Infliximab

The staff at MNGI Digestive Health have been providing therapy to patients with Crohn’s disease and ulcerative colitis since 2000 at our infusion centers. Our physicians and nurses are specially trained to infuse, monitor and educate patients about infliximab and similar therapies.

What is infliximab and how does it work?

  • Infliximab is a medication used to treat chronic inflammation in the GI tract that is present in Crohn's disease and ulcerative colitis.
  • The medication works by blocking your immune system's over-production of a protein called TNF-alpha, a primary cause of inflammation.
  • Infliximab targets and neutralizes TNF-alpha, which relieves the inflammation that can lead to symptoms of Crohn's disease or ulcerative colitis.

How is infliximab given?

  • Infliximab is given by intravenous (IV) infusion.
  • You will receive your first dose followed by additional doses at two and six weeks and then every eight weeks thereafter.

What can I expect during the infusion? Do I need to prepare?

  • The actual infusion takes about 2 hours for your first 3 doses.  You should plan on spending about 3 hours at the infusion center for these appointments.  Subsequent infusions take about 1 hour, and you should plan on spending about 2 hours at the infusion center.
  • You will need to arrive at least 20 minutes prior to each infusion appointment.
  • If you have a fever or are on antibiotics, call to inform your MNGI provider. The infusion appointment may need to be rescheduled.
  • An infusion nurse will administer the medication through an intravenous (IV) line and monitor you throughout the infusion. Please drink plenty of fluids throughout the day prior to your appointment to assist with IV insertion.
  • You will be able to eat or drink, read or watch TV during the infusion. You may bring snacks and drinks from home. WiFi is available.
  • You will need to take any pre-medications ordered by your provider at home prior to arriving for your infusion.
  • You may experience muscle aches or tiredness after your infusion. Many patients go home to rest afterwards.
  • You will need on-going lab monitoring and office visits while on treatment to assess your response to therapy.
  • Minors ages 9 through 15 must have a parent/guardian with them for the entire infusion. Minors ages 16 through age 17 must have a parent/guardian with them for the first 30 minutes of the infusion, then readily available by phone.

Before receiving this medication…

  • You will need to have a Quantiferon, TSPOT, Mantoux test or chest x-ray prior to your infusion to evaluate for tuberculosis (TB). 
  • You will also need a blood test to check for hepatitis B.  Please have these results sent to us if they are not done through our clinic.
  • Our staff will assist you in identifying and enrolling in any payment assistance programs that are available to you.
  • You will need to notify your healthcare provider if you are pregnant or planning to become pregnant.

What are the side effects of infliximab?

  • Infliximab is generally well tolerated with manageable reported reactions lasting a short time.
  • Mild reactions include: chest tightness, chills, headache, hives, itching, low-grade fever or rash.
  • Severe reactions include: difficulty breathing, fever greater than 101° F, low blood pressure, swelling, throat tightness or wheezing.
  • You will be closely monitored throughout the infusion for any sign of reaction.
  • In the unlikely event that you experience an infusion reaction, you may need to have a driver to take you home, as the medications used to treat the reaction can cause drowsiness.

What monitoring will I need on infliximab?

  • This drug can interfere with white blood cell production and may cause liver injury.
  • Lab work is needed every 6 months to check your complete blood counts and liver function. It is important to get your lab work done at the recommended intervals. 
  • We will also evaluate you for tuberculosis (TB) with Quantiferon, TSPOT or Mantoux testing every three years or less.

Are there any long-term concerns of using infliximab?

  • Some patients have had serious infections while receiving infliximab. These infections include TB (tuberculosis) and infections caused by viruses, fungi (such as histoplasmosis) or bacteria that have spread throughout the body. If you develop a fever, feel very tired, have a cough or flu-like symptoms while you are taking infliximab or after you have taken infliximab, you should contact our office right away.
  • Reports of a type of blood cancer called lymphoma in patients on infliximab are rare but occur more often than expected for people in general. If you take infliximab your risk for developing lymphoma or other cancers may increase.
  • Cases of acute and chronic leukemia have been reported in association with infliximab in patients on these medications for indications other than inflammatory bowel disease.  It is unclear if this increased incidence of leukemia is related to the medication. 
  • Rarely, a small number of patients who have received infliximab along with another immunosuppressing drug have developed a rare type of cancer called Hepatosplenic T-cell Lymphoma. Most of these patients were teenage or young males. 
  • Rarely patients receiving infliximab have developed non-melanoma skin cancer which is generally not life threatening if treated. Tell your doctor if you have a bump or open sore that doesn’t heal.
  • There have been reports of new heart failure or worsening heart failure in patients taking infliximab. Symptoms include shortness of breath, swelling of your ankles or feet, or sudden weight gain.
  • There have been rare cases of patients developing disorders that affect their nervous system. If you experience any changes in your vision, weakness in your arms and/or legs, and numbness or tingling in any part of your body, notify our office.
  • In some cases, patients have developed symptoms that are like the symptoms of Lupus. Notify your health care provider if you have chest discomfort,  or pain that does not go away, shortness of breath, joint pain or a rash on the cheeks or arms that gets worse in the sun.
  • There have been reports of an association between this medication and the onset of psoriasis. Tell your doctor is you develop red scaly patches. or raised bumps on the skin that are filled with pus.
  • In some patients taking infliximab, the body may not make enough of the blood cells that help fight infection or help stop bleeding. Contact our office if you have a fever that does not go away, bruise or bleed very easily, or look very pale.
  • In some cases, there have been reports of hepatitis B reactivation in patients who carry the virus in their blood. Contact our office if you feel unwell, have a poor appetite, if you notice tiredness (fatigue) or experience fever, skin rash or joint pain.
  • Serious liver problems have been rarely reported. If you experience any of the following symptoms you should contact our office immediately: jaundice (skin and eyes turning yellow), dark brown-colored urine, right sided abdominal pain, fever or severe fatigue (tiredness).

Call your doctor right away if you develop any of the above side effects or symptoms.

612-871-1145.

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