Can I take a GLP-1 (Glucagon-like peptide-1) receptor agonist and Remicade (Infliximab) today?

Taking GLP-1 Receptor Agonists with Remicade (Infliximab)

Yes, you can take a GLP-1 receptor agonist and Remicade (infliximab) on the same day as there are no known significant drug interactions between these medications. 1

Pharmacological Considerations

GLP-1 Receptor Agonists

• GLP-1 receptor agonists work by activating GLP-1 receptors to enhance insulin secretion and inhibit glucagon secretion in a glucose-dependent manner 2
• They also slow gastric emptying and reduce food intake via central appetite suppression 1
• Available in different formulations:
  • Daily injections (liraglutide, lixisenatide) 2
  • Weekly injections (semaglutide, dulaglutide, exenatide once-weekly) 2
  • Oral formulation (semaglutide) 2

Remicade (Infliximab)

• Remicade is a TNF-alpha inhibitor used for autoimmune conditions 1
• No specific contraindications exist for concurrent use with GLP-1 receptor agonists 1

Administration Guidance

For Daily GLP-1 Receptor Agonists

• Daily GLP-1 receptor agonists should be administered as prescribed, typically before meals 1
• Injection of daily GLP-1 receptor agonists should be premeal 1

For Weekly GLP-1 Receptor Agonists

• Once-weekly GLP-1 receptor agonists can be taken at any time during the day regardless of meal times 1
• No need to adjust timing relative to Remicade infusion 1

For Remicade Administration

• Remicade is administered as an intravenous infusion in a healthcare setting 1
• No specific timing adjustments are needed when also taking GLP-1 receptor agonists 1

Important Considerations

Potential Side Effects

• GLP-1 receptor agonists commonly cause gastrointestinal side effects, especially during initiation and titration 1, 2
  • Nausea, vomiting, and diarrhea may occur but typically diminish over time 1
• These side effects are not expected to be worsened by concurrent Remicade administration 3

Hypoglycemia Risk

• GLP-1 receptor agonists alone have a low risk of hypoglycemia due to their glucose-dependent mechanism of action 4
• If you're also taking insulin or insulin secretagogues, be aware of potential hypoglycemia risk 1

Perioperative Considerations

• If you're receiving Remicade infusion in a perioperative context, recent guidelines recommend continuing GLP-1 receptor agonists throughout the perioperative period 1
• The risk of pulmonary aspiration should be discussed with your healthcare provider if you're undergoing procedures requiring anesthesia 1

Monitoring Recommendations

• Monitor for gastrointestinal side effects, which are typically transient 5
• If side effects do not resolve over time (a few weeks), follow up with your healthcare provider 1
• Regular blood glucose monitoring is recommended, especially when starting either medication 1

Special Situations

• If you have renal impairment, dose adjustments may be needed for certain GLP-1 receptor agonists 1
• If you're taking oral medications that require consistent absorption (like oral contraceptives or levothyroxine), be aware that GLP-1 receptor agonists may affect their absorption due to delayed gastric emptying 6

Remember to always inform all your healthcare providers about all medications you're taking to ensure comprehensive care and monitoring.