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Waiting til after c-section to continue Remicade... Will it still be effective?

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Posted 7/15/2014 1:53 PM (GMT 0)
Hi everyone, I am new here. I have been on remicade every 8 weeks (a few times longer than 8 weeks). I was in remission and feeling great and now I am pregnant. My OB suggested if I would like to prolong the remicade while feeling well (but use it if I started feeling like a flare-up was coming on) and have an infusion right after delivery, that would be okay.

Has anyone else taken that long off of remicade and then started it back up? Was it still effective?

I had a big flare after my first baby (this was before I started remicade), but it had been so long since I had a flare that I didn't do anything to prevent it. This time I want to avoid the big flare, so I am hoping that this plan will work.
Posted 7/15/2014 2:27 PM (GMT 0)
I thought there was a standard practice to using remicade during pregnancy. I hope others answer because I am no expert, but I would counsel you to continue using remi during your pregnancy (it presents no risk to your baby) and make a very careful plan about when to take your last infusion with the understanding that you will have a C-section on a specific date.
Posted 7/15/2014 3:49 PM (GMT 0)
I hope more people share their experience too. I know it is safe to have the infusions during pregnancy, but we were thinking of holding off since I was feeling healthy for now. I will keep you updated with what my GI doctor says.
Posted 7/15/2014 6:47 PM (GMT 0)
I had infusions the whole pregnancy, my last at 29 weeks, and then we did one right after the c-section at 37 weeks. If you have a sudden flare, then you could lose the baby. Or cause problems from lack of nutrition. Honestly, it's not a risk I'd be willing to take.
Posted 7/15/2014 10:03 PM (GMT 0)
I think scifigal2k's schedule is the way to go, unless there have been new guidelines issued that change that.
Generally, you keep taking it until around the beginning of the third trimester, then hold off until after the delivery/c-section (at least I think that's the standard recommendation).

I'll try to look through my conference notes and see what they said (since I'm a guy who's not going to have kids, the pregnancy presentations are my chance to day-dream wink )

If I'm wrong about any of this, someone please feel free to correct me.

As for your concerns about effectiveness, there is data that shows that stopping it and re-starting can increase the odds of losing effectiveness and also data that show an increase in risk of developing a reaction to it, as well as developing antibodies to it. But with only missing one or two doses, those risks aren't too bad, and it's what is necessary to prevent the baby from being immunosuppressed.
Posted 7/16/2014 12:14 AM (GMT 0)
Here is a link for info about Remicade and pregnancy:

http://www.pregnancystudies.org/ongoing-pregnancy-studies/autoimmune-studies/specific-treatments-autoimmune/infliximab-remicade-fact-sheet/
Posted 7/16/2014 12:16 AM (GMT 0)
And more info:

http://www.ncbi.nlm.nih.gov/pubmed/21621603
Posted 7/16/2014 1:11 AM (GMT 0)
Thank you so much for your information and responses!
Posted 7/17/2014 12:33 AM (GMT 0)
I was on remicade until I became pregnant. I went off for the entire pregnancy. Had a great pregnancy. Flared about a month after delivery and tried to get back on remicade but it didn't work. So I had to switch to Humira which I got an okay 6 yrs out of. Now I'm on Cimzia. If I were to get pregnant now, I'd probably stay on the meds.
Posted 7/17/2014 1:01 AM (GMT 0)
That is really great to know, thank you! How long were you on Remicade before you got pregnant and went off of it?

Post Edited (Jac2014) : 7/16/2014 7:17:59 PM (GMT-6)

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