Some of us take MTX and remicade simultaneously, not a prob. You can take MTX via IV and also in pill form.
Beyond remicade and humira, there is also xeljanz. Xeljanz is a pill-formed biologic, and might be easier if shots bother her.
Remicade infusions are a tiny needle prick and then no sensation thereafter. It is the equivalent to getting a flu shot, tetanus booster, and or any of the variety of shots a child/adult would get. I would expect her to react the same to remicade infusions as she would to those aforementioned things.
When you start a biologic, you go through what is known as loading dosages. The goal is to get your blood concentration of the biologic up to ideal therapeutic (healing) dose. So, you get a bunch of shots (humira) or IV infusions (remicade) close together when you start out. For adult patients, that is an infusion of 5mgs of medication for every 1-kilogram of body weight at week zero (0), two (2), and six (6), after which it is an eight (8) week interval. Not so sure on pediatric cases but I would assume it is somewhat similar, maybe with less medication each dosage.
I've never experienced any side effects from remicade. The most common side effects are infusion-site reactions during or within 48-hours of an IV infusion (generally mild things like a rash, tiredness, shortness of breath, elevated heart rate, etc.). They give you premedications of tylenol and an antihistamine (either drowsy-benadryl or non-drowsy-claratin) to help prevent those reactions. Some say they're very tired after the IV infusion, so it might be good to schedule that and have the rest of the day to take it easy, and nap if needed.
It really depends where she gets her IV infusion. I used to get them at my gastereoenteroligist office, it was a room with 2-4 other Crohn's and UC patients. At the hospital, you never know what you're going to get. I get my infusions now at the hospital, they put me in the PPR (Post Procedure Recovery) room, so in addition to other Crohn's and UC patients getting Remicade, you also get people who just got out of endoscopy, out of surgery, etc. Sometimes you might have some cancer patients getting their chemo at the hospital areas. You can get remicade done at some sports medicine places, as it is a simple IV infusion and there might be other options. I'd certainly ask around and see who does them and what your insurance covers. Oh, and some do get home-IV infusions as well (a nurse visits your home and does the infusion there) that could be done at your home and be less concerning for her if she's in a familiar place!
But a rundown of how it goes for remicade. You arrive they weigh you (weight-based drug), give you premeds of tylenol and an antihistamine, the nurse initially checks temperature and pulse and will periodically thereafter throughout the infusion. They set the IV (a tiny needle prick), and start the IV drip. The IV bag is on a wheelie-stand, so you can wheel to the bathroom as frequent as is needed. It is a long wait for the IV drip, typically 2.5-3 hours, so bring activities to keep her busy (books, games, etc.). They often offer you drinks and snacks while you wait (bring safe foods/drinks if she has any food intolerance/concerns). They remove the IV, put a bandaid on, and you are sent on your way. Again, some folks are tired in the hours after the infusion so cannot hurt to have the remainder of the day to relax. Keep an eye on the infusion site for 48-hours afterwards, look for rashes etc.
Moderator Ulcerative Colitis
John, 40, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasaYou might have UC if your dream home renovation project is to add one of those techie Japanese toilets with voice activated seat warmer, bidet, deodorizer, and soothing music...
Post Edited (iPoop) : 11/6/2018 8:27:59 AM (GMT-7)