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Do you get pre-medicated?

nogutsnoglory

Moderator
I haven't been pre-medicated for Remicade but it seems many are.

What if anything do you pre-med with? Anti-histamine, steroids?

Does that only prevent a reaction or can the steroids help prevent antibody development?
 
I get a Benadryl-type med in my IV 30 minutes prior to the infusion. I had one silly little itchy hive that would appear on my arm every time. So now I get the antihistamine just in case I react worse.
 
When I was on Remicade, I got pre-medicated with both IV Benadryl, and oral Tylenol. I'm thinking this was perhaps because I was still in pediatrics when I started with the Remicade...
 

Jennifer

Adminstrator
Staff member
Location
SLO
People are often given an antihistamine etc. before Remicade in case there is a reaction. I was given an antihistamine and acetaminophen 30 minutes before the infusion.

"Anaphylaxis might occur at any time during REMICADE® infusion. Approximately 20% of patients treated with REMICADE® in all clinical trials experienced an infusion reaction compared with 10% of patients treated with placebo (see ADVERSE REACTIONS, Infusion-Related Reactions). Prior to infusion with REMICADE®, premedication may be administered at the physician's discretion. Premedication could include antihistamines (anti-H1 +/- anti-H2), acetaminophen, and/or corticosteroids."
http://www.remicade.com/hcp/infusion-overview
 

nogutsnoglory

Moderator
I don't like the idea of being pre-medicated. If I have a reaction I'll take the meds but why unnecessarily put more meds in my body if not needed?
 

Jennifer

Adminstrator
Staff member
Location
SLO
That's up to you. I know the place I had my infusions at would not do the infusion if you didn't take the antihistamine and Tylenol.
 
I could sign a waiver (and did) at first because Benadryl makes me loopy. I had to take a break (no insurance) from infusions for a while and when I went back on, I had Tylenol, Benadryl and a steroid. Does not prevent antibodies, just reactions.
 
I am offered a Tylenol before my infusions but generally don't bother to take it. I always fall asleep during the infusions and wake up feeling pretty good. The only time it bothered me was when a new nurse turned up the dose too fast and put it through in one hour. I was sick, sick, sick for a long time after that one so now I make sure that they take the two to three hours to do the infusion.
 

Jennifer

Adminstrator
Staff member
Location
SLO
Oh my gosh rrhood1 that's way too fast! I'm sorry. :( Did you let your doctor or the hospital/facility know about it? That's really dangerous.
 
I've seen plenty of people sit through a one hour infusion, it's not that uncommon. I could never do it though, no matter how much I wanted to. My hive appears when the infusion kicks into high gear at the end. So I too have to take it slow and steady.
 
My infusions were two hours, until I started to get reactions. Then they slowed down to about three hours, even pushing it to four one time.
 

rygon

Moderator
I have cortisone steroids (I think tha'ts the one) beforehand and I have never had a reaction to infliximab at all.

Grimsby does a 1hr infusion once you have had over 12 infusions at 2hrs with no side effects. I've heard Leeds do it at 30mins.
 

Lisa

Adminstrator
Staff member
Location
New York, USA
WOW...this is right off the Remicade website -

REMICADE® is given by IV infusion
If your doctor decides REMICADE® is right for you, you'll receive it as an intravenous (IV) infusion from a healthcare professional over a period of no less than 2 hours. REMICADE® is the only medication of its kind to require as few as 6 treatments a year after 3 starter doses. That’s once every 8 weeks.
Not sure what guidelines are being followed for those facilities that are infusing at a quicker rate...

As for pre-meds - I was getting none, then after my skin issues popped up, started getting solumedrol and benadryl IV prior to the infiusion - my new GI tried a new med (minus the solumedrol) and kept the Benadryl - and in fact, my skin issue doesn't look as bad - I have my next infusion in a little over a week - will see how that one goes!
 

rygon

Moderator
I was told by my nurse that remicade said that it could be taken in an hour. They asked about 30mins and remicade said that there would be no problem with this, but wouldn't directly say it was ok or add it to their guidelines (from what I recall)
 
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