4 Infliximab (Remicade) Interactions to Be Aware of

What do Crohn’s disease, plaque psoriasis, and rheumatoid or psoriatic arthritis have in common? All of these conditions are autoimmune disorders that cause chronic inflammation. And infliximab (Remicade) is FDA-approved to treat them all. 

Infliximab is a 2-hour intravenous (IV) infusion given by a healthcare professional. It reduces inflammation caused by an overactive immune system. But infliximab may interact with other medications, especially those that also affect the immune system.

Here, we’ll review four types of medications that could interact with infliximab (and infliximab biosimilars). Before you start getting infliximab infusions, share your current medication list with your healthcare provider. This will help them identify possible interactions.

Promotion disclosure

Infliximab

Avg retail price

$7299.99(Save 45.20%)

GoodRx discount

$4000.50

See all discounts

How it works

Use GoodRx to find medications, pharmacies, and discounts.

GoodRx discounts can help you pay less for your prescription.

Bring your free coupon or savings card to the pharmacy.

1. Biological medications

Infliximab is a biological medication, meaning it’s made from a living source. You shouldn’t combine infliximab with other biologic medications that treat the same conditions. If you do, you have a greater risk of developing serious infections. 

These medications include:

• Adalimumab (Humira)

• Etanercept (Enbrel)

• Tocilizumab (Actemra)

• Anakinra (Kineret)

• Abatacept (Orencia)

• Any biosimilars of the above medications

There may be times when you can’t avoid combining infliximab treatment with one of these medications — such as if you’re switching from one medication to the other. Your healthcare provider will determine the best way to manage this safely.

2. Immunosuppressants

An immunosuppressant medication can reduce swelling and other symptoms caused by your immune system. This can be useful in some cases, but if you’re already receiving infliximab, it can also be dangerous. Combining infliximab and immunosuppressants can make it harder for your body to fight off infections. 

Some examples of immunosuppressant medications include:

• Mycophenolate (Cellcept)

• Methotrexate

• Corticosteroids, like prednisone or methylprednisolone (Medrol)

• Azathioprine (Imuran)

There are times your healthcare provider may decide it’s necessary for you to take one of these medications at the same time as infliximab. For example, an immunosuppressant may be useful for preventing or treating an infusion reaction caused by infliximab. In these cases, you should watch for any signs or symptoms of an infection.

Let your healthcare provider know right away if you experience any of the following symptoms:

• Fever

• Shortness of breath

• Sore throat

• Cough

• Chills

• Muscle aches

• Pain while peeing

• Diarrhea

• Warm, painful, or red skin

If you have an infection, your healthcare team may decide to delay your next infliximab dose to give your body time to fight off the infection.

3. Live vaccines

Live vaccines contain a weakened version of a living virus or bacteria. If your immune system is working well, these vaccines are safe to take.  But since infliximab weakens your immune system, you’re at a higher risk of becoming infected with the virus or bacteria that the vaccine is trying to protect you from.

Live vaccines include:

• Measles, mumps, and rubella (MMR)

• Yellow fever

• Varicella (chickenpox)

• Cholera

• Nasal influenza mist (FluMist)

• Rotavirus

• Smallpox

• Oral typhoid

It is best to make sure all your vaccines are up to date before you start receiving infliximab infusions. But your pharmacist or healthcare provider can tell you if a specific vaccine is safe for you to receive after you start infliximab.

If you have a baby while you’re receiving infliximab, they shouldn’t receive any live vaccines until 6 months after they’re born.

4. Medications broken down by certain liver enzymes

Your liver makes certain enzymes (proteins) that break down medications in your body. When you start or stop receiving infliximab, it can affect the levels of one of these enzymes. And this, in turn, can raise or lower the levels of other medications in your body that are broken down by the same enzyme.

This usually isn’t a big deal, but there are certain medications that have a “narrow therapeutic window.” This means that just a tiny change in the level of medication in your body can affect how well the medication works and the side effects you experience.

Some examples of these medications are:

• Warfarin (Coumadin, Jantoven)

• Cyclosporine (Sandimmune, Neoral)

• Theophylline

If you’re taking one of these medications in combination with infliximab, your healthcare provider will likely keep an eye out for this interaction. But if you notice any new or worsening side effects of your other medications after you start or stop receiving infliximab, be sure to let your provider know right away. This can also happen if your infliximab dose changes during the course of your treatment.

When should I contact my healthcare provider about an infliximab interaction?

Be sure to show your pharmacist or healthcare provider a list of your current medications before you start treatment with infliximab. This can help them identify any potential interactions before they occur. 

Your list should include prescription medications, over-the-counter medications, and any vitamins or supplements. And don’t forget to add infliximab to your medication list once you start receiving it. It can be easy to forget to do this, since you’ll only receive the infusion every 6 to 8 weeks.

In the meantime, if you have concerns about potential interactions, reach out to your pharmacist or healthcare provider. If you notice any signs of infection or side effects that don’t go away, let your provider know. But, if you experience any severe symptoms, it’s best to seek emergency care immediately.

Why trust our experts?

Written by:

Emilie White, PharmD

Emilie White is a clinical pharmacist with over a decade of hospital pharmacy experience. Her professional areas of interest include critical care as well as infectious and autoimmune diseases.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Our editorial standards

Meet our experts