Digestive Health Associates

and the Southwest Endoscopy Center

IBD Medication Monitoring


This guideline is intended to be an educational device to provide information that may assist us in providing care to patients. This guideline is not a rule and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions in any particular case involve a complex analysis of the patient’s condition and available courses of action. Therefore, clinical considerations may lead a physician to take a course of action that varies from this guideline.



Aminosalicylates
Sulfasalazine

CBC and CMP
-baseline
-Q2w x 6, then Qm x 3, then Q6m
UA and urinary quantitative microalbumin (morning well-hydrated spot urine specimen)
-baseline
-Qm x 3, then Q3m x 4, then Q6m

Mesalamine and other 5-ASA agents
CBC and CMP
-baseline
-q12m
UA and Urinary quantitative microalbumin (morning well-hydrated urine spot urine specimen)
-baseline
-Qm x 3, then Q3m x 4, then Q6m



Thiopurines and Other Anti-metabolites
6-mercaptopurine and azathioprine
PROMETHEUS® TPMT Enzyme - #3320
-baseline
CBC
-baseline
-q1w x 2, then q2w x 2, then q4w x 2, then q2 m
CMP
-with every other CBC
PROMETHEUS® Thiopurine Metabolites - #3200 Thiopurine metabolite (6-TGN, 6-MMPN) levels
-as directed by attending physician
Dermatologic examination for nonmelanoma skin cancer
-as directed by attending physician

Methotrexate (SC, given weekly at induction dose of 25 mg/w for 3m, then maintenance of 15 mg/w; supplemental oral folate 1 mg/d)
CBC, CMP
-baseline
-monthly
Dermatologic examination for nonmelanoma skin cancer
-as directed by attending physician

Corticosteroids
Budesonide
BP and blood glucose
-quarterly
Ophthalmology examination
-annually
DEXA
-baseline
-annually (if stable after 2 annual evaluations, decrease frequency or suspend)

TNF-inhibitors
Baseline
Chest x-ray PA and lateral
PPD with controls or QuantiFERON TB Gold In Tube
Coccidioides Antibodies, IgG & IgM by ELISA 0050137
Hepatitis B Virus Surface Antibody 0020090
Hepatitis B Virus Surface Antigen with Reflex to Confirmation 0020089

Vaccination history
Annually
Pap smear
Dermatologic examination for nonmelanoma skin cancer
-as directed by attending physician