Prior to Initiating Therapy

• Complete initial/baseline bloodwork such as complete blood counts, renal function, liver function.

While on Therapy

• Complete yearly Renal (kidney) function test often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP).
• Complete yearly urinalysis.

Prior to Initiating Therapy

• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)].

While on Therapy

• Complete routine bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)] every 3-6 months.
• Complete yearly urinalysis.
• Take daily folic acid supplements (1mg /day and up 2 mg/day if pregnant).

NOTE: More frequent lab monitoring may be necessary during first few months of therapy.

Prior to Initiating Therapy

• Complete Tuberculosis (TB) screening prior to initiating medication (e.g., QuantiFERON-TB Gold or PPD. If high risk or indeterminate results from QuantiFERON-TB Gold or PPD: Chest X-ray).
• Check Hepatitis B Immunity Status (preferably before starting therapy but can be done after starting therapy) and re/vaccinate if not immune.
• Avoid live vaccines within 4 weeks of starting therapy and during therapy
• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)].

While on Therapy

• Complete annual TB risk assessment and screening if meeting criteria for high risk.
• Avoid live vaccines.
• Complete routine bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)] every 3-6 months.
• Consider requesting a lab order to measure drug concentrations to ensure there is a therapeutic amount in your system, especially when you are symptomatic. (This can be considered shorty after starting therapy).
• Traveling Soon? You may be considered high-risk for TB if you are traveling to certain countries. Check if your destination is high-risk for TB here: https://wwwnc.cdc.gov/travel/destinations/list

Prior to Initiating Therapy

• Enroll in TOUCH program.
• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)].

While on Therapy

• Complete routine bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)] every 3-6 months.

Prior to Initiating Therapy

• Complete Tuberculosis (TB) screening prior to initiating medication (e.g., QuantiFERON-TB Gold or PPD. If high risk or indeterminate results from QuantiFERON-TB Gold or PPD: Chest X-ray).
• Avoid live vaccines within 4 weeks of starting therapy.
• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)].

While on Therapy

• Complete annual TB risk assessment and screening if meeting criteria for high risk.
• Avoid live vaccines.
• Complete routine bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)] every 3-6 months. For Skyrizi, liver function monitoring is recommended within the first 3 months of initiating therapy, and up to 6 months for Omvoh.
• Consider requesting a lab order to measure drug concentrations to ensure there is a therapeutic amount in your system, especially when you are symptomatic.
• Traveling Soon? You may be considered high-risk for TB if you are traveling to certain countries. Check if your destination is high-risk for TB here: https://wwwnc.cdc.gov/travel/destinations/list

Prior to Initiating Therapy

• Optional: Patients at high risk for tuberculosis (TB) may be screened for TB, at discretion of the provider.
• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)].
• Avoid live vaccines within 4 weeks of starting therapy.

While on Therapy

• Avoid live vaccines.
• Complete routine bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)] every 3-6 months.
• Consider requesting a lab order to measure drug concentrations to ensure there is a therapeutic amount in your system, especially when you are symptomatic.

Consider an ophthalmology exam to monitor for ocular side effects.

Inform your GI provider of all courses of steroids so a bone density exam* may be recommended, as necessary.

Generally, a bone density exam may be considered if you have used oral corticosteroids lasting > 3 months, or if you have used oral corticosteroids lasting 1 year within the past 2 years.
Women 65 or older should receive a bone density for preventative screening every 2 years regardless of steroid exposure.

Consider an ophthalmology exam to monitor for ocular side effects.

Inform your GI provider of all courses of steroids so a bone density exam* may be recommended, as necessary.

Generally, a bone density exam may be considered if you have used oral corticosteroids lasting > 3 months, or if you have used oral corticosteroids lasting 1 year within the past 2 years.

Women 65 or older should receive a bone density for preventative screening every 2 years regardless of steroid exposure.

Prior to Initiating Therapy

• Review all medications, including herbal supplements, with provider.
• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function, potassium levels [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)], cholesterol, and magnesium levels.

While on Therapy

• Avoid grapefruit juice.
• Complete routine monitoring of drug concentrations and bloodwork such as complete blood count, renal function, liver function, potassium levels [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)], cholesterol and magnesium levels every 3-6 months.
• Ensure consistency of taking medication, either always with food or always without food.

NOTE: Bloodwork should be monitored more often in the first 3 months of therapy and should be discussed with your provider.

Prior to Initiating Therapy

• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)].

While on Therapy

• Complete routine bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)] every 3-6 months.
• Take daily folic acid supplements (1 mg/day).

NOTE: Bloodwork should be monitored more often in the first 3 months of therapy and should be discussed with your provider.

Considering Pregnancy? It is recommended to stop this therapy 3-6 months prior to getting pregnant. Please include your GI provider in discussions when family-planning so they can support you in having a healthy pregnancy while keeping your IBD under control.

Prior to Initiating Therapy

• Review all medications, including herbal supplements, with provider.
• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function, potassium levels [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)], cholesterol, and magnesium levels.

While on Therapy

• Avoid grapefruit juice.
• Ensure consistency of taking medication, either always with food or always without food.
• Complete routine monitoring of drug concentrations and bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)], cholesterol, and magnesium levels every 3-6 months.

NOTE: Bloodwork should be monitored more often in the first 3 months of therapy and should be discussed with your provider

Prior to Initiating Therapy

• Complete Thiopurine methyltransferase (TPMT) enzyme blood test to ensure a safe start to the medication. Results can impact starting dose.
• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)].

While on Therapy

• Complete routine bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)] every 3-6 months.
• Consider requesting a lab order to measure drug concentrations to ensure there is a therapeutic amount in your system (Thiopurine Metabolites).

NOTE: White blood cell counts should be monitored more often in the first 3 months of therapy.

Prior to Initiating Therapy

• Complete Tuberculosis (TB) screening prior to initiating medication (e.g., QuantiFERON-TB Gold or PPD. If high risk or indeterminate results from QuantiFERON-TB Gold or PPD: Chest X-ray).
• Avoid live vaccines within 4 weeks of starting therapy and during therapy.
• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)].
• Consider the Inactive Herpes Zoster vaccine (Shingrix) especially if you are above the age of 50. Please discuss with your GI provider and primary care provider.

While on Therapy

• Complete a Fasting Lipid Profile, recommended 4-8 weeks after starting therapy.
• Complete annual TB risk assessment and screening if you meet criteria for high risk.
• Complete routine bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)] every 3-6 months.

NOTE: Bloodwork should be monitored more often in the first 3 months of therapy and should be discussed with your provider.
Traveling Soon? You may be considered high-risk for TB if you are traveling to certain countries. Check if your destination is high-risk for TB here: https://wwwnc.cdc.gov/travel/destinations/list.Considering Pregnancy? Your GI provider may need to adjust your IBD care plan, so please include your GI provider in discussions when family-planning.

Prior to Initiating Therapy

• Complete an Electrocardiogram (EKG) to screen for preexisting heart rhythm abnormalities.
• Complete blood pressure monitoring
• Review all your medications with your provider to ensure they don’t impact your heart rate.
• Visit an ophthalmologist prior to or near the start of treatment especially if you have diabetes or if you are diagnosed with inflammation or swelling inside your eye.
• Complete initial/baseline bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)].
• Consider the Inactive Herpes Zoster vaccine (Shingrix), especially if above the age of 50. Please discuss with your GI provider and primary care provider.
• Skin checks are recommended prior to or near the start of treatment.

While on Therapy

• Complete routine bloodwork such as complete blood count, renal function, liver function [often part of a Basic or Comprehensive Metabolic Panel (BMP/CMP)] every 3-6 months.
• Skin and eye examinations are recommended periodically while on therapy.

NOTE: Bloodwork should be monitored more often in the first 3 months of therapy and should be discussed with your provider.
Considering Pregnancy? It is recommended to stop this therapy 3-6 months prior to getting pregnant. Please include your GI provider in discussions when family-planning so they can support you in having a healthy pregnancy while keeping your IBD under control.