Infliximab

Mechanism :

Infliximab neutralizes the biological activity of TNFa by binding with high affinity to the soluble and transmembrane forms of TNFa and inhibits binding of TNFa with its receptors. Infliximab does not neutralize TNFß (lymphotoxin a), a related cytokine that utilizes the same receptors as TNFa.

Indication :

• Crohn’s disease
• Ulcerative Colitis
• Juvenile Rheumatoid Arthritis

Contraindications :

Infliximab is contraindicated in any patient with tuberculosis or other severe infection, patients with moderate or severe heart failure or in patients with a history of hypersensitivity to infliximab. Infliximab has been associated with acute infusion-related reactions including anaphylactic shock and delayed hypersensitivity reactions.

Dosing :

Adverse Effect :

Leukopenia, anemia, lymphocytosis, neutropenia, lymphadenopathy, thrombocytopenia, confusion, depression, amnesia, agitation, apathy, headache, dizziness, flushing, hypertension, hypotension, bradycardia, palpitation, abnormal hepatic function, elevated alanine transaminase, rash, urticaria, rosacea, fungal Infections, verruca, pruritus, eczema, pigmentation, alopecia, myalgia, arthralgia, edema, infusion-related reactions, fatigue, chest pain, hot flushes, pain, chills/rigors, anaphylactic reactions, development of anti-nuclear antibodies, infections.

Interaction :

Contraindicated:
Adenovirus Vaccine, Live; BCG Live Intravesical; Influenza Nasal Vaccine, Live; Measles/Mumps/Rubella Vaccine, Live; Rotavirus Vaccine, Live; Smallpox Vaccine (Live Vaccinia Virus); Typhoid Vaccine, Live; Varicella Vaccine, Live; Yellow Fever Vaccine, Live; Zoster Vaccine, Live.
Avoid/Use Alternative:
Abatacept, Adalimumab, Anakinra, Belimumab, Certolizumab Pegol, Etanercept, Golimumab, Infliximab, Natalizumab, Nelfinavir, Pazopanib, Rituximab, Simeprevir, Sipuleucel-T, Tocilizumab, Tofacitinib, Tolvaptan.
Monitor/Modify Treatment:
Aminophylline, Carbamazepine, Chlorpropamide, Cyclosporine, Disopyramide, Flecainide, Fosphenytoin, Glimepiride, Glipizide, Glyburide, Lidocaine, Nateglinide, Perampanel, Phenytoin, Quinidine (Antiarrhythmic), Repaglinide, Sirolimus, Tacrolimus, Theophylline, Tiagabine, Tolazamide, Tolbutamide, Warfarin.

Caution Advised:
Alfentanil, Alprazolam, Amiodarone, Amitriptyline, Amoxapine, Anthrax Vaccine, Antithymocyte Globulin, Atorvastatin, Azathioprine, Basiliximab, Belatacept, Bortezomib, Bupropion, Carisoprodol, Cisapride, Clomipramine, Clozapine, Colchicine, Conivaptan, Desipramine, Dihydroergotamine, Diphtheria/Tetanus and/or Pertussis Vaccine, Dofetilide, Doxazosin, Doxepin, Efalizumab, Eletriptan, Enzalutamide, Eplerenone, Ergotamine, Everolimus, Fentanyl, Fingolimod, Fluvastatin, Haemophilus B Conjugate Vaccine, Haloperidol, Hepatitis A Vaccine, Hepatitis B Vaccine, Human Papillomavirus Vaccine, Hydroxyurea, Ibrutinib, Ifosfamide, Imatinib, Imipramine, Influenza H5N1 Vaccine (Avian Flu), Influenza Vaccine, Japanese Encephalitis Vaccine, Leflunomide, Levonorgestrel (Contraceptive), Levonorgestrel (Post-Coital Contraceptive), Levonorgestrel Intrauterine Device (Contraceptive), Lovastatin, Lurasidone, Lymphocyte Immune Globulin, Antithymocyte Globulin, Meningococcal Vaccine, Meperidine, Methadone, Methylergonovine, Mexiletine, Midazolam, Muromonab-CD3, Mycophenolate Mofetil, Mycophenolic Acid, Nilotinib, Nortriptyline, Obinutuzumab, Omacetaxine Mepesuccinate, Perphenazine, Pimozide, Pneumococcal Vaccine, Poliovirus Vaccine, Ponatinib, Propafenone, Protriptyline, Quinine, Rabies Vaccine, Rilpivirine, Riluzole, Risperidone, Romidepsin, Ruxolitinib, Sildenafil, Simvastatin, Solifenacin, Sufentanil, Sunitinib, Tacrine, Tadalafil, Temsirolimus, Teniposide, Teriflunomide, Tetrabenazine, Thioridazine, Thiotepa, Tizanidine, Toremifene, Tramadol, Triazolam, Trimipramine, Typhoid Vi Polysaccharide Vaccine, Ustekinumab, Vardenafil, Vinblastine, Vincristine, Vinorelbine, Zolmitriptan.

Hepatic Dose :