L04AB02 - Infliximab |
Propably not porphyrinogenic |
PNP |
Important Information
Patients on immunosuppressive therapy have an increased risk of infections. Since infections have a potential to trigger acute porphyric attacks vigilance is motivated regarding signs or symptoms of infection and/or possible symptoms of a porphyric attack. Side effects like nausea and vomiting may potentially be porphyrinogenic through reduction in carbohydrate intake.
Side effects
Infections are common in patients using immunosuppressants and since infections might trigger an acute porphyric attack, vigilance regarding signs and symptoms of an infection and/ or a porphyric attack is recommended. Common adverse reactions of infliximab that can be confused with an acute porphyric attack are gastrointestinal discomfort and nausea. These side effects may potentially be porphyrinogenic if leading to a decrease in carbohydrate intake.
Rationale
Infliximab is an antibody preparation not metabolized by CYP. No pharmacokinetic porphyrinogenic effects are suspected.
Chemical description
Infliximab is a chimeric human-murine immunoglobulin G1 kappa (IgG1 kappa) monoclonal antibody that has a high affinity for human tumor necrosis factor (TNF; TNF-alpha).
Therapeutic characteristics
Infliximab is a biologic response modifier, used in the treatment of patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis, and Crohns disease and ulcerative colitis. It is administered by intravenous infusion.
Metabolism and pharmakokinetics
Mechanisms for elimination of monoclonal antibodies are not well documented but are reported to include proteolysis by the liver and the reticuloendothelial system, target-mediated elimination and nonspecific endocytosis (Keizer 2010).
References
- Scientific articles
- Keizer RJ, Huitema AD et al. Clinical pharmacokinetics of therapeutic monoclonal antibodies. Clin Pharmacokinet. 2010 Aug; 49 (8):493-507. #2040
- Drug reference publications
- McEvoy GK, editor. Infliximab. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (31.09.10). #2291
- Sweetman SC, editor. Martindale: The complete drug reference. Infliximab. Pharmaceutical Press 2009. #2292
- Government bodies
- European Public Assessment Report, Remicade (Scientific discussion).European Medicines Agency (EMEA). Accessible from: emea.europa.eu #2290
- Summary of Product Characteristics
- The electronic Medicines Compendium (eMC). Remicade. Summary of Product Characteristics (SPC). #2293
Similar drugs
© NAPOS 2024