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Re: Remicade - Maximum Dose

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Hi ,

I'm not sure I agree with your Docs reasoning, but I'm no MD. The

reason I don't agree is that from there you have no where to go.

Unless you switch meds again. I was on enbrel before remicade and

opted remicade over humira because the dose could be played with. I

think the usual theory is to find the point at which it's working by

increasing the dose and/or shortening the intervals, then hopefully

there is still room to increase and shorten for a long as possible

I started off at I believe 3mg remicade/kg body weight 8wks and now

I'm up to almost 5mg/kg 6wks.... This brings me to a livable point,

not a point where I can get up and holler, 'I'm delivered'. My Rhuem

hesitates to increase because of the cost to my insurance and fear

they may pull the plug on the whole thing. " not what I want " .

Soooo, I take a little more mtx as I get to the end of my infusion

interval and that seems to get me by.

By doing this, I'm hopefully buying more time with remicade and I'll

still be able to get a couple of increases before reaching the max,

10mg/kg 4wks or my insurance companies max, whatever that might be,

I've heard rumored it's 7mg/Kg 4wks.

I am just trying to make it through until the next best thing comes

along. I've still to try humira. And we've discussed cycling back

to enbrel. But, for me, the remicade has been the most effective

drug yet and I'm glad I still have a little room to grow with it.

I was only on enbrel 9mths before it started it's decline in

effectiveness, though I was on it 15mths before we finally gave up.

So if you were on enbrel for 3 years before it stopped working, I

would call that a huge success for you with biologics.

I hope you respond wonderfully to remicade and that it works for you

for a very long time.

>

> This Is My First Posting On Any Message Board For What That's

Worth.

> Anyway, Here Goes. I've Had Psoriatic Arthritis For Six Years. I

> Started With Asulfazine And Methotrexate For A Few Years Followed

By 10

> Months Of Humira Which Eventually Lost Its Effect, Followed By

Three

> Years Of Enbrel Which Lost Its Effect. Four Months Ago I Started

> Taking Remicade Infusions. Because Of A General Lack Of Positive

> Results, My Third Infusion Was A " Double Dose " . I Visited My

> Rheumatologist Today Who Suggested That I Take The Maximum Dosage

Which

> I Gathered Was A Combination Of More Remicade More Often Than

Generally

> Used. My Concern Is The Long-Term Effects Of Such A Large Dose.

Any

> Input Would Be Appreciated. Thanks.

>

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i told my rheumatologist that i would get back to him in the next

week with my reply. i have printed out your response and discuss

your comments with him. thanx very much for the knowledgeable input.

This Is My First Posting On Any Message Board For What That's

Worth. Anyway, Here Goes. I've Had Psoriatic Arthritis For Six

Years. I Started With Asulfazine And Methotrexate For A Few Years

Followed By 10 Months Of Humira Which Eventually Lost Its Effect,

Followed By Three Years Of Enbrel Which Lost Its Effect. Four

Months Ago I Started Taking Remicade Infusions. Because Of A

General Lack Of Positive Results, My Third Infusion Was A " Double

Dose " . I Visited My Rheumatologist Today Who Suggested That I Take

The Maximum Dosage Which

I Gathered Was A Combination Of More Remicade More Often Than

Generally

Used. My Concern Is The Long-Term Effects Of Such A Large Dose.

Any Input Would Be Appreciated. Thanks.

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thanks for the input, betz. unfortunately, i am quite the skeptic.

my natural tendency is to ignore the advice of the manufacturer

although i'll probably give them a call to hear what they have to

say. I don't have a lot of faith in the pharmaceutical giants that

seem to charge unreasonable sums for their products. I guess it would

hurt to call them.

>

> , welcome to the group. I would call the Remicaid helpline and

ask

> them that very question. When I took Enbrel, they were VERY helpful

> with all of my questions. -Betz

>

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In a message dated 10/10/2006 2:27:17 P.M. Pacific Daylight Time,

palral@... writes:

.. I Visited My

Rheumatologist Today Who Suggested That I Take The Maximum Dosage Which

I Gathered Was A Combination Of More Remicade More Often Than Generally

Used. My Concern Is The Long-Term Effects Of Such A Large Dose. Any

Input Would Be Appreciated. Thanks

Hi there...my rheumy has told me that Crohn's patients get Remicade in much,

much higher doses that PA patients (I think he said 4x the PA dose). He

also said (he was one of the rheumies who conducted a lot of the clinical

trials) that Remicade was approved at lower doses for PA/RA because they were

trying to keep it cost comparable to Enbrel and Humira.

Technically, the Remicade drug leaves your system after 28 days, but most

insurances only approve infusions only 6 weeks. So they try to improve your

condition by raising the dose vs. the timing of infusions...

Hope that helps...worth checking it out online a bit more or with your

rheumy....

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Let me know how it goes. I'm interested.

Good Luck!!

>

> This Is My First Posting On Any Message Board For What That's

> Worth. Anyway, Here Goes. I've Had Psoriatic Arthritis For Six

> Years. I Started With Asulfazine And Methotrexate For A Few Years

> Followed By 10 Months Of Humira Which Eventually Lost Its Effect,

> Followed By Three Years Of Enbrel Which Lost Its Effect. Four

> Months Ago I Started Taking Remicade Infusions. Because Of A

> General Lack Of Positive Results, My Third Infusion Was A " Double

> Dose " . I Visited My Rheumatologist Today Who Suggested That I

Take

> The Maximum Dosage Which

> I Gathered Was A Combination Of More Remicade More Often Than

> Generally

> Used. My Concern Is The Long-Term Effects Of Such A Large Dose.

> Any Input Would Be Appreciated. Thanks.

>

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  • 4 weeks later...

In a message dated 10/10/2006 21:27:20 GMT Standard Time, palral@...

writes:

This Is My First Posting On Any Message Board For What That's Worth.

Anyway, Here Goes. I've Had Psoriatic Arthritis For Six Years.

Hi ,

Welcome to the group. I'm glad you found us but sorry you had to. I can't

really help you with your Remicade problem as I am on Enbrel but hopefully

someone will have by now. This is a wonderful group you find yourself in, full

of

knowledgeable and caring people. I hope you get what you are looking for from

us.

Take care,

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