How is immune suppressant medication monitored?
This varies with the individual medication. Some medicines require you to have regular blood tests. These monitor your blood cells (white cells, red cells and platelets), and check that numbers aren't getting too low. There may also be blood tests to check the medication isn't affecting your liver or kidney function. For other immune-suppressing medication, you may have a regular blood test to see how well it is working. For example, if you take steroids for polymyalgia rheumatica (PMR), a blood test is done to check the levels of inflammation in your body. As these levels come down, the dose may be gradually reduced. If the blood tests show the disease is active again, you may need to increase the dose. Similar blood tests are done for monitoring of some of the medicines used to treat rheumatoid arthritis.
It may also vary over time. For example, for some medicines, such as methotrexate, you will originally need frequent blood tests every one or two weeks, whereas once you have been on them for a while, if things seem to be stable, this will drop to every three months.
Ask your GP or specialist about the monitoring requirements of your medication.
Are there any other tests?
Other tests may be needed for the condition for which you are having treatment. In some cancers, for example, bone marrow biopsy might be needed to monitor what is happening. In HIV and AIDS, specific blood tests on immune function may be used to monitor what is happening.
Your specialist may also monitor you for any changes in your skin, as immune suppression can make you more susceptible to skin cancers.
Other tests and monitoring requirements will depend on the specific medication. For example, if you take oral steroids, your weight and blood pressure may be monitored, as weight gain and high blood pressure can be side-effects of this type of medication. On steroids, your bone density will also be monitored, as they can cause 'thinning' of the bones (osteoporosis), and your eyes will be monitored for cataracts.
Further reading and references
Immunisation against infectious disease - the Green Book (latest edition); Public Health England
Immunosuppression; Travel Health Pro Fact Sheet
Splenectomy; Public Health England, January 2015
Wilsdon TD, Hill CL; Managing the drug treatment of rheumatoid arthritis. Aust Prescr. 2017 Apr40(2):51-58. doi: 10.18773/austprescr.2017.012. Epub 2017 Apr 3.
Yu SH, Bordeaux JS, Baron ED; The immune system and skin cancer. Adv Exp Med Biol. 2014810:182-91.
Skin cancer in transplant recipients; DermNet NZ
Renal transplantation - immunosuppressive regimens for children and adolescents; NICE Technology Appraisal Guidance (2006)
Moini M, Schilsky ML, Tichy EM; Review on immunosuppression in liver transplantation. World J Hepatol. 2015 Jun 87(10):1355-68. doi: 10.4254/wjh.v7.i10.1355.
Has anybody else got this condition that is willing to discuss their treatment and how they are coping with this disease?I have been living with AIH for 14 years, first diagnosed when i was 14 years...cathy67411
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