Has anyone experienced a break like this, and if so, did they have flare ups during the break? Also, how long after the next dose did flare ups go away.
With remicade you want to maintain an ideal therapeutic (healing) level of remicade within your system. Skipping 4-weeks has undoubtedly dropped you out of therapeutic range and caused your flare. This infusion at the normal dose may not put you back into therapeutic range. You might need a stronger dosage (10mgs per kilogram instead of 5mgs/kg) and/or more frequent dosages (4 week or 6 week interval, instead of 8 weeks) to get your remicade levels back up to the needed amount. Certainly, discuss this with your gasteroenteroligist.
You can ask for a "infliximab serum trough levels and anti-infliximab antibody levels" blood test to help with the dosing.
Prometheus labs originated the test and still offers it for a big price:/www.prometheuslabs.com/Resources/Anser-IFX/Anser_IFX_Product_Detail.pdf
It's also generic and available from Labcorp and a number of other labs:/www.labcorp.com/test-menu/29496/infliximab-concentration-and-anti-infliximab-antibody
Certainly add standard flare protocol in addition to getting your remicade infusion. You might need to temporarily add new meds (like uceris/prednisone) and/or up your dosage of other medications. All depends how severe your symptoms are. The old adage applies that it takes more medications to achieve a remission than to sustain a remission. You've lost yours and might need more meds and stronger dosages to get back into a remission.
Moderator Ulcerative Colitis
John, 39, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasaUC experience: wakeup with noisy bowels so no lingering in bed, soon after poop with discomfort/pain/mild-nausea, eat something, poop, get dressed, poop, leave in car and worry whole drive about more...