Remicade is the brand name for the biologic response modifier infliximab. Biologic response modifiers like Remicade boost certain functions of the immune system and suppress others. Because of these varying actions, Remicade has serious side effects in light of its proven benefits. Physicians consider the risk-to-benefit ratio when deciding whether to treat a patient who has knee pain from rheumatoid arthritis with Remicade.
Flu Symptoms
According to Donna D. Ignatavicius, M.S., R.N., and M. Linda Workman, Ph.D., authors of "Medical-Surgical Nursing: Critical Thinking for Collaborative Care," the most commonly reported side effect of Remicade is flu-like symptoms. People taking Remicade report fatigue, fever, body aches and chills. Symptoms can be severe enough to cause people to stop using the medication. Continued use does not diminish this adverse effect.
Infections
The National Library of Medicine's DailyMed website provides a black-box warning to people regarding the increased risk of infection while taking Remicade. Although Remicade helps boost certain immune responses, such as increasing neutrophils and leukocytes to fight infection, it simultaneously decreases the body's inflammatory response and other aspects of the immune system. This action places people taking Remicade at risk for developing infections. The DailyMed reports that 36 percent of clinical trial subjects developed infections, predominantly upper respiratory system and urinary system infections. Serious and sometimes fatal infections such as bacterial sepsis, activation of latent tuberculosis, reactivation of hepatitis B virus and invasive fungal infections have occurred. Patients are instructed to be vigilant for signs and symptoms of infection such as fever, cough and malaise or redness, warmth and drainage from any skin site. The DailyMed reports that such opportunistic infections have required hospitalization and have resulted in death.
Cancer
There is an increased risk of developing cancer when Remicade is taken in conjunction with other immunosuppressants. Adolescents taking azathioprine or 6-mercaptopurine for Crohn's or rheumatoid arthritis treatment have developed hepatosplenic T-cell lymphoma, which is a cancer of the lymph tissue in the liver and spleen. This type of cancer is aggressive and usually fatal. Patients who add Remicade to treat chronic obstructive pulmonary disease experience a higher rate of lung and neck malignancies than the general population.
Anaphylaxis
Anaphylaxis is a severe and potentially fatal allergic reaction. Early symptoms of allergic sensitivity resemble the common flu symptoms caused by Remicade. Billie Ann Wilson, Ph.D., Margaret Shannon, Ph.D., and Kelly Shields, Pharm.D., authors of "Pearson Nurse's Drug Guide 2010," advise patients who experience flu-like symptoms along with hives, chest pain, breathing difficulties and low blood pressure to seek emergency care, as these are symptoms of anaphylaxis.
References
- "Medical-Surgical Nursing: Critical Thinking for Collaborative Care"; Donna D. Ignatavicius, M.S., R.N., and M. Linda Workman, Ph.D.; 2006
- National Library of Medicine's DailyMed: Remicade Injection
- "Pearson Nurse's Drug Guide 2010"; B.A. Wilson, T.M. Shannon and K.M. Shields; 2010
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