Infliximab (Remicade, Remsima)
Also known as: Infliximab · Remicade · Remsima · Inflectra
Infliximab is a biologic infusion used in inflammatory arthritis when tablets are not enough. You may see it under different names: Remicade is the original brand, and Remsima is one of the biosimilar versions used in Malaysia. It is one of the earliest biologics and still an important option.
Calm, careful medication review by a consultant rheumatologist.
Infliximab: a guide for patients
Tap the image to open the full-size version you can save or print.
For nurses and infusion staff
This is the two-page pack I use for infliximab infusions in day-care. Page one is the physician order and nursing checklist covering pre-infusion screening, dose and the infusion rate ladder. Page two is the infusion monitoring chart for vitals and reaction checks, including the slower schedule for patients with a previous infusion reaction. Nurses are welcome to print it.
What this medicine is
Infliximab is a monoclonal antibody that blocks TNF, a key driver of joint and skin inflammation. It is given as a drip into a vein, usually every few weeks, at a day-care unit. The active medicine is the same whichever name is on the bag. Remicade is the originator, while Remsima, Inflectra and other biosimilars are highly similar versions approved after careful comparison studies. Biosimilars are usually more affordable, which is often what makes long-term treatment possible, and I use them in exactly the same way clinically.
Uses and context
It is used in rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and other spondyloarthritis, often when injection biologics are not suitable or not enough. Because it is an infusion given in a supervised setting, it also suits patients who prefer not to self-inject at home, or who need the reassurance of a scheduled hospital review.
How this relates to rheumatology care
Before starting, I screen carefully for TB, hepatitis and other infections. Infusions are scheduled at the hospital day-care unit and take a few hours, with observation for reactions. I review response and safety at each visit.
What safety checks may matter
TB screening before starting
Hepatitis B and C screening
Vaccination review before starting
Baseline blood counts and liver function
Infusion setting with staff trained to manage reactions
Side effects and red flags
If you have emergency symptoms such as severe allergic reaction, breathing difficulty, chest pain, stroke-like symptoms, severe abdominal pain, vomiting blood, black stools, sudden vision loss, severe infection symptoms, or severe weakness or confusion, please seek urgent medical care first rather than waiting for a WhatsApp reply.
Rash, itching, breathlessness or fever during or after infusion
Persistent fever, chills or cough
New shortness of breath
Signs of severe allergic reaction
A new or changing skin lesion
New neurological symptoms
Things worth knowing day to day
Avoid live vaccines while on infliximab.
Tell surgeons and dentists that you are on a biologic before procedures.
Do not delay treating suspected infections; contact me early.
Long gaps between doses can increase risk of infusion reactions on restart.
Questions patients often ask me about this medicine
Speak with me
If Remicade or an infliximab biosimilar has been suggested, please message my clinic. I would like to explain what to expect and help you plan your infusion schedule.
Other medications used in rheumatology care
This page is for general education only and does not replace medical advice. Please consult a qualified healthcare professional for diagnosis and treatment. Do not start, stop, or change any medicine without advice from your doctor.