Dr. Elizabeth Squirell · Gastroenterologist · Kingston Health Sciences Centre
Starting a biologic or advanced pill
What happens before and after you start a biologic or advanced pill for IBD. Screening tests, vaccines, how each is given, infections, travel, pregnancy and paying for it.
Key points
- Before you start, you will need blood tests for hepatitis B and C and a TB test. Some pills also need a heart tracing (ECG) or cholesterol test.
- Get any live vaccines (like MMR or chickenpox) at least 4 weeks before you start. You can't have them while on treatment.
- Get other vaccines, like Shingrix and the flu shot, before you start if you can. They are still safe once you are on treatment.
- Call your IBD team if you have a fever or an infection, or are given antibiotics, before your next dose.
- Don't stop or skip doses without talking to your team, even for surgery or travel.
- See a travel clinic early. Some travel vaccines, like yellow fever, are live and not allowed.
- Planning a pregnancy? Tell your team before you try, so your plan is safe for you and the baby.
- Ask about the drug maker's patient support program. Its staff can help with insurance forms, teaching and booking.
Go to emergency or call 911 if you have
- A high fever with shaking chills, or you feel very unwell
- Trouble breathing, or swelling of the face, lips or throat
- Heavy bleeding from your bottom, or you feel faint or dizzy
- Severe belly pain that does not settle
- Vomiting, and you cannot keep fluids down