What You Should Tell the Doctor before Starting lnfliximab
You should tell your doctor if you:
- are pregnant or planning on becoming pregnant
- are breast-feeding
- have a history of heart failure
- have problems with your immune system (HIV/AIDS)
- have had a recent severe infection or are prone to chronic or recurring infections
- have, have had, or have been expose to tuberculosis; you will need to have a skin test done; if you have tuberculosis, you will need medication to treat the tuberculosis before you start infliximab therapy in order to prevent a recurrence of tuberculosis infections
- are taking any medications or herbal supplements
- have had an allergic reaction to infliximab or one of its components
- have a history of liver disease (i.e., hepatitis B)
- have problems or diseases with the nervous system such as multiple sclerosis; if you experience any numbness, tingling, or visual changes before, during, or after infliximab treatment, you should tell your doctor; a small number of patients who have received infliximab have experienced a worsening of their multiple sclerosis and other rare diseases of the nervous system (Guillain-Barre, optic neuritis)
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| Before Using Infliximab |
What You Should Tell the Doctor While Taking lnfliximab
Contact your doctor while taking infliximab if any of the following occur:
You develop an allergic reaction:
Some patients can develop an allergic reaction to biologic agents, which are produced from living cells. Infliximab is partly developed from mouse cells.
Your body might recognize infliximab as a foreign substance, so it is possible to develop a reaction to the drug. This reaction can be mild and might present as an itch or hives. Serious allergic reactions are less common but are possible. These include difficulty breathing, wheezing, hives, and high or low blood pressure. Tell your doctor immediately if you develop any of these signs or symptoms during or after treatment so that she or he can reduce the speed of the infusion, stop the infusion, and/or prescribe medications. If you have a very severe reaction, your doctor will stop infliximab treatment altogether.
Some reactions can occur several days to one week after infliximab infusion. These delayed reactions can involve muscle or joint paint, fever, or a rash. Tell your doctor if you develop any of these symptoms.
You develop an infection:
As with other treatments, it is very important to advise your doctor if you develop an infection or any symptoms of an infection. If your doctor gives you treatment for an infection, it should be taken right away and as prescribed. Treatment with infliximab should be stopped if you develop a serious infection. Symptoms could include fever, tiredness, cough, and flu-like symptoms. If you feel unwell but do not have a fever, it is still important to tell your doctor. Since infliximab suppresses your immune system, your body may not respond to an infection with a fever as it would normally. Medications that suppress your immune system make you more susceptible to developing an infection.
If your doctor gives you treatment for an infection, it should be taken right away and as prescribed. The treatment with infliximab should be stopped if you develop a serious infection. After your infection has been treated, it is usually possible to have infliximab again to treat your psoriasis.
You develop the symptoms of heart failure:
Tell your doctor immediately if you develop new or worsening symptoms of heart failure such as shortness of breath or swelling of your feet, ankles, or calves.
Your body weight changes:
The amount of infliximab is based on your weight. If your body weight changes significantly, your doctor might change your dose.
You require a vaccine
You should not receive live vaccines while taking infliximab. Tell your doctor if you need a vaccine.
If you develop cancer:.
Tell your doctor right away. lnfliximab can suppress the immune system, which is important in fighting cancer.
What Side Effects Can lnfliximab Cause?
Side effects are possible with any medication, including any of the biologic agents. These medications are specifically designed to target a key process in the immune abnormalities of psoriasis. It is hoped that these medications will be safer in the long term for patients partly because of the specific way in which they work. Most of these medications have been monitored only for short-term safety because they are so new. In the future, it will be very important to ensure these medications are safe over the long term. lnfliximab has been given to more than 1 million people worldwide since 1998. It has been approved in Canada for the treatment of Crohn's disease and rheumatoid arthritis; approval is pending for treatment of psoriasis in Canada and the United States.
Most of infliximab's side effects are mild and tend to resolve on their own or with additional treatment. However, as with any medication, there are possibilities of less common but severe side effects. Additional side effects are listed below:
- serious infusion reactions such as hives, difficulty breathing, and low blood pressure
- mild infusion reactions such as rash or itchy skin
- upper respiratory infections
- headache
- nausea
- cough
- sinusitis
- infections due to low immune response
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| Before Using Infliximab |
Higher rates of lymphoma were reported in patients receiving infliximab. Many of these patients were on other immunosuppressant medications at the time or had been in past. In addition, they also had other medical conditions, e.g., rheumatoid arthritis. Because these factors could have predisposed these patients to developing lymphoma, it is unclear how and if infliximab will increase a patient's risk of lymphoma.
Cancers, heart failure, liver injury, and neurologic events were rarely reported in patients receiving infliximab. It is not clear how and if infliximab has caused these rare side effects. To find out more, you can check out Before Using Infliximab.