Infliximab
Trade name
Remicade, Inflectra, Renflexis
Presentation and preparation
|
Vial size
(powder volume) |
Fluid to add
|
Volume to add
|
Resulting concentration
|
|---|---|---|---|
| 100 mg (negligible) |
Water for injections | 10 mL | 10 mg/mL |
Use a 21-gauge needle or smaller for reconstitution. Direct stream of water to the glass wall of the vial and swirl gently to dissolve. Do not shake. Allow reconstituted vial to stand for 5 minutes before withdrawing dose.
IV administration
Caution: Complex infusion preparation.
Withdraw and discard a volume equal to the infliximab dose volume from a 250 mL sodium chloride 0.9% bag; then, slowly add the infliximab dose to the bag. Gently mix. Do not shake.
Final concentration should be between 0.4 mg/mL and 4 mg/mL.
Standard infusion protocol (first 3 doses): Infuse over at least 2 hours via a low protein binding in-line filter (pore size 1.2 micron or less).
Rapid infusion protocol (4th dose onwards, for doses less than 10 mg/kg only): Infuse over at least 1 hour via a low protein binding in-line filter (pore size 1.2 micron or less). Patients who do not tolerate the rapid infusion protocol should revert to the standard infusion protocol.
Doses of 10 mg/kg or higher should always be infused using the standard protocol.
Other routes of administration
IM: Not recommended.
SC: Not recommended.
Compatible IV fluids
Sodium chloride 0.9%
Additional information
Use only when facilities for cardiac monitoring and cardio-respiratory resuscitation exist.
Observe closely for anaphylactic and adverse reactions, including fever, chills, pruritis, dyspnoea and chest pain.
Premedication with corticosteroids, antipyretic agents and/or antihistamine prior to the infusion may reduce the incidence and intensity of side effects during the infusion. Refer to relevant local guideline.
Monitor patient for infusion reactions reactions during and for at least 1 to 2 hours after infliximab infusion. Rate of administration may be reduced if not tolerated.
Therapeutic Drug Monitoring may be required: refer to local guidelines.
Reconstituted solution should be opalescent and colourless or light yellow.
Refrigerate, do not freeze.
Inflectra and Renflexis are biosimilar products to Remicade.