Preparing for Your First Remicade (or Infliximab Biosimilar) Infusion

What is Remicade / Infliximab?

Infliximab is a prescription-only monoclonal antibody that is administered via IV into the body. It has been used for over 20 years and may be referenced commonly under the brand name Remicade. It can be given to adult or pediatric patients (ages 6-17).

Patients usually receive their first and second dose of infliximab two weeks apart, while the third infusion is administered four weeks after the second dose. After a patient has received their first three infusions of infliximab, patients at IVX Health return every six to eight weeks for a maintenance dose.

What is an Infliximab Biosimilar?

Many specialists may also prescribe an infliximab biosimilar such as Avsola, Inflectra, or Renflexis – in lieu of Remicade. Biosimilars are medications that use the same biologic materials as the reference drug, with no substantial differences in safety or efficacy (as determined by the FDA). Often times a patient’s health plan will require they start therapy on a biosimilar, as these may be more cost effective.

 

What are Infliximab Infusions Used to Treat?

Infliximab can help with autoimmune conditions such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, severe plaque psoriasis, and other conditions. Remicade, Avsola, Inflectra, and Renflexis are most often prescribed by a specialist physician, such as a gastroenterologist, rheumatologist, or other referring specialist.

Infliximab works by blocking the tumor necrosis factor alpha (TNF-alpha) — a naturally-occurring substance in our bodies that causes inflammation. Blocking this substance helps decrease inflammation and also weakens the immune system, thus preventing further damage from the autoimmune disease.

Patient Support and Financial Assistance

Infliximab can be costly out-of-pocket, but being an informed consumer can really pay off. Whether you have private or commercial insurance, Medicare or Medicaid, or no insurance coverage at all, there are financial assistance options and programs available to you.

With the Janssen CarePath Savings Program for Remicade, eligible patients with private or commercial insurance may end up paying as little as $5 per injection (up to $20,000 maximum annually).  Once enrolled, you will be individually assigned a Care Coordinator who can explain what to expect to pay out-of-pocket and offer financial support options and savings programs that may complement your pre-existing healthcare coverage (Health Insurance Marketplace plans are included). Depending on your health insurance plan, savings may go towards your deductible, co-pay, or co-insurance.

This coordinator will also work with you and your doctor to coordinate with pharmacies, offer treatment videos, answer questions, and find infusion centers.

If your health plan does not include coverage for Infliximab or you do not receive approval, you and your doctor reserve the right to petition the coverage provider to explain its decision and possibly make an exception to its policy.

See each manufacturer’s financial assistance programs if you are receiving doses of Avsola, Renflexis, or Inflectra. All of these programs offer eligible patients the opportunity to pay only $5 per infusion.

There are also additional state-sponsored programs, Medicaid Savings Program, Medicaid, and other independent co-pay assistance programs.  Johnson & Johnson Patient Assistance Foundation might be able to provide financial assistance, as well as other independent foundations, such as Patient Advocate Foundation and Patient Services Inc. Note that eligibility is not guaranteed in any independent program.

Before Your Infliximab Infusion

Before your first infliximab infusion, it is important to discuss with your prescribing physician your intake of food, alcohol, or tobacco. It’s also important to be skin tested for tuberculosis before your first treatment and alert your doctor if you’ve been exposed to chicken pox, shingles, measles or pneumococcal disease, or if you have a heart condition, liver injury, any infections, cancer, hepatitis B, or nervous system disorders. You may be asked to give a blood or urine sample before your visit to check for some of these issues.

If you have recently received a vaccine or are scheduled to receive one, you should not begin or continue your infliximab infusions without speaking to your doctor.

The day before your visit, you will want to make sure you are well-rested and well-hydrated. Patients should plan to eat a meal before their infusion at IVX Health, though complimentary drinks and snacks are always provided during your care experience. You might also want to prepare yourself for certain side effects, such as having acetaminophen on hand, proper time to rest, etc.

What to Bring to Your Infliximab Infusion

Here at IVX Health, all of our private patient suites have large flat screen TVs with cable, Netflix, and high-speed WiFi. You are free to bring things from home to help pass the time, such as a book, laptop, tablet, sudoku, etc., and you may also like to bring a comfy pillow in case you’d rather nap. IVX Health has soft, warm blankets available for all patients.

When it comes to what to wear, dress in comfortable, loose-fitting clothing for more comfort and also to allow easier access for the IVX clinical team of infusion nurses and nurse practitioners to gain access and start your IV infusion. As the medication is delivered, many patients may experience a cooling sensation, so consider dressing in layers in case you get hot or cold.

When Arriving at IVX Health

When you arrive for your first appointment, you are greeted by one of our IVX Health team members and escorted immediately to your private suite. An IVX clinician will capture some additional information, including your demographics and medication history. We will also confirm the insurance we have on file.

Click here learn more about the patient experience at IVX Health.

Before the Infusion Begins

Once we are ready to begin your treatment, one of our clinicians will explain the procedure to you and answer any of your questions. Before treatment, an IVX infusion nurse will give you a basic check of your vital signs and overall health. You will not need to undress for your infliximab infusion.

The correct dosage will be determined by the order from your referring specialist physician and your height and weight. Your doctor might also have you take other medications before your infusion to help prevent side effects.

Your First Infusion

A healthcare provider will begin by using rubbing alcohol to sterilize the location on your arm where the IV needle will be placed. After inserting the needle, the nurse will hold the IV line in place with some tape and attach it to the bag of medication. You simply sit or recline in our comfortable leather recliners as the infusion is administered.

One of our healthcare professionals will come in every 30 minutes during the infusion to check your vitals. Most infliximab infusions take about two to three hours.

What to Expect After Your Infliximab Infusion

Immediately after receiving your Remicade, Avsola, Inflectra, or Renflexis infusion, you will be closely monitored at our center for approximately two hours to detect any possible allergic reactions or side effects you might have. You might feel drowsy after your infusion.

Acute reactions that occur during treatment usually subside as the infusion slows down. Reactions that occur during treatment or within 24 hours of receiving a dose may include:

• Heart palpitations
• Fever
• Pain in the chest
• Nausea
• Itching
• Sweating
• Flushing
• Blood pressure variations
• Breathing difficulties

You may also experience delayed reactions up to two weeks after an infusion, including rash, joint aches, muscle aches, and lethargy.  You can take over-the-counter medications, such as ibuprofen or an antihistamine, to help combat these reactions. Always contact your referring provider with any concerns relating to a reaction after your infusion.

There are some rare side effects that can occur after your infliximab infusion, including:

• Severe infection (such as pneumonia, tuberculosis, sepsis)
• Liver injury
• Increased risk of cancers (e.g., lymphoma, skin, cervical)
• Neurologic disease
• Blood disorders
• An allergic reaction to the protein in infliximab

After treatment, patients need to monitor the development of and report to their doctor any skin growths, open or painful sores, flu-like symptoms, or lack of appetite.

You’re Ready!

Now that you know what to expect before, during, and after your infliximab infusion at IVX Health Center.

If biologics like Remicade (or an infliximab biosimilar such as Avsola, Renflexis, or Inflectra) are a part of your autoimmune disease treatment plan, then consider choosing IVX Health for your ongoing care needs. IVX Health makes it possible to receive your therapy in a comfortable, convenient, and private environment.

At IVX Health, we truly are invested in helping you live your best life. If you’re ready to experience a new kind of infusion clinic, click here to learn how to move your infusion or injection therapy to IVX Health.