Is anyone taking Remsima by subcutaneous injection?

[bienassis]

I am about to change from IV infusions to SC injections to avoid the hospital visit at this time of Covid 19. The dosage is 120mg every two weeks as opposed to 140mg every eight weeks. This dose is for all weights - but I'm 45kg, and it would be the same dose for someone of 75kg! I also have Methotrexate 10mg by SC injection.

I was told I will be the only RA patient at my hospital having the drug by SC injection.

Any comments?

[AgedCrone]

That is a rather large increase in dose...have you double checked it?

[bienassis in reply to AgedCrone]

Yes, I have checked it - NICE in their latest Evidence Summary published 21 July give details. But nobody explains why the dosage by SC differs so much from IV. It doesn't look as though many RA patients are receiving the drug in SC form as yet.

[AgedCrone in reply to bienassis]

If you are still worried about it I’d give your rheumy nurse a call.

[bienassis in reply to AgedCrone]

I am in fact expecting a call from my rheumy nurse as she is arranging the changeover from IV form to SC form. She has to let me know when the injections arrive at the hospital - they have only recently been ordered - and what arrangements she is making for home delivery.

[AgedCrone in reply to bienassis]

Make a list of your questions...then you will be all set.

Good Luck with it.

[bienassis in reply to AgedCrone]

I will certainly do that. Many thanks for your interest. I'm new to HealthUnlocked and this is the first question I've asked. But RA is an old companion - 53 years of "friendship"!

[AgedCrone in reply to bienassis]

I’m way behind you...but I know what you mean. You might not get the answer you want to hear here....but someone will always have a suggestion!

[oldtimer]

you might find it helpful to use the generic name: infliximab as more people would have experience of that. See if anything comes up if you put it in the search box.

The dosage does sound a bit odd, but I haven't come across anyone having it by subcut injection. There is a NICE document on it which states that the sc dose is fixed at 120mg - have a look if you haven't seen it.

[bienassis in reply to oldtimer]

Thank for your thoughts on this; it does seem that 120mg is the correct dose (NICE information) for sc injection - given every two weeks. I'm still puzzled why there is such a difference in dosage, and the rheumatology specialist nurse hasn't explained why this should be. I wonder (and I have no medical knowledge) if the SC absorption is less efficient than the IV. It does seem that different methods of administration of a drug affect the absorption. I changed from methotrexate tablets some while ago to SC injections and was told more of the medicine would be absorbed. As much as 40% of absorption was lost in tablet form. So, perhaps IV is more efficient than SC injections! Bu I really don't know.

I have yet to start the injections - this all came about rather suddenly and I'm waiting for a delivery from the hospital. NICE issued an Evidence Summary on 21st July giving details. Remsima by SC injections was "passed" in March this year for general use here. I believe it has been used for sometime in other countries.

Keep well!