Infliximab REMICADE®

WHAT ARE THE MOST LIKELY SIDE EFFECTS?

Like all drugs, Infliximab can have side effects, although not everyone experiences these. Some side effects can happen almost immediately, in direct response to the infusion. Others may not appear for several days, weeks or even longer. It can take up to 6 months after the last dose for Infliximab to be completely eliminated from the body, so some effects might appear during this time.

Some side effects are mild and will go away on their own, or following a slight change to the infusion programme. Others may be more serious and will require treatment.

Side effects of Infliximab may include the following:

• Symptoms that may mean you are having a reaction to the infusion or an allergic reaction to infliximab. These might happen during or soon after your infusion, or could be delayed for up to 12 days. Tell the hospital staff treating you if you begin to experience any of these symptoms during your infusion, or contact your doctor straight away if you have them once you get home. They include hives (red, raised, itchy patches of skin) or other skin rashes, difficulty swallowing or breathing, pains in your chest or muscles or joints, fever or chills, swelling of the face or hands, headaches or a sore throat
• A greater chance of suffering from infections such as colds and flu, urinary tract infections, and conjunctivitis, and also some more serious infections such as pneumonia and sepsis (general inflammation and problems with blood clotting). You may also be at greater risk of developing tuberculosis (TB), or of having underlying TB reactivated while on infliximab. Tell your doctor if you begin to feel very tired or have a fever, a cough, flu-like symptoms or warm, red, painful skin
• Skin reactions such as psoriasis (red scaly patches), rashes and skin lesions, ulcers and hives, and swollen face and lips. Tell your doctor if you develop any of these symptoms
• Blood problems. Your body may not make enough of the blood cells that help fight infections or help to stop bleeding. Symptoms include a fever that does not go away, bruising or bleeding very easily, sore throat, or looking very pale
• A worsening of a heart problem. Let your doctor know if you notice any new or worse symptoms such as shortness of breath, swelling of the ankles or sudden weight gain
• An increased risk of developing certain types of cancers including lymphoma (which affects the lymph glands). You may be more at risk if you are also taking immunosuppressive drugs such as azathioprine or methotrexate and it is more common in young men. However, it is difficult to know exactly what the risk is, as these cancers happen only rarely and very few people are affected. Infliximab therapy may not be advised if you have had previous cancer
• In rare cases, liver problems. Tell your doctor if you notice a yellowing of the skin which may be a sign of jaundice, or feel very tired, have dark brown coloured urine or pain in the upper right side of the stomach area
• Very rarely, nervous system problems. Tell your doctor if you get any numbness, tingling or problems with your sight
• Lupus-like syndrome - chest discomfort or pain that does not go away, shortness of breath, joint pain, rash on the cheeks or arms that gets worse in the sun
• Infliximab may also cause side effects such as headaches, abdominal pain, nausea, joint pain, and fatigue, eye problems and depression

As mentioned above, your doctor should talk through the risks and benefits before you start on Infliximab. Let your doctor or IBD nurse know about any new symptoms you develop while on Infliximab, whenever they occur. Your IBD team should also be able to help with any queries and concerns.

References