SERIOUS INFECTIONS
Patients treated with REMICADE® (infliximab) are at increased risk for developing
serious infections that may lead to hospitalization or death. Most patients who
developed these infections were taking concomitant immuno suppressants such as
methotrexate or corticosteroids. Discontinue REMICADE® if a patient develops a serious
infection or sepsis.
Reported infections include:
• Active tuberculosis (TB), including reactivation of latent TB. Patients frequently
presented with disseminated or extrapulmonary disease. Patients should be tested
for latent TB before and during treatment with REMICADE®.
1,2 Treatment for latent
infection should be initiated prior to treatment with REMICADE®.
• Invasive fungal infections, including histoplasmosis, coccidioidomycosis, candidiasis,
aspergillosis, blastomycosis and pneumocystosis. Patients may present with
disseminated, rather than localized, disease. Empiric anti-fungal therapy should be
considered in patients at risk for invasive fungal infections who develop severe
systemic illness.
• Bacterial, viral, and other infections due to opportunistic pathogens, including
Legionella and Listeria.
The risks and benefits of treatment with REMICADE® should be carefully considered
prior to initiating therapy in patients with chronic or recurrent infection. Closely monitor
patients for the development of signs and symptoms of infection during and after
treatment with REMICADE®, including the possible development of TB in patients who
tested negative for latent TB infection prior to initiating therapy, who are on treatment
for latent TB, or who were previously treated for TB infection
Risk of infection may be higher in patients greater than 65 years of age, pediatric patients,
patients with co-morbid conditions and/or patients taking concomitant immunosuppressant
therapy. In clinical trials, other serious infections observed in patients treated with
REMICADE® included pneumonia, cellulitis, abscess, and skin ulceration.
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