Specific drug interaction studies have not been conducted. The majority of patients in rheumatoid arthritis, Crohn’s disease or ulcerative colitis clinical trials received one or more concomitant medications. In rheumatoid arthritis, concomitant medications besides MTX were nonsteroidal anti-inflammatory agents, folic acid, corticosteroids and/or narcotics. Concomitant Crohn’s disease medications were antibiotics, antivirals, corticosteroids, 6-mercaptopurine/azathioprine (6-MP/AZA), methotrexate (MTX), and aminosalicylates. Patients with Crohn’s disease who received immunosuppressants tended to experience fewer infusion reactions compared to patients using no immunosuppressants (see WARNINGS AND PRECAUTIONS, Immunogenicity and ADVERSE REACTIONS, Infusion-related Reactions).
Concurrent Use of INFLECTRA® with other Biological Therapeutics
The combination of INFLECTRA® with other biological therapeutics used to treat the same conditions as INFLECTRA®, including anakinra or abatacept, is not recommended (see WARNINGS AND PRECAUTIONS, Risk of Infections).
Live Vaccines/Therapeutic Infectious Agents
It is recommended that live vaccines not be given concurrently with INFLECTRA®. It is also recommended that live vaccines not be given to infants after in utero exposure to infliximab for injection for at least 6 months following birth (see WARNINGS AND PRECAUTIONS).
It is recommended that therapeutic infectious agents not be given concurrently with INFLECTRA® (see WARNINGS AND PRECAUTIONS).
Cytochrome P450 Substrates
The formation of CYP450 enzymes may be suppressed by increased levels of cytokines (e.g., TNFα, IL-1, IL-6, IL-10, IFN) during chronic inflammation. Therefore, it is expected that for a molecule that antagonizes cytokine activity, such as infliximab for injection, the formation of CYP450 enzymes could be normalized. Upon initiation or discontinuation of INFLECTRA® in patients being treated with CYP450 substrates with a narrow therapeutic index, monitoring of the effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) is recommended and the individual dose of the drug product may be adjusted as needed.
Interactions with other drugs have not been established.
Interactions with food have not been established.
Interactions with herbal products have not been established.
Drug-Laboratory Test Interactions
Interactions with laboratory tests have not been established.