What’s the Difference Between Remicade (Infliximab) and Inflectra (Infliximab-Dyyb)?

Living with an autoimmune disorder can feel like navigating a storm, one that never seems to dissipate and consistently affects your daily life. Thankfully, many medications can help ease these conditions, such as Remicade (infliximab) and Inflectra (infliximab-dyyb).

Here, we'll help you learn more about Remicade and Inflectra and what you can expect if your healthcare professional (HCP) has prescribed one of them for you.

What are Remicade and Inflectra?

Remicade is a biologic medication that’s FDA approved to treat autoimmune disorders such as Crohn’s disease and rheumatoid arthritis (RA). Biologics are medications that come from natural or living sources, such as proteins and tissues. Because of their complex nature, they’re hard to copy and can be costly to produce.

Inflectra is a biosimilar to Remicade. A biosimilar is a biologic medication that’s highly similar to its reference biologic. They’re comparable in terms of safety and effectiveness, but biosimilars tend to be more affordable. As such, some people think of Inflectra as a “generic” version of Remicade. It’s like a Remicade alternative.

Good to know: Inflectra isn’t the only biosimilar to Remicade. Two other Remicade biosimilars, called Renflexis (infliximab-abda) and Avsola (infliximab-axxq), are also available. The choice between Remicade or one of its biosimilars will likely depend on your insurance coverage and your infusion center's medication supply.

Are Remicade and Inflectra the same?

Not exactly, but they’re very similar. Let’s take a closer look at how Remicade and Inflectra compare.

1. Remicade and Inflectra have similar uses

Remicade and Inflectra help lower inflammation in your body. They both treat symptoms caused by:

• Moderate to severe Crohn's disease in people ages 6 and older

• Moderate to severe ulcerative colitis in people ages 6 and older

• Moderate to severe RA in adults

• Ankylosing spondylitis in adults

• Psoriatic arthritis in adults

• Severe plaque psoriasis in adults

2. They’re both injected into a vein

Remicade and Inflectra are given as intravenous (IV) infusions, which means they’re injected directly into a vein over a period of time. This is done by a trained HCP in a hospital or clinic setting. They’re usually given once every 6 to 8 weeks after the first few doses. You can’t inject them yourself.

Good to know: Zymfentra (infliximab-dyyb) was FDA approved in October 2023 as the first under-the-skin (subcutaneous) infliximab product. It’s approved for the treatment of moderate to severe Crohn’s disease and ulcerative colitis in adults. This medication is recommended to be used following 10 weeks of treatment with an IV-administered infliximab product such as Remicade or Inflectra. But, because it’s administered differently, Zymfentra isn’t technically considered a biosimilar to Remicade.

3. Both medications block a protein called tumor necrosis factor

Remicade and Inflectra work the same way. They block a protein called tumor necrosis factor (TNF)-alpha. In large amounts, TNF-alpha can cause inflammation and swelling. Remicade and Inflectra block TNF-alpha to help lower inflammation in your body. They’re called “TNF inhibitors” because of this.

4. Their safety and effectiveness is comparable

There aren’t any clinically meaningful safety or effectiveness differences between Remicade and Inflectra. They’re both safe and effective treatment options for the autoimmune disorders that they’re approved to treat.

But, unlike brand and generic medications, they aren’t considered chemically equivalent. This is because they’re made from living organisms, such as proteins and tissues, which are difficult to copy exactly. Remicade and Inflectra also can't be interchanged for one another automatically, like brands and generics often are at the pharmacy. This is part of why your insurance coverage, if applicable, may cover one medication over the other.

Inflectra vs. Remicade: What are the differences?

While there are similarities between Inflectra and Remicade, there are few notable differences.

Cost

The main difference between the two medications is rather simple: affordability. As mentioned above, biologic medications can have a relatively high price tag. And because they’re used to treat serious health conditions, accessing and affording treatment is especially important.

Biosimilars tend to cost less than their reference counterparts. This is largely because their path to approval is shorter and cheaper. Biosimilar manufacturers don't need to go through the same number of clinical trials or spend as much money on research. The reference product already set the stage for knowing what to expect with the treatment, so repeating these studies isn’t usually considered necessary. Because of this, biosimilars such as Inflectra are typically less expensive.

Insurance coverage

Insurance coverage is another significant difference between Remicade and Inflectra. 

As mentioned above, biosimilars tend to cost less than their reference counterparts. Despite this, many health insurance plans still prefer to cover reference biologics such as Remicade. However, some insurers do cover biosimilars. And over time, it’s expected that more and more insurance plans will prefer to cover biosimilars over reference biologics.

The most affordable option for you will likely depend on the product that your insurance plan prefers to cover. If you don’t have health insurance or are underinsured, the most affordable option will likely be manufacturer-based patient assistance programs (or other savings opportunities) you may qualify for.

Manufacturers

Another difference between the two medications is who makes them. Remicade is manufactured by Janssen Biotech, while Inflectra is manufactured by Pfizer. Both manufacturers offer different savings programs to help with out-of-pocket costs associated with treatment. These savings opportunities are explained more below.

Does Inflectra really work as well as Remicade?

Yes. Before approving Inflectra as a biosimilar to Remicade, the FDA evaluated several different factors. This includes looking at structural similarities between the two medications as well as comparing safety and effectiveness.

For example, in three separate studies, Inflectra was comparable to Remicade in treating RA, ankylosing spondylitis, and Crohn’s disease. And because it’s approved for the same uses as Remicade, the FDA expects Inflectra to work as well as Remicade in all other FDA-approved uses.

How long do they take to work?

Sadly, there's not a straightforward answer for this. It can take weeks to months for Remicade or Inflectra to start working. It’s uncommon for your symptoms to improve right away. You should talk to your HCP about how to best manage your symptoms until your infusion starts to help you feel better.

Remicade side effects vs. Inflectra side effects: Are there any differences?

There aren’t any notable safety differences between Remicade and Inflectra. They can cause similar side effects. Common side effects include:

• Infections (e.g., upper respiratory infection or sinus infection)

• Infusion-related reactions (e.g., headache, reddening of the skin, or rash)

• Headache

• Stomach pain

• Nausea

Warnings and serious side effects

Both Remicade and Inflectra may cause more serious side effects in some cases. They have boxed warnings — the FDA's most serious warning — about potential risks of new or worsening cancers or serious infections. These risks stem from their effects on your immune system.

The following side effects are also serious and should be reported to your HCP immediately:

• Serious allergic reactions such as anaphylaxis (e.g., trouble breathing, hives, or swelling of the face or throat)

• Symptoms of heart failure (e.g., trouble breathing, sudden weight gain, or swelling in ankles or feet)

• Symptoms of liver damage (e.g., yellow eyes or skin, pain in the upper-right area of your stomach, or swelling of the stomach)

• Symptoms of nervous system disorders (e.g., numbness in any part of your body, seizures, or weakness)

• Reactivation of hepatitis B (e.g., joint pain, fever, or poor appetite)

• Drug-induced lupus (e.g., chest pain, joint pain, or a rash on your cheeks or arms)

Can you switch between Remicade and Inflectra?

Yes, it’s possible to switch between Remicade and Inflectra — or vice versa. You may need to do this if your insurance plan’s formulary was updated, you switched insurers, or your HCP recommends the switch from a clinical perspective.

This is largely because insurance plans tend to prefer to cover one product over the other. Or they may even prefer to cover one of the other Remicade biosimilars. If this is the case, your HCP will need to write you a new prescription order since they can’t be interchanged automatically at the infusion center.

Keep in mind: Even though Remicade and Inflectra are similar to each other, it’s technically possible that your body may respond differently to either one. It’s important to let your HCP know if you notice any differences in how you feel after switching from one medication to the other.

How to save on Remicade and Inflectra

Remicade and Inflectra are biologic medications that are administered by an HCP. But GoodRx can still help you navigate ways to save on your prescription.

• Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, a Remicade infusion can cost as little as $5 if you use the manufacturer’s savings card. Inflectra is as little as $0 if you use the manufacturer’s savings card.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for the Remicade or Inflectra patient assistance programs, which offer the medications at no charge.

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Written by:

Makaela Premont, PharmD

Makaela Premont, PharmD, is a pharmacist and the founder of uniquelymickie.com, a website dedicated to helping pharmacy students and pharmacists create a life that they enjoy. She received her Doctorate of Pharmacy from the University of South Carolina and is a licensed pharmacist in North Carolina.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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