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(in flix' I mab)Infliximab, infliximab-dyyb, and infliximab-abda injection may decrease your ability to fight infection and increase the risk that you will get a serious infection, including severe viral, bacterial, or fungal infections that may spread throughout the body. These infections may need to be treated in a hospital and may cause death. Tell your doctor if you often get any type of infection or if you think you may have any type of infection now. This includes minor infections (such as open cuts or sores), infections that come and go (such as cold sores) and chronic infections that do not go away. Also tell your doctor if you have diabetes or any condition that affects your immune system and if you live or have ever lived in areas such as the Ohio or Mississippi river valleys where severe fungal infections are more common. Ask your doctor if you do not know if infections are more common in your area. Also tell your doctor if you are taking medications that decrease the activity of the immune system such as abatacept (Orencia); anakinra (Kineret); methotrexate (Rheumatrex); steroids such as dexamethasone, methylprednisolone (Medrol), prednisolone (Prelone), or prednisone; or tocilizumab (Actemra). Your doctor will monitor you for signs of infection during and shortly after your treatment. If you have any of the following symptoms before you begin your treatment or if you experience any of the following symptoms during or shortly after your treatment, call your doctor immediately: weakness; sweating; difficulty breathing; sore throat; cough; coughing up bloody mucus; fever; extreme tiredness; flu-like symptoms; warm, red, or painful skin; diarrhea; stomach pain; or other signs of infection. You may be infected with tuberculosis (TB, a severe lung infection) or hepatitis B (a virus that affects the liver) but not have any symptoms of the disease. In this case, infliximab, infliximab-dyyb, and infliximab-abda injection may increase the risk that your infection will become more serious and you will develop symptoms. Your doctor will perform a skin test to see if you have an inactive TB infection and may order a blood test to see if you have an inactive hepatitis B infection. If necessary, your doctor will give you medication to treat this infection before you start using infliximab, infliximab-dyyb, or infliximab-abda injection. Tell your doctor if you have or have ever had TB, if you have lived in or visited a place where TB is common, or if you have been around someone who has TB. If you have any of the following symptoms of TB, or if you develop any of these symptoms during your treatment, call your doctor immediately: cough, weight loss, loss of muscle tone fever, or night sweats. Also call your doctor immediately if you have any of these symptoms of hepatitis B or if you develop any of these symptoms during or after your treatment: excessive tiredness, yellowing of the skin or eyes, loss of appetite, nausea or vomiting, muscle aches, dark urine, clay-colored bowel movements, fever, chills, stomach pain, or rash. Some children, teenagers, and young adults who received infliximab injection or similar medications developed severe or life-threatening cancers including lymphoma (cancer that begins in the cells that fight infection). Some teenage and young adult males who took infliximab or similar medications developed hepatosplenic T-cell lymphoma (HSTCL), a very serious form of cancer that often causes death within a short period of time. Most of the people who developed HSTCL were being treated for Crohn's disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever) or ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum) with infliximab or a similar medication along with another medication called azathioprine (Imuran) or 6-mercaptopurine (Purinethol). Tell your child's doctor if your child has ever had any type of cancer. If your child develops any of these symptoms during his treatment, call his doctor immediately: unexplained weight loss; swollen glands in the neck, underarms, or groin; or easy bruising or bleeding. Talk to your child's doctor about the risks of giving infliximab injection to your child. Talk to your doctor about the risks of using infliximab, infliximab-dyyb, and infliximab-abda injection.
- rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function) that is also being treated with methotrexate (Rheumatrex, Trexall).
- Crohn's disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever) in adults and children 6 years of age or older that has not improved when treated with other medications.
- ulcerative colitis (condition that causes swelling and sores in the lining of the large intestine) in adults that has not improved when treated with other medications. Infliximab may also be used to relieve symptoms of ulcerative colitis in children 6 years of age or older that has not improved when treated with other medications.
- ankylosing spondylitis (a condition in which the body attacks the joints of the spine and other areas causing pain and joint damage).
- psoriasis (a skin disease in which red, scaly patches form on some areas of the body).
- psoriatic arthritis (a condition that causes joint pain and swelling and scales on the skin).
Before using infliximab, infliximab-dyyb, or infliximab-abda injection,
- tell your doctor and pharmacist if you are allergic to infliximab injection, any medications made from murine (mouse) proteins, any other medications, or any of the ingredients in infliximab, infliximab-dyyb, or infliximab-abda injection. Ask your doctor or pharmacist if you don't know whether a medication you are allergic to is made from murine proteins. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: anticoagulants (blood thinners) such as warfarin (Coumadin), cyclosporine (Gengraf, Neoral, Sandimmune), and theophylline (Theochron, Theolair, Uniphyl). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had congestive heart failure (condition in which the heart cannot pump enough blood to other parts of the body). Your doctor may tell you not to use infliximab, infliximab-dyyb, or infliximab-abda injection.
- tell your doctor if you have ever been treated with phototherapy (a treatment for psoriasis that involves exposing the skin to ultraviolet light) and if you have or have ever had a disease that affects your nervous system, such as multiple sclerosis (MS; loss of coordination, weakness, and numbness due to nerve damage), Guillain-Barre syndrome (weakness, tingling, and possible paralysis due to sudden nerve damage) or optic neuritis (inflammation of the nerve that sends messages from the eye to the brain); numbness, burning or tingling in any part of your body; seizures; chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways); any type of cancer; bleeding problems or diseases that affect your blood; or heart disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using infliximab, infliximab-dyyb, or infliximab-abda injection, call your doctor. If you use infliximab, infliximab-dyyb, or infliximab-abda injection during your pregnancy, be sure to talk to your baby's doctor about this after your baby is born. Your baby may need to receive certain vaccinations later than usual.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are using infliximab, infliximab-dyyb, or infliximab-abda injection.
- do not have any vaccinations without talking to your doctor. Also tell your doctor if you have recently received a vaccine. If your child will be treated with infliximab injection, talk to his or her doctor about vaccinations that should be given before the start of treatment. If possible, your child should be given all vaccinations needed for children of his or her age before beginning treatment.
- you should know that you may have a delayed allergic reaction 3 to 12 days after you receive infliximab, infliximab-dyyb, or infliximab-abda injection. Tell your doctor if you experience any of the following symptoms several days or longer after your treatment: muscle or joint pain; fever; rash; hives; itching; swelling of the hands, face, or lips; difficulty swallowing; sore throat; and headache.
- stomach pain
- runny nose
- back pain
- white patches in the mouth
- vaginal itching, burning, and pain, or other signs of a yeast infection
- any type of rash, including a rash on the cheeks or arms that gets worse in the sun
- chest pain
- swelling of the feet, ankles, stomach, or lower legs
- sudden weight gain
- shortness of breath
- blurred vision or vision changes
- weakness in arms or legs
- muscle or joint pain
- numbness or tingling in any part of the body
- yellowing of the skin or eyes
- dark colored urine
- loss of appetite
- pain in the upper right part of the stomach
- unusual bruising or bleeding
- blood in stool
- pale skin
- red, scaly patches or pus-filled bumps on the skin