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Infliximab is given as an intravenous (IV) infusion – that is, through a drip into a vein in your arm. It cannot be given as tablets because your digestive system would destroy it.
Infliximab infusions are usually given in hospital by a trained member of staff. You will probably be treated as a day outpatient (unless you are already in the hospital) and will be able to have the infusion while sitting in a chair, so you won’t have to undress, get into bed or stay overnight.
The initial infusion itself usually takes from about two to four hours, but subsequent infusions may be given faster depending on the local practice. For example, some clinics now use faster infusions for people who have had at least 3 successful treatments. If you have previously had an infusion reaction, the infusion time may be increased in order to decrease the risk of another reaction. You may be given paracetamol, antihistamine or hydrocortisone just before the infusion, to minimize the risk of side effects.
You will be closely observed by your medical team during the infusion and for two hours afterward to make sure that you do not develop an allergic reaction. While the infusion itself takes two hours, most treatment sessions take 4-6 hours in total including monitoring time. However, different hospitals may do this differently, and some hospitals allow patients to go home as soon as the infusion has finished.
The recommended dose is 5 mg of Infliximab for every kilogram you weight. However, in some cases it could be escalated to 10 mg/kg.
Most people with IBD have an initial infusion followed by another infusion two weeks later and a third after six weeks. If you respond well to the treatment, it is likely you will be put onto a maintenance programme of an infusion every eight weeks. If there has been no improvement after two or three doses, then infliximab is unlikely to be effective for you and an alternative treatment will be sought.