What Can't You Eat on Infliximab? A Guide to Dietary Restrictions

October 23, 2025 •

4 min read

Over 1.4 million people in the U.S. have Inflammatory Bowel Disease (IBD), a condition often treated with infliximab. Given that infliximab is an immunosuppressant, patients must exercise caution with their diet to minimize the risk of serious foodborne infections from bacteria like Listeria or Salmonella.

Quick Summary

Taking infliximab requires strict food safety precautions to prevent infections from certain raw or undercooked foods. Key foods to avoid include raw eggs, undercooked meats, and unpasteurized dairy products, with a strong focus on hygiene.

Key Points

Avoid Raw Foods: Steer clear of raw or undercooked meat, poultry, fish, and eggs to prevent serious foodborne illnesses like Salmonella.
Choose Pasteurized Dairy: Always check labels and avoid unpasteurized milk and dairy products, as they can carry harmful bacteria like Listeria.
Be Wary of Soft Cheeses: Even if pasteurized, mold-ripened soft cheeses like brie and blue cheese are often risky due to fungal infection concerns with immunosuppressants.
Practice Excellent Hygiene: Wash hands, separate utensils for raw foods, and cook all food thoroughly to minimize infection risks.
Limit Alcohol: Excessive alcohol can affect the liver, and while no direct interaction is known, it's wise to limit consumption and discuss it with your doctor.
Get Personalized Advice: Always consult your healthcare provider for dietary advice, especially concerning underlying conditions like IBD, to avoid flare-ups.

Understanding Infliximab's Impact on Your Immune System

Infliximab, a type of biologic medication, works by suppressing certain parts of your immune system. While this is essential for treating conditions like Crohn's disease, ulcerative colitis, and rheumatoid arthritis, it also leaves you more vulnerable to infections. A healthy immune system can typically fight off bacteria found in certain foods, but an immunocompromised system cannot, making what you eat a critical part of your treatment plan.

Raw and Undercooked Foods to Avoid

The most significant dietary restriction while on infliximab revolves around minimizing exposure to foodborne pathogens. This means avoiding any foods that are not thoroughly cooked or that are processed in unhygienic conditions. The following list details the types of foods that should be avoided:

Raw or Undercooked Eggs: The risk of Salmonella infection from raw or undercooked eggs is too high for individuals on infliximab. This includes dishes where eggs are not fully cooked, such as runny yolks, homemade mayonnaise, Caesar salad dressing, and unbaked cookie dough or cake batter.
Undercooked Meat and Poultry: Raw or rare meats, including beef, pork, and poultry, can harbor harmful bacteria. All meat and poultry must be cooked to a safe internal temperature to ensure any pathogens are destroyed.
Undercooked Seafood: Raw fish and shellfish, like those found in sushi, oysters, or clams, should be avoided entirely. Cook all seafood thoroughly until it becomes opaque.
Pâté: Pâté can be a source of Listeria, a bacteria particularly dangerous for those with weakened immune systems. Avoid all types of pâté, especially undercooked versions.
Raw Sprouts: Alfalfa, bean, and other sprouts require a warm, humid environment to grow, which is also an ideal breeding ground for bacteria. Cooking sprouts can make them safer, but many opt to avoid them altogether.

Unpasteurized Dairy and Other Restrictions

Not all dairy products are safe when your immune system is suppressed. Pasteurization is a heat process that kills harmful germs, so it's essential to only consume pasteurized dairy.

Unpasteurized Milk and Dairy: Raw or unpasteurized milk and any products made from it, including cheeses and ice cream, must be avoided. Check labels carefully.
Soft, Mold-Ripened Cheeses: Even if pasteurized, certain mold-ripened soft cheeses like blue cheese, brie, feta, and Camembert pose an increased risk of fungal infections for those on biologics. Hard cheeses like Parmesan are generally safer.

Comparison of Cheeses: Safe vs. Risky on Infliximab


Type of Cheese	Processing	Food Safety Status on Infliximab
Hard Cheeses (e.g., Cheddar, Parmesan)	Pasteurized	Generally Safe - Lower moisture content reduces microbial risk.
Soft Cheeses (e.g., Feta, Brie, Blue)	Can be pasteurized, but mold-ripened	Risky - Higher risk of fungal or bacterial infection.
Processed Cheeses (e.g., Cream Cheese, Cottage Cheese)	Pasteurized	Generally Safe - Processed to kill bacteria.
Unpasteurized Soft Cheese (e.g., farmer's market options)	Unpasteurized	High Risk - Likely contains harmful bacteria.

Practicing Impeccable Food Hygiene

In addition to avoiding specific foods, maintaining excellent food hygiene is a non-negotiable part of your infliximab treatment. Following these steps will help protect you from infection:

Wash Hands Frequently: Wash your hands with soap and water before and after handling food, especially after touching raw meat.
Separate Food: Use separate cutting boards and utensils for raw meat and other foods to prevent cross-contamination.
Properly Store Leftovers: Cool and refrigerate leftovers rapidly. Ensure they are reheated to a safe internal temperature (165°F / 74°C) before eating.
Clean Surfaces: Regularly sanitize kitchen countertops, utensils, and other food preparation surfaces.
Wash Produce: Thoroughly wash all fruits and vegetables before consuming.

Alcohol Consumption and Other Considerations

While no direct interaction between infliximab and alcohol has been reported, excessive alcohol consumption can cause liver damage. Since infliximab may also affect the liver, drinking large amounts of alcohol during treatment could increase the risk of liver problems. It is best to limit or avoid alcohol and to discuss consumption with your doctor, especially if you have an underlying condition like psoriasis or are on combination therapy with other drugs that impact liver function. For underlying conditions such as Crohn's disease, personalized dietary guidance is often necessary. A plant-based diet, for instance, may be beneficial for some but might need adjustments during active disease flares.

Conclusion

Managing your diet carefully while on infliximab is a crucial, non-negotiable part of your treatment plan to prevent serious foodborne infections. The primary focus is on avoiding raw or undercooked foods and unpasteurized dairy products, which pose the highest risk due to the medication's immunosuppressive effects. By adhering to these dietary restrictions and maintaining strict food hygiene, you can significantly reduce your risk of complications and help optimize the effectiveness of your infliximab therapy.

For more detailed information on living with inflammatory bowel disease, the Crohn's & Colitis UK website provides comprehensive resources and support: Crohn's & Colitis UK

Frequently Asked Questions

Infliximab is an immunosuppressant medication, meaning it dampens your immune system to treat conditions like Crohn's disease. This makes you more susceptible to infections from bacteria that are often found in raw or undercooked foods, such as Listeria and Salmonella.

No, it is recommended to avoid all forms of raw or undercooked seafood, including sushi with raw fish, while taking infliximab. Thoroughly cooked fish is a safer alternative.

You can eat dairy products, but they must be pasteurized. Avoid all unpasteurized milk and dairy products, and be cautious with mold-ripened soft cheeses, as these carry a higher risk of infection for immunocompromised individuals.

If you accidentally consume a risky food, monitor yourself closely for any signs of food poisoning, such as fever, nausea, or diarrhea. Contact your doctor immediately if you develop symptoms or feel unwell.

There are no known direct interactions, but excessive alcohol consumption can cause liver damage. Since infliximab may also affect the liver, limiting or avoiding alcohol can help reduce the risk of liver problems.

Yes, diet is an important consideration for Crohn's patients on infliximab. While general food safety is key, your doctor or dietitian may provide specific advice, as dietary needs can change, especially during active disease flares.

Yes, but they must be handled and reheated with care. Leftovers should be cooled rapidly and refrigerated properly. When reheating, ensure they reach a minimum internal temperature of 165°F (74°C) to kill any potential bacteria.