Posted 3/16/2013 7:03 AM (GMT -6)
The typical loading schedule for Remicade is first infusion at 0 weeks, next at 2 weeks, next at 6 weeks, and then every eight weeks thereafter. (In other words, the time between the first two infusions is two weeks, then you wait four weeks, then you wait eight weeks). This isn't written in stone -- if you don't have a positive response to the first two infusions, your GI might choose to increase the dose of the next infusion and/or do it sooner. Another thing you can try if you aren't having a response to Remicade is an infliximab levels blood test -- it can be kind of pricey (my insurance co. would never give me a straight answer about whether they'd cover it or not), but it can help your GI decide if you are truly a Remicade non-responder or if you need a higher dose to reach therapeutic levels in your blood. The standard dose is 5 mg/kg but some people need up to 20 mg/kg.
I had three Remicade infusions, the first at the standard 5 mg/kg and the next two at 10 mg/kg. Never had any positive response at all, not even a minor improvement in symptoms. When people say it can take a few months for Remicade to kick in they're almost always talking about reaching remission or a significant improvement in symptoms -- if you're a responder and you're receiving the appropriate dose, you should start noticing small changes after the first couple of infusions. I wish I had known that because I waited months holding out hope when it was already clear to my GI that I was almost definitely a non-responder.
dx'ed UC pancolitis 5/12 w/ moderate-severe inflammation
past meds: asacol hd, VSL#3, apriso, rowasa, xifaxan, 6mp, cortifoam, pentasa, cimzia, canasa, butyrate, flagyl, cipro, prednisone, remicade, methotrexate, cholestyramine, cortenema
current meds: canasa, no more steroids!
step one: colectomy w/ end ileostomy, 1/16/13
so much happier already!