Remicade dosages

I am on 5 mg/kg, which from my observation on this forum seems to be the "standard" dose.  How does anyone end up on the higher, eg double dose- failing to get remission and off prednisone on the "standard" dose?  Those of us who go on Remi are usually in dire straits to begin with, so I'm surprised that one would, to paraphrase the Untouchables movie line, "go to a knife fight with a knife" as opposed to a gun.  I know Remi is incredibly expensive, and most of us on it are lucky that our insurance covers us.  Just wondering.  I'll bring it up with my GI next visit.  Two infusions done, next will be after a 4 week gap, then every 8 weeks.  Got some results in terms of bowel movements an formed stool, but the pain remains very nasty.

I was actually started on the higher dose. I was hospitalized for a very severe flare and was almost rushed off to surgery. I was getting worse even on prednisone so I started Remicade and noticed improvement after about a week. I was hopefully going to be going down to 5 mg/kg at my last infusion but I started flaring about 2 weeks before so i'm still at 10mg/kg.

Thanks everybody. So far I have seen definite improvements on the standard dose, but last night a bit of a setback (so far still formed stool, no blood, less pain but that yucky UCish feeling in gut as of last night) so I know it will not be continuously smooth sailing either. Good to know that if worse comes to worse I can always ratchet it up another notch if my GI approves. As far as side effects that I notice from Remi so far- nothing, not even on the day of the infusion.

I started with 5 mg/kg every 8 weeks, since September 2005 but recently I'm flaring and my GI's decided to go with 10 mg/kg every 6 weeks to then again save me from surgery, but I'm thinking about doing the surgery in a nearby future, I hate meds, I'm just waiting to finish my Bach degree

some food for thought on the dosing- until you're finished with the initial loading doses period, I doubt a GI would up your dose. Once you get to the 8 week infusion schedule, they'll have you get a few doses at that schedule & see how you do with it. If the med lasts the full 8 weeks, etc. Then if you find yourself having problems at week 5-7, the next step would be to shorten your dosing schedule to 6 weeks or so. Then after a few doses at that schedule, if you're still having problems, then your doctor may decide to try the 10mg/kg dose. It really can take a while for the Remicade to really kick in & do it's job fully- plus, most doctors tend to err on the side of caution, & would rather not prescribe the higher dose unless they absolutely have too. My own GI never mentioned upping the dose & I had no idea you could even do that until I had a consult with the Head of the GI Dept. at Beth Israel Hospital in Boston. He said you could go as high as 10ms/kg every 4 weeks. So when my GI got the report of our visit, we decided to try the 10mg/kg dose every 8 weeks. That still was leaving me short, as I was getting symptomatic around week 5-6, so we shortened the dosing schedule to every 6 weeks. That's as much med in as short a time as my own GI feels comfortable with. If I start having serious issues at my current dose & dosing schedule, I'm in trouble- we will try Humira if my insurance pays for it, & if that doesn't work then it's off to surgery.