Home Drug Guide Infliximab-qbtx

Drug Guide

Generic Name

Infliximab-qbtx

Brand Names Ixifi

Classification

Therapeutic: Immunosuppressant/Anti-TNF alpha agent

Pharmacological: Monoclonal antibody

FDA Approved Indications

Crohn's disease
Ulcerative colitis
Rheumatoid arthritis
Ankylosing spondylitis
Psoriatic arthritis
Plaque psoriasis

Mechanism of Action

Infliximab-qbtx is a chimeric monoclonal antibody that binds to tumor necrosis factor-alpha (TNF-α), inhibiting its activity and thereby reducing inflammation.

Dosage and Administration

Adult: Typically 5 mg/kg IV at weeks 0, 2, and 6, then every 8 weeks; dose adjustments based on response and tolerability.

Pediatric: Dosing based on weight, generally similar to adult dosing, administered IV; specific protocols vary based on condition.

Geriatric: Use with caution; consider hepatic and renal function, comorbidities, and concomitant medications.

Renal Impairment: Adjust dosing cautiously; no specific dose adjustments established, monitor renal function.

Hepatic Impairment: Use with caution; no specific dose adjustments established, assess hepatic function regularly.

Pharmacokinetics

Absorption: Administered IV, so bypasses absorption barriers.

Distribution: Distributed mainly in plasma and extracellular fluid.

Metabolism: Metabolized via catabolic pathways typical for monoclonal antibodies, principally by proteolytic degradation.

Excretion: Eliminated via protein catabolism; no renal or hepatic clearance data available indicating significant elimination.

Half Life: Approximately 8-10 days.

Contraindications

Hypersensitivity to infliximab or its components.
Active infections, including TB.

Precautions

Screen for latent TB prior to initiation.
Monitor for infections during therapy.
Use with caution in patients with congestive heart failure, demyelinating diseases, or a history of malignancies.

Adverse Reactions - Common

Infusion reactions (fever, chills, pruritus, rash) (Common)
Infections (upper respiratory, urinary tract) (Common)
Headache (Common)

Adverse Reactions - Serious

Severe infections (e.g., pneumonia, sepsis) (Less common)
Lymphoma and other malignancies (Rare)
Hepatosplenic T-cell lymphoma (mainly in young males with IBD) (Very rare)

Drug-Drug Interactions

Other immunosuppressants (e.g., azathioprine, methotrexate)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, infusion reactions, adverse effects; assess for TB before and during treatment.

Diagnoses:

Risk for infection
Impaired skin integrity

Implementation: Administer IV infusion as prescribed; premedicate if necessary; monitor vital signs during infusion.

Evaluation: Assess effectiveness in controlling disease symptoms; monitor for adverse reactions and infections.

Patient/Family Teaching

Report signs of infection immediately.
Attend all scheduled infusions and follow-up appointments.
Inform healthcare provider of all medications and supplements.

Special Considerations

Black Box Warnings:

Serious infections, including tuberculosis and opportunistic infections.
Lymphomas and other malignancies.

Genetic Factors: Increased risk of lymphoma may be associated with concomitant immunosuppressants.

Lab Test Interference: May cause false-positive tests for infection (e.g., TB tests).

Overdose Management

Signs/Symptoms: Unknown, but may include severe infections or infusion reactions.

Treatment: Supportive care; manage symptoms; no specific antidote.

Storage and Handling

Storage: Store vials refrigerated at 2-8°C.

Stability: Unopened vials can be stored for up to 24 months; do not freeze after reconstitution.