried out with intolerance or inefficiency, as well as in the presence of contraindications to the standard therapy regimen. “Remicade” medication reduces the symptoms of the disease, supports remission and improves the quality of life of young patients.
- Ulcerative colitis in adults. The drug "Remicade", reviews of which are presented below, is prescribed if conventional therapy was ineffective. Treatment with this agent helps to reduce the signs of the disease, heal the intestinal mucosa, reduce dosages or cancel GCS. It should also be noted that after the appointment of this tool there is no need for the patient to stay in the hospital.
- Ulcerative colitis in children. Treatment with this drug is prescribed for children aged 6-18 years, in the event that conventional therapy was ineffective.
- Ankylosing spondylitis (with the ineffectiveness of standard therapy). How does the Remicade medication help with this diagnosis? Instructions for use reports that this tool reduces the symptoms of the disease and improves the functioning of the joints.
- Psoriasis (with the ineffectiveness of standard therapy). How does Remicade help with psoriasis? Reviews of experts say that this drug reduces inflammation on the skin and normalizes the processes of differentiation of keratinocytes.
- Psoriatic arthritis (with the ineffectiveness of standard therapy). The drug "Remicade" is prescribed in combination with "Methotrexate" or as monotherapy in the presence of contraindications or intolerance to the latter. As a result of treatment, the symptoms of arthritis are reduced, the functional activity of patients is improved, and the degree of radiological progression in psoriatic polyarthritis is also reduced.
Contraindications
Treatment with Remicade is prohibited when:
- severe infectious process (for example, sepsis, abscess, tuberculosis, opportunistic infections) ;
- hypersensitivity of the patient to infliximab, as well as mouse proteins and any other components of the drug;
- under the age of 6 years (with ulcerative colitis and Crohn's disease);
- pregnancy
- heart failure;
- under the age of 18;
- with breastfeeding.
The drug "Remicade": instructions for use. And where to enter (is it only in a hospital)?
The medication in question should be administered only under the supervision of a specialist (that is, in a hospital), who has sufficient experience in diagnosing and successfully treating the above diseases.
The solution is administered drip intravenously for 120 minutes. In this case, the speed should not be higher than 2 ml per minute. It is necessary to carry out procedures with the use of an infusion system.
The dosage of the drug depends on the indications.
Rheumatoid arthritis
With this diagnosis, the initial single dose should be 3 mg per kg. The drug is administered again after 3-6 weeks. Then it is used every two months.
In the event that the therapeutic effect has not been achieved, consider discontinuing therapy.
Typically, the drug "Remicade" for rheumatoid arthritis is prescribed along with "Methotrexate".
Ulcerative colitis
The initial dosage for this diagnosis is 5 mg per kg of body weight. In the same dose, the drug is administered after 3-6 weeks. Then, medical procedures are carried out every two months.
If necessary, the dose can be increased to 10 mg per kg. The effect of therapy is usually observed within 14 weeks. In the event that it is absent, treatment should be continued.
Psoriatic arthritis
In psoriatic arthritis, the drug "Remicade" is prescribed in an initial dose of 5 mg per kg. The drug is administered again after 3-6 weeks. Then it is used every 7-8 weeks.
You can prescribe a medication in combination with Methotrexate.
Crohn's disease
With this diagnosis, adults are shown single doses of 5 mg per kg. If the therapeutic effect was not achieved within 2 weeks, then the drug is canceled.
With the positive effect of the drug, the following schemes are possible:
- The solution is administered in the same dose as during the first infusion, and after 3-6 weeks is reused. After that, injections are done every two months. If required, the dosage can be increased to 10 mg per kg.
- The medication is administered only for relapses, if after the first use no more than 16 weeks have passed.
Crohn's disease in young children
Crohn's disease of moderate or severe degree in children under 18 years of age involves the use of an initial dose of 5 mg per kg. Subsequent injections should be done after 3-6 weeks. Then the medication is used every two months. If required, the dosage is adjusted to 10 mg per kg.
As a rule, such a medicine is combined with immunomodulators of 6-mercaptopurine, Azathioprine, or Methotrexate. If the therapeutic effect has not been achieved (within 10-11 weeks), then the use of the drug is undesirable.
Crohn's disease accompanied by fistulas
A single dose of the drug with this diagnosis is 5 mg per kg (in adults). The drug is reused after 3-6 weeks. If the therapeutic effect after 3 injections is not observed, then further treatment is impractical.
With the positive effect of the drug, the following schemes are possible:
- re-introduction after 3-6 weeks, and then every two months;
- the medication is administered with relapse if less than 16 weeks have passed.
Ankylosing Spondylitis
How is Remicade used for this diagnosis? Instructions for use states that with this disease, the initial dosage of the drug should be 5 mg per kg. After this, the medicine is administered after 3-6 weeks.
Treatment should not be continued if the effect is not noticeable within a month and a half.
Psoriasis
In the treatment of psoriasis, the initial dose of the drug is 5 mg per kg. Re-use of the drug is prescribed after 3-6 weeks, and then every eight weeks.
The process of preparing the solution for infusion
The solution must be prepared according to the following scheme:
- The dose and number of vials are calculated.
- The drug powder is dissolved in 10 ml of liquid using a syringe. To do this, remove the lid (plastic) from the solvent bottle, and wipe the cork with alcohol. The needle is inserted through its center, and the fluid is directed along the wall.
- The solution is thoroughly mixed (by rotational movements) until the powder dissolves. The medicinal fluid should be either colorless or yellow. If a foam has formed during mixing in the vial, then the solution must be infused for 5 minutes. Translucent fine particles may be present in the finished medicine.
- The total volume of the drug was adjusted with 0.9% sodium chloride solution (up to 250 ml). To do this, the prepared liquid is added to the bottle, which already contains sodium chloride. Both components are thoroughly mixed.
- The introduction of the drug is carried out no later than 3 hours after preparation of the drug solution.
It is forbidden to enter the medication together with other means through the same system. If there are foreign inclusions or opaque particles in the solution, it is not recommended to use it.
An unused amount of the drug must be disposed of.
Side effects
When using the medication, the following adverse reactions are possible:
- depression, apathy, increased anxiety, dizziness, drowsiness, nervousness, amnesia, psychosis, headache;
- pulmonary edema, sinusitis, bronchospasm, shortness of breath, allergic reactions, pneumonia, nosebleeds, bronchitis, pleurisy;
- conjunctivitis, keratoconjunctivitis, endophthalmitis;
- swelling and urinary tract infections;
- hot flashes, impaired peripheral circulation, bradycardia, ecchymosis, hematoma, vasospasm, fainting, palpitations, cyanosis, petechiae, arrhythmia;
- thrombocytopenia, anemia, neutrocytopenia, leukocytopenia, lymphocytopenia, lymphadenopathy, lymphocytosis;
- cheilitis, constipation, cholecystitis, reflux, diverticulitis, diarrhea, nausea, indigestion, impaired liver function;
- skin rash, dry skin, alopecia, seborrhea, itching, furunculosis, urticaria, hyperhidrosis, fungal dermatitis, warts, hyperkeratosis, erysipelas, skin pigmentation disturbance, bullous rash.
Reviews about the drug
Now you know how to use Remicade. Instructions for the use of the medication were described above.
In most cases, the tool in question copes with the task. Therefore, patient reviews are mostly positive. People using this solution report that after the injection the pain is almost completely gone. However, some patients are afraid of the addiction that it can cause.