infliximab at a glance
Medicine class
Monoclonal antibody and TNF-alpha inhibitor.
Main uses
Crohn’s disease, ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and plaque psoriasis.
How it is given
By intravenous infusion in a clinical setting or, for appropriate adults, by subcutaneous injection after training.
Key safety issue
It can reduce resistance to infection, so screening and ongoing vigilance are required.
What is infliximab used for?
Licensed uses depend on the product, condition-specific eligibility and specialist assessment:
Moderately to severely active or fistulising Crohn’s disease.
Moderately to severely active ulcerative colitis.
Active rheumatoid arthritis, used with methotrexate.
Active, progressive psoriatic arthritis, with methotrexate or alone when methotrexate is unsuitable.
Severe active ankylosing spondylitis.
Moderate to severe plaque psoriasis after failure, intolerance or contraindication to other systemic treatment.
The intravenous product also covers severe Crohn’s disease and ulcerative colitis in children and adolescents aged 6 to 17 years; the selected subcutaneous product is for adults only.
How does infliximab work?
Infliximab binds soluble and cell-associated TNF-alpha and blocks its inflammatory activity. This can reduce inflammation but may also weaken immune defence against infection.
infliximab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 100 mg
Injection
Route: Parenteral
Strengths: 120 mg
How to take infliximab
Intravenous infliximab is prepared and given by healthcare professionals, with observation for infusion reactions. The pre-filled pen is injected under the skin and may be used at home only after training and specialist approval.
Allow the pen to warm naturally; do not use external heat or shake it.
Check that the liquid is not cloudy, discoloured or visibly particulate.
Use an advised site on the thigh, abdomen or outer upper arm. Rotate sites and avoid damaged or tender skin.
Put used pens immediately in an approved sharps container.
Tell the team about infection symptoms or an allergic reaction before the next administration.
infliximab side effects
Common or expected effects
- Upper respiratory or viral infections
- Headache
- Abdominal pain or nausea
- Tiredness
- Muscle, joint or back pain
- Infusion-related symptoms or injection-site pain, redness, swelling or itching
Get urgent medical advice
- Serious infection, including tuberculosis, sepsis or opportunistic infection
- Severe immediate or delayed allergic reaction
- New or worsening heart failure
- Hepatitis, jaundice or other serious liver injury
- Low blood-cell counts causing persistent fever, pallor, bruising or bleeding
- Demyelinating neurological disorders, severe skin reactions or lupus-like illness
- Rare malignancies, including lymphoma
infliximab in pregnancy
Infliximab may be used in pregnancy when specialist assessment concludes that controlling the inflammatory disease outweighs potential risks. Available data do not indicate an increased malformation rate, but infliximab can cross the placenta and remain in the infant. Tell the child’s healthcare team because live-vaccine timing may need to change. Selected product information advises avoiding live vaccines for 12 months after exposure in the womb unless specialist criteria support earlier vaccination.
infliximab while breastfeeding
Infliximab is found at low levels in breast milk and is expected to be largely broken down in the infant’s gut. Use while breastfeeding can be considered. Discuss this with the specialist team and tell the baby’s healthcare professionals before any live vaccine is given.
infliximab interactions
Provide a complete list of prescribed, non-prescribed and complementary treatments. Important combinations include:
Anakinra
Concurrent use is not recommended because serious infection and neutropenia may be more likely without added benefit.
Abatacept
Concurrent use is not recommended because infection risk increases without demonstrated additional benefit.
Other biological treatments for the same disease
Overlapping immune effects may increase infection and other adverse-reaction risks.
Common questions about infliximab
Answers are fully visible for fast scanning and source review.
What is infliximab used for?
It treats selected inflammatory bowel, joint, spinal and skin diseases when specialist-defined criteria are met.
Is infliximab an immunosuppressant?
Yes. By blocking TNF-alpha it reduces harmful inflammation but can also weaken defence against infection.
Is infliximab given by infusion or injection?
Both forms exist. The selected Flixabi product is an intravenous infusion, while the selected Remsima pen is injected under the skin by appropriately selected adults.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.