Transitioning from Remicade to Zymfentra: What to Know About the Recent Zymfentra Launch

When other inflammatory bowel disease (IBD) treatments fall short, many people turn to Remicade (infliximab). This intravenous (IV) infusion helps adults and kids with ulcerative colitis (UC) or Crohn’s disease find relief from their gut-related symptoms. This can lead to IBD remission.

Remicade has gained significant backing over the past decades for this reason. But no medication is perfect. Some people who receive Remicade infusions want a more affordable or convenient option.

If the hassle of an IV infusion is a roadblock for you, there’s good news. You can now receive infliximab as an under-the-skin (subcutaneous) injection. Here’s what to know about Zymfentra — an infliximab injection you can safely administer at home.

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What is Zymfentra?

Zymfentra (infliximab-dyyb) is an under-the-skin injection that’s given once every 2 weeks. It’s used to treat moderately to severely active UC and Crohn’s disease in adults. You can receive Zymfentra if you have IBD and were able to receive Remicade infusions with no issue. It comes as prefilled syringes and injection pens.

Good to know: Three Remicade biosimilars are available: Inflectra (infliximab-dyyb), Renflexis (infliximab-abda), and Avsola (infliximab-axxq). These biosimilars are all given IV, closely resemble Remicade itself, and may be available at a lower cost. Zymfentra was modeled after Inflectra, but it’s not a biosimilar. This is because it’s administered in a different way.

Is Zymfentra available now?

Yes, Zymfentra is now available. The FDA approved it in October 2023, and it launched for commercial use in the U.S. in March 2024. It’s made by a company called Celltrion — the same company that makes Inflectra.

If you’re eligible for Zymfentra, the gastrointestinal (GI) specialist who manages your UC or Crohn’s disease will connect you to a pharmacy that keeps the medication in stock. This will likely be a specialty pharmacy.

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• What to expect: Needles may seem intimidating — but they often get less scary over time. Three people share their experiences with self-injecting medication.

• Interactions with other drugs: Infliximab interacts with several medications. Many of these interactions can be managed with dosage adjustments.

• Explore other options: Zymfentra isn’t the only Remicade alternative. Three infliximab biosimilars are available too.

Is Zymfentra just as safe and effective as Remicade?

Most GI experts expect Zymfentra to deliver the same clinical results as Remicade (and Remicade biosimilars). The main benefits are related to convenience.

With Zymfentra, you won’t have to go to a medical office or clinic to receive it. You can conveniently inject it at home. And administering each dose should only take a few minutes. You won’t need to sit in an infusion chair and wait around. This can give you some time back in your schedule.

There is a tradeoff though. Routine Remicade infusions are typically given once every 8 weeks (2 months). Zymfentra is given once every 2 weeks. Remicade is also approved to treat multiple health conditions in adults and kids. Zymfentra is currently only approved as a maintenance treatment for UC and Crohn’s disease in adults.

Zymfentra’s clinical studies

Most of what we know about Zymfentra’s safety and effectiveness comes from two phase 3 clinical trials (called LIBERTY UC and LIBERTY CD).

In these studies, everyone received IV infliximab for the first few weeks of treatment. This phase, known as the induction phase, aimed to facilitate remission. People who responded positively to the induction treatment were then given either Zymfentra or placebo injections for 1 year.

In both studies, Zymfentra was significantly better than placebo at helping people stay in remission. There weren’t any notable safety differences, either. Head-to-head studies comparing Remicade to Zymfentra are on deck.

How to switch from Remicade to Zymfentra

If you’re interested in switching from Remicade to Zymfentra, make sure to loop in your GI specialist. They can tell you if the switch would make sense for you. They can also reach out to your insurance plan to start the approval process, if needed.

If you’re cleared to make the switch, doing so should be relatively easy. Your next steps will depend on your recent treatment history.

Option 1: You’re currently receiving Remicade maintenance infusions.

• Remicade is typically administered once every 8 weeks for UC and Crohn’s disease. At the time of your next scheduled Remicade dose, you can go ahead and receive Zymfentra instead.

• From this point forward, you can administer Zymfentra once every 2 weeks.

Option 2: You’re not currently receiving Remicade maintenance infusions.

• Before you start Zymfentra, you’ll need to receive induction therapy. You’ll receive 3 Remicade doses over a 6-week timeframe to help your body enter remission.

• You can receive your first Zymfentra dose 4 weeks after your last Remicade dose.

• From this point forward, you can administer Zymfentra once every 2 weeks.

In an interview with GoodRx Health, Maia Kayal, MD, MS — an assistant professor in the Division of Gastroenterology at the Icahn School of Medicine at Mount Sinai and The Susan and Leonard Feinstein Inflammatory Bowel Disease Center — offered additional context on what to expect when switching products. 

“There is no difference in efficacy or safety between a biosimilar and its originator (in this case Remicade),” Kayal said. “[People] who switch from Remicade to Zymfentra should expect no difference; however, [they] should pay close attention to any new symptoms and take their injections on time.”

How to switch from a Remicade biosimilar to Zymfentra

If you’re receiving a Remicade biosimilar and want to switch to Zymfentra, the process is no different from what’s described above. These same steps also apply to Inflectra, Renflexis, and Avsola.

How do you administer Zymfentra?

If you have experience with under-the-skin injections, administering Zymfentra should feel very familiar. The general process is the same as many other subcutaneous medications.

If you haven’t used a medication like Zymfentra before, don’t fret. Here’s a summarized step-by-step guide:

1. When you’re ready for your dose, remove your Zymfentra injection device from the fridge. Let it sit at room temperature for about 30 minutes before you inject it. Warmer injections sting less than cold ones.

2. Look at the syringe (or injection pen). Make sure the liquid inside of the device is free of large particles and looks colorless to light brown. Make sure the device isn’t damaged or expired, either.

3. Gather your supplies. It’s recommended to have an alcohol swab, cotton ball, and sharps container readily available with every dose.

4. Wash your hands, then wipe your intended injection site with an alcohol swab. You can self-inject Zymfentra into your stomach or outer thigh. Alternatively, a caregiver or loved one can inject it into your upper arm.

5. Remove the cap from your device, and then inject the medicine into your body. 

   • For the syringe, place the needle into the skin at a 45-degree(slanted) angle using a dart-like motion. Press the plunger in until it won’t go any further. Pull the device away from your skin to activate the needle guard.

   • For the injection pen, place the device on your skin at a 90-degree (straight up-and-down) angle. Press down to hear a click — this means your injection has started. Maintain this position until 5 seconds have passed since the second (and final) click. Pull the device away from your skin.

6. Place a cotton ball on your skin to stop any bleeding.

7. Throw your entire Zymfentra device into a sharps container. Each device is only designed to be used a single time.

If you have any questions on how to administer Zymfentra, talk to your pharmacist or GI specialist. They can offer more personalized advice.

Good to know: There’s an extra layer of reassurance, too. Your GI specialist will likely administer your first dose of Zymfentra to you. During this time, they can also walk you through how to administer the medication. Seeing this process explained in person can be helpful — especially if you’re a visual learner.

How to save on Zymfentra

A 4-week supply of Zymfentra is reported to cost nearly $6,200. But there are ways to save on Zymfentra, which is only available as a brand-name medication. GoodRx can help you navigate between copay savings cards and patient assistance programs to save money on your prescription.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $5 for Zymfentra using a savings card from the manufacturer.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Zymfentra’s patient assistance program, which offers the medication free of charge.

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Written 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:

Sanjai Sinha, MD

Sanjai Sinha, MD, is a board-certified physician with over 20 years of experience. He specializes in internal medicine.

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