# Remicade level in blood



## Madhu (Oct 14, 2015)

Hi all,

My husband has finished 3 loading doses of Remicade and starts the maintenance dose from Oct end. His GI wanted to check the level of Remicade in his blood. Currently he is on 10 mg/kg dosage. We are waiting for the test reports to come back. I was curious to know what the level should be, for everything to be okay. Is there a specific range and they will alter infusion schedule accordingly?

Thanks
Aarthi


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## FrozenGirl (Oct 14, 2015)

Hello, 

It's still not solidified in terms of what levels lead to best results but I believe when my GI tested mine he said we were aiming for 5-7. Not sure on units and consider I am in Canada so they may use different units. 

As for altering infusion schedule it depends on your doc. Some go by numbers but I think most go by numbers and symptoms. If he is feeling good but have slightly low levels your GI will prob have him stay where he is or try and decrease. Has he always been on 10mg/kg?  If he is just getting into maintenance dosing they might want to put him at the standard 5mg/kg every 8 weeks if he is doing okay and see what happens. 

It's really not an exact science yet so it's hard to say.


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## Madhu (Oct 15, 2015)

Hi Frozengirl,

Thanks for your response. He was diagnosed in Feb this year and by the time we met a specialist in June, he had a horrible flare. Initially his GI did not put him on 10 mg/kg but he had a wait time of 1 month to start Remicade. Within the 1 month, he was suffering like crazy and his GI found that Crohn's in his colon got worse. So he put him on 10 mg/kg which he said is the high dosage and will help him. It worked wonders really. He has completed 3 loading doses so far in this dosage and its as though he is born again. I hope everything continues to stay okay. Will let you know once we get the results


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## FrozenGirl (Oct 15, 2015)

If that is so they may want to decrease his dose assuming his levels are at least 4or 5. I know my GI want me to decrease my dose. Also depending on your insurance there may be more pressure. Hope all goes well.


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## Madhu (Oct 17, 2015)

FrozenGirl said:


> If that is so they may want to decrease his dose assuming his levels are at least 4or 5. I know my GI want me to decrease my dose. Also depending on your insurance there may be more pressure. Hope all goes well.


Got a call from the nurse yesterday saying the Remicade level is good and no antibodies found, which is also good. She didn't mention anything about reducing dosage but said we can stick to the 8-week infusion schedule. I don't know the level either, so will probably get more info when I get my hands on the report.


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## birdonastick (Oct 17, 2015)

I don't know what the latest wisdom is in concurrent drugs and antibodies because they seem to change their minds on this every year or so, but if you find an infliximab strategy that works, talk to the MD about concurrent meds to slow/prevent the formation of antibodies, especially if you're starting more toward the ceiling. You may already have done, I won't assume.


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## FrozenGirl (Oct 17, 2015)

aarthi said:


> Got a call from the nurse yesterday saying the Remicade level is good and no antibodies found, which is also good. She didn't mention anything about reducing dosage but said we can stick to the 8-week infusion schedule. I don't know the level either, so will probably get more info when I get my hands on the report.


That's great. It's probably a good idea to stay on a stable regime for a bit then drop it down and see how it goes then consider reducing.


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## Madhu (Oct 18, 2015)

birdonastick said:


> I don't know what the latest wisdom is in concurrent drugs and antibodies because they seem to change their minds on this every year or so, but if you find an infliximab strategy that works, talk to the MD about concurrent meds to slow/prevent the formation of antibodies, especially if you're starting more toward the ceiling. You may already have done, I won't assume.


By concurrent meds, you mean 6-mp? His GI put him on Purinethol and its been more than 2 months. He said it is to prevent formation of antibodies. He also said that he will be on it for about 6 months only.


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