*Required

    Please let us know if you would like to also receive:

    Janssen Biotech, Inc. will not share your information with anyone else, except as required by law.

    If you want to stop receiving this information, you may ask us to remove you from our contact list by calling toll-free 1-866-222-6410 or by visiting www.remicade.com/unsubscribe.

    By clicking the Submit button below, you accept the terms of use collected on this form and agree that the information you provide will be governed by our site's Privacy Policy.

     Currently takingHave taken in the past
    Aminosalicylate (5-ASA)

    Examples: Azulfidine®*, (sulfasalazine), Asacol®* (mesalamine), Pentasa®* (mesalamine), Lialda®* (mesalamine), Rowasa®* (mesalamine), Colazal®* (balsalazide disodium)

    Immunosuppressant/6-MP

    Examples: Imuran®* (azathioprine), Purinethol®* (mercaptopurine), methotrexate

    Steroid

    Examples: Entocort? EC (budesonide), prednisone

    Biologic Injectable
    Other Medication
    None

    *Indicated trademarks are registered trademarks of their respective owners.