You are using an unsupported browser. Please upgrade your browser to a newer version to get the best experience on DrugBank.
Accession NumberDB00065  (BIOD00004, BTD00004)

Tumor necrosis factor (TNF-alpha) binding antibody (chimeric IgG1). It is composed of human constant and murine variable regions. Infliximab is produced by a recombinant cell line cultured by continuous perfusion

Protein structureDb00065
Protein chemical formulaC6428H9912N1694O1987S46
Protein average weight144190.3000
Ig gamma-1 chain C regionNot AvailableNot Available
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Remicadeinjection, powder, lyophilized, for solution100 mg/10mLintravenousJanssen Biotech, Inc.1998-08-24Not AvailableUs
Remicadepowder for solution100 mgintravenousJanssen IncNot AvailableNot AvailableCanada
Inflectrapowder for solution100 mgintravenousHospira Healthcare CorporationNot AvailableNot AvailableCanada
Remsimapowder for solution100 mgintravenousCelltrion Healthcare Co LtdNot AvailableNot AvailableCanada
Generic Prescription ProductsNot Available
Over the Counter ProductsNot Available
International BrandsNot Available
Brand mixturesNot Available
SaltsNot Available
CAS number170277-31-3
KingdomOrganic Compounds
SuperclassOrganic Acids
ClassCarboxylic Acids and Derivatives
SubclassAmino Acids, Peptides, and Analogues
Direct parentPeptides
Alternative parentsNot Available
SubstituentsNot Available
Classification descriptionNot Available
IndicationTo manage the signs and symptoms, as well as to induce and maintain clinical remission in adults with moderate to severe active Crohn's disease or ulcerative colitis. Also used to manage signs and symptoms of rheumatoid arthritis (in conjunction with methotrexate), ankylosing spondylitis, psoriatic arthritis, and juvenile arthritis.
PharmacodynamicsInfliximab is a chimeric human-murine anti-human tumor necrosis factor (TNF) monoclonal antibody. It binds to tumor necrosis factor alpha (TNFa) and inhibits binding of TNFa with its receptors. This reduces production of pro-inflammatory cytokines such as interleukins (IL) 1 and 6. This also limits leukocyte migration and expression of adhesion molecules by endothelial cells and leukocytes. Infliximab also limits the activation of neutrophil and eosinophil functional activity, reduces production of tissue degrading enzymes produced by synoviocytes and/or chondrocytes. Infliximab decreases synovitis and joint erosions in collagen-induced arthritis and allows eroded joints to heal.
Mechanism of actionInfliximab neutralizes the biological activity of TNFa by binding with high affinity to the soluble and transmembrane forms of TNFa and inhibits binding of TNFa with its receptors. Infliximab does not neutralize TNFb (lymphotoxin a), a related cytokine that utilizes the same receptors as TNFa. TNFa activation normally induces the release of proinflammatory cytokines, the enhancement of leukocyte migration and activation of neutrophils among others. Neutralization of the biological activity of TNFa leads to an overall reduction in inflammation.
AbsorptionOnset of action occurs in about 2 weeks in Crohn's disease.
Volume of distribution

3-6 L

Protein bindingNot Available

Most likely removed by opsonization via the reticuloendothelial system when bound to T lymphocytes, or by human antimurine antibody production. Not metabolized by the CYP enzymes.

Route of eliminationNot Available
Half life9.5 days (7-12 days) in patients with Crohn's disease, plaque psoriasis and rheumatoid arthritis
ClearanceNot Available
ToxicityNot Available
Affected organisms
  • Humans and other mammals
PathwaysNot Available
SNP Mediated Effects
Interacting Gene/EnzymeSNP RS IDAllele nameDefining changeEffectReference(s)
Low affinity immunoglobulin gamma Fc region receptor III-A
Gene symbol: FCGR3A
UniProt: P08637
rs1801274 Not AvailableCC Allele (homozygous)Better ACR20 response18930989
SNP Mediated Adverse Drug ReactionsNot Available
  • J&J and Mitsubisi Tanabe
Dosage forms
Injection, powder, lyophilized, for solutionintravenous100 mg/10mL
Powder for solutionintravenous100 mg
Unit descriptionCostUnit
Remicade 100 mg Solution Vial821.02USDvial
Remicade 100 mg vial789.44USDvial
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
CountryPatent NumberApprovedExpires (estimated)
Experimental Properties
melting point61 °C (FAB fragment), 71 °C (whole mAb)Vermeer, A.W.P. & Norde, W., Biophys. J. 78:394-404 (2000)
hydrophobicity-0.441Not Available
isoelectric point8.25Not Available
Synthesis ReferenceNot Available
General Reference
  1. Knight DM, Trinh H, Le J, Siegel S, Shealy D, McDonough M, Scallon B, Moore MA, Vilcek J, Daddona P, et al.: Construction and initial characterization of a mouse-human chimeric anti-TNF antibody. Mol Immunol. 1993 Nov;30(16):1443-53. Pubmed
    #American Society of Health System Pharmacists, Inc., DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995. Infliximab; [updated 2014 Aug 27; cited 2014 Nov 12]. Available from
  2. Dubinsky MC, Fleshner PP: Treatment of Crohn’s Disease of Inflammatory, Stenotic, and Fistulizing Phenotypes. Curr Treat Options Gastroenterol. 2003 Jun;6(3):183-200. Pubmed
  3. Present DH, Rutgeerts P, Targan S, Hanauer SB, Mayer L, van Hogezand RA, Podolsky DK, Sands BE, Braakman T, DeWoody KL, Schaible TF, van Deventer SJ: Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med. 1999 May 6;340(18):1398-405. Pubmed
  4. Sands BE, Anderson FH, Bernstein CN, Chey WY, Feagan BG, Fedorak RN, Kamm MA, Korzenik JR, Lashner BA, Onken JE, Rachmilewitz D, Rutgeerts P, Wild G, Wolf DC, Marsters PA, Travers SB, Blank MA, van Deventer SJ: Infliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med. 2004 Feb 26;350(9):876-85. Pubmed
  5. Hanauer SB: Crohn’s disease: step up or top down therapy. Best Pract Res Clin Gastroenterol. 2003 Feb;17(1):131-7. Pubmed
    #Lexicomp Online (2014). Infliximab Available at: [Accessed 12 Nov. 2014].
External Links
ATC CodesL04AB02
AHFS Codes
  • 92:00.00
PDB Entries
FDA labelshow(1.21 MB)
MSDSNot Available
Drug Interactions
AbataceptThe combination shoould be avoided as there have been reports of increased risk of serious infections.
AdalimumabBoth bind to TNF alfa and thus combination results in enhanced immunosuppressive effect. It is recommended that simultaneous use of both agents be avoided.
AnakinraCombination may enhance the toxic effect of Anakinra and should be avoided otherwise there may be an increased risk of infection
CanakinumabAvoid combination due to increased risk of infection as anti-TNF agents enhance adverse effects of Canakinumab.
Certolizumab pegolAvoid combination because anti-TNF agents increase adverse effects of certolizumab pegol
DenosumabTherapy should be monitored when combination is initiated as there may be an increase in serious infections.
EtanerceptAvoid combination because etanercept may increase immunosuppressive effects of infliximab.
golimumabAvoid combination with infliximab due to the potential increased immunosuppression of infliximab.
LeflunomideTherapy modification should be considered in order to reduce the risk of hematologic toxicities.
NatalizumabIncrease adverse effects of natalizumab. Avoid combination
PimecrolimusPimecrolimus enhances the adverse effects of immune suppressants thus the combination should be avoided.
RilonaceptAnti-TNF alfa agents enhance adverse effects of rilonacept thus combination should be avoided.
RoflumilastRoflumilast enhances the adverse effects of immune suppressants thus a therapy modification should be considered.
Sipuleucel-TMonitoring is required because immunosuppressants can decrease the therapeutic effect of Sipuleucel-T.
TacrolimusAvoid combination because of risk of enhance adverse effects of immunosuppressants
TocilizumabAvoid combination because enhanced immunosuppression by anti-TNF agents.
TofacitinibAvoid combination with infliximab and other anti-TNF drugs due to the potential enhancement of tofacitinib related adverse effects.
TrastuzumabTrastuzumab may increase the risk of neutropenia and anemia. Monitor closely for signs and symptoms of adverse events.
Food InteractionsNot Available


1. Tumor necrosis factor

Kind: protein

Organism: Human

Pharmacological action: yes

Actions: inhibitor


Name UniProt ID Details
Tumor necrosis factor P01375 Details


  1. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. Pubmed
  2. Mimura T: [Selection of one of the TNF blockers; infliximab and etanercept] Nippon Rinsho. 2007 Jul;65(7):1282-6. Pubmed
  3. Braun J, Baraliakos X, Listing J, Sieper J: Decreased incidence of anterior uveitis in patients with ankylosing spondylitis treated with the anti-tumor necrosis factor agents infliximab and etanercept. Arthritis Rheum. 2005 Aug;52(8):2447-51. Pubmed
  4. Danese S, Sans M, Scaldaferri F, Sgambato A, Rutella S, Cittadini A, Pique JM, Panes J, Katz JA, Gasbarrini A, Fiocchi C: TNF-alpha blockade down-regulates the CD40/CD40L pathway in the mucosal microcirculation: a novel anti-inflammatory mechanism of infliximab in Crohn’s disease. J Immunol. 2006 Feb 15;176(4):2617-24. Pubmed
  5. Magro F, Pereira P, Carneiro F, Veloso FT: Reactive hepatitis in a patient with Crohn’s disease successfully treated with infliximab: does tumor necrosis factor alpha play a role in reactive hepatitis? Inflamm Bowel Dis. 2005 Jan;11(1):88-90. Pubmed
  6. Mori S, Imamura F, Kiyofuji C, Ito K, Koga Y, Honda I, Sugimoto M: Pneumocystis jiroveci pneumonia in a patient with rheumatoid arthritis as a complication of treatment with infliximab, anti-tumor necrosis factor alpha neutralizing antibody. Mod Rheumatol. 2006;16(1):58-62. Pubmed
  7. Maini RN, Feldmann M: How does infliximab work in rheumatoid arthritis? Arthritis Res. 2002;4 Suppl 2:S22-8. Epub 2002 Mar 27. Pubmed
  8. Sapienza MS, Cohen S, Dimarino AJ: Treatment of pyoderma gangrenosum with infliximab in Crohn’s disease. Dig Dis Sci. 2004 Sep;49(9):1454-7. Pubmed
  9. Tobin AM, Kirby B: TNF alpha inhibitors in the treatment of psoriasis and psoriatic arthritis. BioDrugs. 2005;19(1):47-57. Pubmed
  10. Shen C, Assche GV, Colpaert S, Maerten P, Geboes K, Rutgeerts P, Ceuppens JL: Adalimumab induces apoptosis of human monocytes: a comparative study with infliximab and etanercept. Aliment Pharmacol Ther. 2005 Feb 1;21(3):251-8. Pubmed
  11. Popa C, Netea MG, Barrera P, Radstake TR, van Riel PL, Kullberg BJ, Van der Meer JW: Cytokine production of stimulated whole blood cultures in rheumatoid arthritis patients receiving short-term infliximab therapy. Cytokine. 2005 Apr 21;30(2):72-7. Pubmed

comments powered by Disqus
Drug created on June 13, 2005 07:24 / Updated on November 12, 2014 16:07