Anything over 5 mcg/ml is perfect for your remicade/infliximab serum concentration levels when read within 48 hours before your next scheduled infusion. If you had unreadable (that is zero) values or anything under 5 then you might have issues. As an example, my last remicade serum concentration results were 15 mcg/ml, pretty close to your levels.
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What should I know about Remicade before taking it?
flu -like symptoms (such as a runny nose, chills, and muscle aches) Your doctor will monitor you closely for symptoms of infection during and after Remicade treatment. You may need to be treated for an infection before you start to take Remicade. This is for cases in which you have an infection but don’t have symptoms yet.
How do I calculate Remicade ® dosage?
mL reconstituted REMICADE ® = total dose/10 (rounded to nearest tenth). Enter the patient’s weight in pounds (pounds are automatically converted to kilograms). Then hit Enter, and the appropriate dosage amount and number of single vials will populate. Remember to discard any unused solution remaining in the vials.
What class of drug is Remicade?
Remicade belongs to a drug class called tumor necrosis factor-alpha (TNF-alpha) blockers. A class of drugs is a group of medications that work in a similar way. Remicade comes as a vial of powder that’s mixed with a liquid solution. The drug is available in one strength: 100 mg.
How is Remicade different from chemotherapy?
Specifically, Remicade is monoclonal antibody that’s made from immune system cells in a lab. Monoclonal antibodies only block the activity of certain proteins in the body. Chemotherapy, on the other hand, is a chemical drug that destroys rapidly growing cells throughout the body.
What is a normal Remicade level?
Currently, trough levels above 3–5 mg/mL are considered adequate but in fistulazing disease target levels may be higher (~10 mg/mL or more). An active infliximab trough monitoring strategy should be implemented with automatic measurement of drug antibodies in low trough levels.
What is a good Remicade trough level?
Infliximab (Remicade) trough levels >7 μg/ml provide better control of inflammation in inflammatory bowel disease without increasing the risk of infection, according to a Slovenian single-center study of 183 patients.
How do I know if infliximab is working?
At some hospitals you may also be given a special blood test to check the level of infliximab in the blood. This can help you doctor see how well the infliximab is working, and also if you have developed any antibodies to it. It can help the doctor to decide whether your dose needs changing.
What should infliximab antibody levels be?
The cutoff values for infliximab and anti-infliximab antibody trough levels were also determined for UC patients: 0.8 μg/mL for infliximab (75% sensitivity [95% CI, 35-97] and 100% specificity [95% CI, 48–100]) and 10 U/mL for anti-infliximab antibodies (80% sensitivity [95% CI, 44–97] and 100% specificity [95% CI, 69– ...
What happens if I develop antibodies to infliximab?
Patients who develop anti-infliximab antibodies are at higher risk for developing infusion reactions, and a reduced duration of response, to treatment with infliximab. Co-treatment with an immunosuppressive drug(s) can suppress the antibody response and prolong the clinical response to infliximab.
What are anti-infliximab antibodies?
Abstract. Infliximab is a chimeric monoclonal antibody directed against tumour necrosis factor-α. When used in inflammatory bowel disease, primary nonresponse is found in at least 10% of patients, with secondary loss of response occurring in a further 10-15% per year.
What happens when biologics stop working?
Sometimes, biologic drugs will help you for a while and then don't work as well. It's not clear why. If it happens to you, tell your doctor. They'll probably switch you to another biologic or add another type of RA drug, like methotrexate or sulfasalazine, so your treatment works better.
How long does it take for Remicade infusions to work?
How long it takes to work, and whether or not it will work, varies from person-to-person. Some people report an improvement in symptoms after a few days, others up to 6 weeks after their first infusion.
Can you have a flare while on Remicade?
Symptom flares can also indicate a change in your body's response to your current treatment. For example, each year a portion of patients who take either immunomodulator or biologic medications such as infliximab (Remicade) or adalimumab (Humira) stop responding to their medication.
What happens when Remicade stops working?
If the Prometheus test reports a normal trough level of Remicade with little to no antibodies present, and the patient's condition doesn't stabilize or improve, then the medication is no longer therapeutic. The only recourse for the patient is to begin a new treatment.
How do I monitor infliximab?
How to monitor anti-TNF-alpha therapy (infliximab and adalimumab)?height, weight and sex.posology, injection schedule, concomitant use of immunosuppressants.serum concentrations of albumin and CRP.serum concentration of TNF alpha.presence and levels of potential antidrug antibodies.
How much sodium chloride to dilute in remicade?
Dilute the total volume of the reconstituted REMICADE® solution to 250 mL* with sterile 0.9% Sodium Chloride Injection, USP, (do not dilute with any other diluent) as follows:
How long does it take for a remicade to cause a fatal accident?
Serious cerebrovascular accidents, myocardial ischemia/infarction (some fatal), hypotension, hypertension, and arrhythmias have been reported during and within 24 hours of initiation of REMICADE® infusion. Cases of transient visual loss have been reported during or within 2 hours of infusion of REMICADE®. Monitor patients during infusion and if serious reaction occurs, discontinue infusion. Further management of reactions should be dictated by signs and symptoms.
How long does it take for reconstituted solution to stand?
Allow the reconstituted solution to stand for 5 minutes. Visually inspect the reconstituted solution for particulate matter and discoloration. The reconstituted solution should be colorless to light yellow and opalescent, and the solution may develop a few translucent particles as infliximab is a protein. Do not use if the lyophilized powder has not fully dissolved or if opaque particles, discoloration, or other foreign particles are present. Do not store unused reconstituted REMICADE® solution
How to calculate vials?
Vials = total dosage/100 (rounded up to nearest whole vial).
What should be inspected for in a parenteral drug?
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. If visibly opaque particles, discoloration, or other foreign particulates are observed, the solution should not be used.
Why is thorough patient assessment and screening for hypersensitivity reactions important?
Thorough patient assessment and screening for hypersensitivity reactions are key to helping to prevent infusion-related events.
What to do before infusing remicade?
Before infusing REMICADE®, provide patients or their caregivers with the Medication Guide for REMICADE®. You can obtain a printable PDF of the full Prescribing Information and the Medication Guide here. Refer to the Preparation and Administration Instructions and important information on what to do in the event your patient experiences an infusion reaction.
Why do some people not respond to remicade?
Unfortunately, some patients no longer respond to Remicade because their symptoms become too severe or complicated. In my case, my gastroenterologist believed I might have developed antibodies, making me immune to the medication.
Why do doctors discourage medication holidays?
Doctors often discourage a “medication holiday,” because it can cause IBD symptoms to return or worsen. A 2012 study found that almost half of the patients who ceased Remicade after achieving remission relapsed within a year.
Is Remicade a therapeutic drug?
If the Prometheus test reports a normal trough level of Remicade with little to no antibodies present, and the patient’s condition doesn ’t stabilize or improve, then the medication is no longer therapeutic. The only recourse for the patient is to begin a new treatment.
Does Remicade suppress TNF-A?
Remicade suppresses the immune response generated by TNF-a, thereby reducing inflammation. In turn, the body might recognize the medication as an antigen and begin producing anti-infliximab antibodies. To find out if I had developed antibodies, my doctor did two things.
Does remicade lose effectiveness?
When Remicade loses effectiveness. Remicade can begin to lose effectiveness for several reasons. For one, my Crohn’s could be worsening because I’ve been on Remicade for more than 12 years. My gastroenterologist warned me the medication could lose effectiveness over time.
Can antibodies cause remicade?
Antibodies or an insufficient dosage can result in a below-normal Remicade level. To counteract and balance the antibodies, the doctor might increase the dose, frequency, or both before deciding to switch to a different medication. Increasing the dose or frequency of treatment can also restore efficacy and maintain remission.