If patient has a history of moderate to severe heart failure, has been associated with an exacerbation of heart failure; doses > 5 mg/kg are contraindicated. Close monitoring is recommended. If patient has demyelinating diseases, such as multiple sclerosis, is contraindicated.

How to monitor anti-TNF-alpha therapy ( and )? height, weight and sex. posology, injection schedule, concomitant use of immunosuppressants. serum concentrations of albumin and CRP. serum concentration of TNF alpha. presence and levels of potential antidrug antibodies.

Monitor signs of hypersensitivity reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough, dyspnea) or skin reactions (rash, pruritus, urticaria). Be especially alert for allergy-like responses that occur during and after administration (infusion reactions).

Administering antihistamine and acetaminophen 90 minutes before the infusion. Using a test dose of . Patients with a prior history of an anaphylactic reaction to should receive , antihistamine, and acetaminophen before infusion.

Side Effects Black, tarry stools. bladder pain. bloody or cloudy urine. body aches or pain. chest pain. cough producing mucus. difficult, burning, or painful urination. difficulty breathing.

It is important to have your heart checked closely if you receive . Call your doctor right away if you have trouble breathing, swelling in the ankles and feet, or a sudden weight gain. Do not take other medicines unless they have been discussed with your doctor.