Patient’s initial dose should be administered over 2-3 hours. A titration infusion rate is as follows for doses less than or equal to 1000 mg:

a. 10 mL/hour for first 15 minutes.
b. Increase rate to 20 mL/hour for 15 minutes.
c. Increase rate to 40 mL/hour for 15 minutes
d. Increase rate to 80 mL/hour for 15 minutes.
e. Increase rate to 150 mL/hour for 30 minutes
f. Increase and maintain rate at 250 mL/hour for remainder of infusion

If a patient is known to have had a previous reaction to infliximab, the maximum infusion rate is 125 mL/hour.

For doses greater than 1000mg, the following infusion rate titration is suggested:

a. 20 mL/hour for first 15 minutes
b. Increase rate to 40 mL/hour for 15 minutes
c. Increase rate to 80 mL/hour for 15 minutes
d. Increase rate to 160 mL/hour for 15 minutes
e. Increase rate to 300 mL/hour for 30 minutes
f. Increase and maintain rate at 500 mL/hour for remainder of infusion

In patients who have received and tolerated at least 3 prior infusions, the rate of infusion may be shortened to 60 minutes for Remicade or infliximab biosimilar for adult patients. (NOTE: For pediatric patients, a 1-hour infusion requires an LIP order.) Rates are as follows:

a. For a dose ≤1000 mg, the infusion may be initiated at 100 mL/hour for the first 15 minutes and then increased to 300 mL/hour for the remaining 45 minutes.

b. For doses >1000 mg, the infusion may be initiated at 200 mL/hour for the first 15 minutes and increased to 600 mL/hour for the remaining 45 minutes

Rapid rate may be continued for patients tolerating rapid rate with Remicade and who are switched to an infliximab biosimilar.

For 1st infusion or for any patient with history of infusion-related adverse reactions, monitor patient for 30 minutes after completion of treatment.