Remicade interactions: Alcohol, medications, and other factors

Before you start treatment with Remicade, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Remicade interacts with supplements, herbs, or vitamins, see the “Remicade and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Remicade. Keep in mind that this table doesn’t include all drugs that may interact with Remicade. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* Remicade is a type of biologic drug called a TNF blocker.
† For details about this interaction, see the “Drug interactions in depth” section below.
‡ For details about Remicade’s side effects, see this article.

In some cases, factors or conditions could prevent your doctor from prescribing Remicade due to the risk of harm. These are known as contraindications. The Remicade contraindications include:

Having moderate or severe heart failure

If you have moderate or severe heart failure, your doctor is unlikely to prescribe Remicade above a certain dosage. Receiving the drug at higher doses may worsen heart failure. Your doctor will prescribe the dosage of Remicade that’s right for you.

If you have questions about this, talk with your doctor before starting treatment with Remicade. To learn more about Remicade’s dosage, see this article.

Having had an allergic reaction to Remicade or any of its ingredients

If you have had an allergic reaction to Remicade or any of its ingredients, your doctor will likely not prescribe Remicade. Receiving the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Before you start treatment with Remicade, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Remicade.

There aren’t any known interactions between Remicade and alcohol. However, your doctor may advise you to limit alcohol consumption during Remicade treatment.

This is because consuming large amounts of alcohol can cause liver damage. Remicade may also cause liver damage as a side effect. This means that drinking large amounts of alcohol during Remicade treatment may increase the risk of liver problems.

If you have questions about limiting the amount of alcohol you consume during Remicade treatment, talk with your doctor. To learn more about Remicade’s side effects, see this article.

Here’s a closer look at certain drug interactions of Remicade.

Other biologics

As with Remicade, other biologics are prescribed to treat many conditions. This includes autoimmune conditions such as ulcerative colitis and rheumatoid arthritis.

Interaction result: Treatment with Remicade and other biologics can increase the risk of infection as a side effect of either medication.

Interaction explained: Remicade and other biologics can lower the immune system’s ability to fight infection. As a result, either drug can increase your risk of infection when taken alone. Using these drugs together further increases this risk.

Keep in mind that Remicade has a boxed warning about the risk of serious infection. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “Boxed warnings” at the beginning of this article.

Examples of biologic drugs: Here are some biologics that may interact with Remicade:

• abatacept (Orencia)
• anakinra (Kineret)
• anifrolumab-fnia (Saphnelo)
• belimumab (Benlysta)
• rituximab (Rituxan)

Steps you or your doctor may take: Before starting Remicade treatment, tell your doctor about other medications you take. They can help you determine if you’re prescribed another biologic.

Your doctor is unlikely to prescribe Remicade with another biologic drug. Since Remicade and other biologics are often prescribed for similar conditions, your doctor can recommend the one that’s right for your condition.

To learn more about Remicade and other biologics, talk with your doctor or pharmacist.

Corticosteroids

Corticosteroids are prescribed for conditions involving inflammation. This includes the autoimmune conditions Remicade is prescribed to treat, such as ulcerative colitis and rheumatoid arthritis.

Interaction result: Taking a corticosteroid with Remicade can increase the risk of infection as a side effect of either drug.

Interaction explained: Both Remicade and corticosteroids can lower the ability of your immune system to protect against infection. Taking either drug alone may increase your risk of infection. However, when taken together, this risk increases further.

In fact, Remicade has a boxed warning about the risk of serious infection. A boxed warning is the most serious warning from the FDA. For more information, see “Boxed warnings” at the beginning of this article.

Examples of corticosteroid drugs: Here are some corticosteroids that may interact with Remicade:

• dexamethasone (Hemady)
• methylprednisolone (Medrol)
• prednisone (Rayos)

Steps you or your doctor may take: Before starting Remicade treatment, tell your doctor if you’re taking a corticosteroid. They can recommend whether it’s safe to take it with Remicade.

If your doctor prescribes Remicade with a corticosteroid, they’ll discuss your risk of infection. They may advise you to watch closely for symptoms of infection, such as fever, body aches, and cough.

If you have symptoms of an infection while taking while taking these drugs together, talk with your doctor. They can give you tests to check for an infection and recommend what to do if you have one.

To learn more about Remicade and corticosteroids, talk with your doctor or pharmacist.

Warfarin

Warfarin (Jantoven) is prescribed to treat and help prevent blood clots in certain situations.

Interaction result: Treatment with Remicade and warfarin may affect how well warfarin works.

Interaction explained: Remicade is used to treat conditions that cause inflammation in the body. Inflammation may affect the activity of certain proteins that break down warfarin in the body. Starting or stopping Remicade treatment may lead to changes in inflammation that affect the level of warfarin in your system. This could affect how well warfarin works for your condition.

Steps you or your doctor may take: Before starting Remicade treatment, tell your doctor if you’re taking warfarin. They can recommend whether it’s safe for you to take these medications together.

While you’re taking warfarin, your doctor will give you blood tests to check the drug’s effectiveness. If your doctor prescribes warfarin and Remicade together, they may order tests for you more frequently when starting and stopping Remicade treatment. This will help your doctor to closely monitor how well warfarin is working for you.

To learn more about Remicade and warfarin, talk with your doctor or pharmacist.

Remicade may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Remicade.

Remicade and supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Remicade and herbs

There are no reports of herbs interacting with Remicade. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Remicade treatment.

Remicade and vitamins

There are no reports of vitamins interacting with Remicade. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Remicade.

Remicade and food

There are no reports of foods interacting with Remicade. If you’d like to learn more about eating certain foods during treatment with Remicade, talk with your doctor.

Remicade interactions with vaccines

Remicade may interact with live vaccines. A live vaccine contains weakened pieces of the virus or bacterium it’s meant to defend against. Live vaccines usually won’t cause infection for people with healthy immune systems.

However, Remicade may weaken your immune system. So getting a live vaccine during Remicade treatment could mean your immune system is not able to fight the virus or bacterium. This may cause you to develop symptoms of the illness the vaccine is meant to defend against.

Examples of live vaccines to avoid during Remicade treatment include:

• measles, mumps, rubella (MMR)
• chickenpox
• yellow fever
• nasal spray flu vaccine (FluMist)

Before starting Remicade, talk with your doctor or pharmacist about any vaccines you may need. If you need a live vaccine, your doctor may give it before starting Remicade treatment. Your doctor or pharmacist can advise you on whether it’s safe to receive other vaccines during Remicade treatment.

Remicade interactions with lab tests

Remicade may interfere with the results of a skin test for tuberculosis (TB). Having this test done during Remicade treatment may cause a false-negative result. This means the test may show that you do not have TB in your system even if you do. False-negative results can occur for up to 6 weeks after your last Remicade dose.

You’ll likely receive a TB skin test before starting Remicade treatment. However, your doctor may not repeat this test while you’re receiving the drug. For additional information, talk with your doctor.

If you have questions about getting any lab tests during Enbrel treatment, talk with the healthcare professional ordering the test.

REMICADE AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Remicade. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Remicade. The impact of cannabis may affect how well you stick to your Remicade treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Remicade. Before you take this drug, be sure to talk with your doctor about your health history. Remicade may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Remicade include:

Heart failure: If you have heart failure, talk with your doctor before starting Remicade treatment. The drug may worsen this condition. Your doctor can tell you whether Remicade is a safe treatment option.

If you have moderate or severe heart failure, your doctor is unlikely to prescribe Remicade above a certain dosage. To learn more about this, see the “When to avoid Remicade” section above.

Liver problems: Remicade treatment may lead to liver damage, which may worsen an existing liver problem. If you have a liver problem, such as liver failure, talk with your doctor. They can tell you whether Remicade is a safe treatment option. To learn more about Remicade’s side effects, see this article.

Nerve problems: Treatment with Remicade may worsen nerve problems, such as multiple sclerosis. If you have a nerve problem, talk with your doctor before using Remicade. They can recommend whether the drug is a safe treatment option for you.

Hepatitis B or current infection: Before starting Remicade treatment, tell your doctor if you ever had hepatitis B or if you currently have an infection.

Remicade may reactivate the hepatitis B virus in people who already have this virus in their bodies. With reactivation, the virus becomes active again and causes symptoms of infection. Remicade may also worsen an existing infection or increase the risk of a new one.

If you have hepatitis B or a current infection, your doctor can advise whether Remicade is a safe treatment option. They may delay the start of Remicade treatment until the infection has been managed.

Risk of serious infections and cancer: Certain factors may increase the risk of serious infections and cancer with Remicade. Remicade has boxed warnings about these risks. A boxed warning is a serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warnings at the top of this article.

Allergic reaction: If you’ve had an allergic reaction to Remicade or any of its ingredients, your doctor will likely not prescribe Remicade. Receiving the drug can cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Breastfeeding: It’s not known whether it’s safe to use Remicade while breastfeeding. The drug passes into breast milk, but it isn’t known what effects Remicade may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Remicade. They can talk with you about treatment options and ways to feed your child.

Pregnancy: It isn’t known for certain whether Remicade is safe to use while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting Remicade. They can advise you on the right treatment plan for you.

Here are some frequently asked questions about Remicade and possible interactions.

Can I take antibiotics while on Remicade?

In general, yes, it’s safe to take antibiotics during Remicade treatment. There are no reports of interactions between these medications.

Antibiotics are prescribed for bacterial infections. Certain drugs that treat some of the same conditions as Remicade are known to interact with antibiotics. Examples include apremilast (Otezla) and upadacitinib (Rinvoq).

If you have questions about taking Remicade with an antibiotic, talk with your doctor or pharmacist.

How do the interactions of Remicade compare with those of Taltz?

Remicade and ixekizumab (Taltz) have some of the same interactions. But Remicade has other interactions that are not known to occur with Taltz.

For example, both drugs may interact with certain vaccines* and other biologics such as abatacept (Orencia). However, Remicade may also interact with theophylline (Elixophyllin, Theo-24, others) and warfarin (Jantoven).† Taltz isn’t known to interact with these drugs.

Similar to Remicade, Taltz is prescribed for plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. Remicade can be prescribed for other conditions as well. To learn more about Taltz’s interactions, see this article.

If you have other questions about Remicade and Taltz, talk with your doctor or pharmacist.

* For details about this interaction, see the “Remicade and other interactions” section above.
† For details about this interaction, see the “Drug interactions in depth” section above.

Is there an interaction between Remicade and turmeric?

No, there are no reports of Remicade interacting with turmeric.

Turmeric is a spice thought to ease inflammation and relieve pain, including that of conditions Remicade is used to treat. However, it isn’t known for certain whether turmeric is effective for these conditions. Your doctor can recommend whether taking turmeric with Remicade may be helpful for your condition.

If you’re interested in learning more about Remicade and turmeric, talk with your doctor.

You can take certain steps to help prevent interactions with Remicade. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Remicade label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Remicade doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

Besides learning about interactions, you may want to find out more about Remicade. These resources might help:

• Overview of Remicade: For a general overview of Remicade, see this article.
• Side effects: If you’re interested in the side effects of Remicade, see this article. Another option is to refer to the Remicade prescribing information.
• Dosage specifics: To learn about the dosage of Remicade, see this article.
• Drug comparison: For information about how Remicade compares with Humira, read this article.
• Cost: If you’d like to learn about Remicade and cost, see this article.
• Facts about your condition: To learn more about the conditions Remicade is approved to treat, refer to the following:
  • Ankylosing spondylitis: See our list of back pain articles.
  • Crohn’s disease: See our list of Crohn’s/IBD articles.
  • Plaque psoriasis: See our list of dermatology articles.
  • Psoriatic arthritis: See our list of psoriatic arthritis articles.
  • Rheumatoid arthritis: See our list of rheumatology articles.
  • Ulcerative colitis: See our list of ulcerative colitis articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.