Anti-Tumour Necrosis Factor (Anti-TNF)

Common side-effects:

• Infection (colds, sinusitis, urinary tract infections and skin infections)
• Injection site reactions (bleeding, bruising, redness, itching, pain and swelling)
• Infusion reactions of infliximab: Flushing, Chills, chest tightness,  shortness of breath, hypotension or hypertension (pre-medication given to prevent infusion reactions)
• Headache
• Rash

Uncommon side-effects:

• Severe infections (pneumonia, joint infection, activation of tuberculosis)
• Low blood platelet count
• Localized swelling of the skin or hives
• Lung inflammation 

Rare side-effects:

• Combined low platelet, red and white blood cell count
• Severe muscle weakness
• Seizures

Long term use of anti-TNF may increase the risk of lymphoma and other cancers. You may be more at risk if you are also taking immunosuppressant such as methotrexate and azathioprine.

Patient should be tested for tuberculosis before starting anti-TNF therapy.

Hepatitis B and C testing may be done. Hepatitis B and C infection may get worse during the anti-TNF therapy.

If you have heart problems, as anti-TNF could make your symptoms worse, therefore your heart will need to be monitored closely before and after the treatment.

Come back to the hospital for regular blood test as instructed by your doctor.

Because adverse effects can happen at any time during the course of treatment and some side effects may not cause symptoms, it is really important that you have your regular blood test. This can monitor the side-effects of anti-TNF.

Move the injection site where you give the shot each time.