Doctor Discussion Guide: What to Ask About Switching UC Meds

There’s no known nonsurgical cure for UC, and no medication will completely get rid of the condition. But based on the responses of survey participants with UC, one older study indicated that, if given the choice, 86.4 percent of them would rather try a new medication than have surgery to remove their colon.

A more recent small study showed that of those interviewed, most felt like they did not have a choice when deciding on surgery for UC. The study highlights the need for better communication leading up to the decision.

There are many medications that can help you reach and maintain remission. Before talking with a healthcare professional, you may want to think about what will make a medication right for you.

Ask yourself:

• Am I concerned about any side effects more than others (e.g., infection or weight gain)?
• Am I concerned about the cost of the medication?
• Am I worried about any preexisting conditions (e.g., migraine, heart issues, cancer)?
• Have I given my current medication a chance to work?
• Do I want to get pregnant or breastfeed?
• Am I worried about my — or my partner’s — fertility?
• Am I taking any vitamins and supplements that I should mention?
• Am I prepared to take a medication or combination of medications long term?

With this information in mind, a doctor will then be in a better position to suggest a medication that is right for you.

It’s often hard to know when your medication needs adjusting because there are so many outside factors to consider.

For instance, your medication might be helping you remain in UC remission, but the side effects could be problematic. Or you might’ve had a long period of remission, decided to stop taking your medications, and now need a new prescription due to a flare-up.

If you begin to have more frequent flare-ups or your UC symptoms are getting worse, it’s time to chat with a doctor about other medications that might be a better fit for your needs.

Remember, it’s important to talk with your healthcare team before making any changes to your treatment plan, including medications.

There are many drug therapies to consider when dealing with UC. Most medications fall within the following categories:

• Tofacitinib (Xeljanz): This is a newer option in a class of medications called Janus kinase inhibitors. It works in a unique way to reduce inflammation in people with moderate to severe ulcerative colitis.
• Aminosalicylates: These are anti-inflammatory drugs that are used to treat mild to moderate UC flare-ups. They are seen as the first line of defense for UC.
• Immune system suppressors or immunomodulators: These medications can help reduce inflammation in the body by suppressing the immune system. They are used to treat moderate to severe cases of UC.
• Biologics: These medications work to stop enzymes and proteins that develop naturally in your
  body from causing inflammation. They are used to treat moderate to severe cases of UC.
• Corticosteroids: These medications affect the body’s natural inflammatory process. They’re primarily used for short-term treatment of emergency flare-ups.

In the beginning weeks of taking your new medication, a healthcare professional might recommend that you create a daily medication log or use a health tracker. This will help you keep track of both the benefits and side effects that you’re experiencing from the treatment.

A doctor can also give you tips to help you stay on track with your new medication. These might include:

• Take the medication correctly. This sounds easy, but many people get into the habit of missing medications and taking them at the wrong time.
• Do not increase or decrease a dose without talking with a healthcare professional first.
• Use the same pharmacy to fill your prescription every time. Developing a rapport with your pharmacist helps them stay up to date on your healthcare and medication needs, which can potentially help them catch patterns that you might miss.
• Avoid expired medication.
• Do not take anyone else’s medications, even in a pinch.

Answering your questions is a part of the job for healthcare professionals who treat people with UC.

If you’re concerned about making a switch to a different medication, jot down the list of concerns that you’re most worried about. You can also join helpful online groups that can be a safe space to discuss medications and their effects.

Finally, do your research on UC and gather any questions you may have for a doctor to help prepare you for your next appointment. Support groups can help you connect with others experiencing the same challenges of living with UC.