Drug reference

Infliximab

Monoclonal Antibody · Immunosuppressant

Monoclonal AntibodyImmunosuppressant

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

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Mechanism

Infliximab is a chimeric (75% human, 25% murine) IgG1 monoclonal antibody that binds with high affinity to both soluble and transmembrane forms of tumor necrosis factor-alpha (TNF-α). By neutralizing TNF-α, it interrupts the inflammatory cascade that drives tissue destruction in rheumatoid arthritis, Crohn's disease, and other autoimmune conditions. Binding to membrane-bound TNF-α also triggers complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity, eliminating TNF-producing inflammatory cells.

Indications

Granulomatosis with polyangiitisMicroscopic polyangiitisRheumatoid arthritisPemphigus vulgarisseveral autoimmune disordersmoderate-to-severe crohn’s diseaseankylosing spondylitisplaque psoriasispsoriatic arthritisulcerative colitismoderate-to-severe Crohn’s disease (including fistulizing disease resistant to other therapies)induction and maintenance of remission in adults and children with moderate-to-severe Crohn’s diseaseacute and chronic treatment of moderate-to-severe ulcerative colitis

Dosing

Adult: maximum cumulative cyclophosphamide dose, or . cyclophosphamide is contra-indicated or not tolerated, or . the patient has not completed their family, and treatment with cyclophosphamide may materially affect their fertility, or . the disease has remained active or progressed despite a course of cyclophosphamide lasting 3–6 months or . the patient has had uroepithelial malignancy.…

Pharmacokinetics

Half-life

About 8 to 10 days.

Contraindications

severe congestive heart failure

Side effects

Common

infusion reaction (fever, urticaria, hypotension, dyspnea within 1 to 2 h)acute infusion reactions (fever, chills, urticaria, anaphylaxis)subacute reactions (serum sickness–like)respiratory infections

Serious

development of antinuclear antibodies
lupus-like syndrome (rarely)
increased risk of serious infections
lymphomas
other malignancies
fatal hepatosplenic t-cell lymphomas (in adolescent and young adult patients with crohn’s disease when combined with azathioprine or 6-mp)
infection (from immunosuppression, increased with steroids)
reactivation of tuberculosis
opportunistic infections with subsequent dissemination
increased incidence of non-Hodgkin lymphoma (causal role not established)
drug-induced lupus
multiple sclerosis–like syndrome
nonmelanoma skin cancer