Remicade: The Infusion Experience

For a whole year I was taking a medication called Lialda, a topical, slow-release anti-inflammatory that kept me in remission up until this spring when I picked up a C. Difficile bacterial infection. The C. Diff sent me into a flare up of my Ulcerative Colitis that could not be controlled by the Lialda, and my doctors decided to put me on a stronger medication—Remicade.

Remicade (Infliximab) is my current long term treatment for my UC. Remicade is a drug that's classified as a biologic. It is a combination of mouse and human DNA that creates an antibody that targets a particular type of white blood cell—TNF-α (tumor necrosis factor alpha). Sounds like something from a sci-fi movie, right? Well, these antibodies suppress the white blood cells, which in turn suppresses the immune reaction of the body (and, in my case, the overreaction that causes UC). I was a little disappointed to have to be on an immunosuppressant medication, but it’s better than the alternative of dealing with the UC. Hopefully the Remicade will continue to keep me in remission and prevent any more flare ups. Fingers crossed!

Almost two weeks ago I had my fourth Remicade treatment, and three days ago was my first day without Prednisone since being in the hospital. Finally the long taper is over. It's been pretty strange not having to take any pills at all after a year of taking Lialda every morning and every night. Remicade is administered in the form of an infusion every six weeks. The first three doses are given closer together to build up the amount of the drug in the body. Eventually the infusions are spread out to every six to eight weeks, depending on what is determined to be best for the individual. It’s important for me to get these infusions consistently every six weeks, as inconsistency in taking the medication increases the risk of my body developing antibodies to it, rendering it ineffective.

Sleeping through a Remicade infusion.

I have to go into the local infusion center every six weeks, where nurses administer the Remicade via IV. The infusion lasts around 3 hours; the trade-off for not having to take any pills, I guess. First the nurses hook you up to an IV with a standard saline drip. Before receiving the dose of Remicade, I have to take a few “pre-medications” as a precaution. Benadryl and Tylenol are given in case I have developed antibodies in between infusions and have an allergic reaction to the Remicade. I take 25mg of Benadryl, instead of the usual 50mg because just half the amount will render me quite drowsy. I usually end up sleeping through the infusions, even though they have individual TVs for us to entertain ourselves.

The blue, disk-shaped Remicade filter.

When the nurses finally attach the Remicade to your IV, it is important that you double check that there is a filter on the line for the medication. This filter is to prevent molecules that are too large from entering the bloodstream. One of the first times I was being given the dose (in the hospital, no less) the nursing staff forgot to put the filter on. Luckily my dad caught the error before they started the drip the first time. So for those of you on Remicade, always double check that the filter is equipped!

The Remicade seems to be working so far, though it’s hard to tell since I've only been off the steroids for a few days. I've been eating some more fibrous foods as well, without experiencing any adverse side effects. Haven’t tried salads yet, but I’ll work my way up to it again. So far so good.