If Mercaptopurine isn’t working after 8-12 weeks, or if you experience intolerable side effects, discuss alternative therapies with your gastroenterologist. These side effects might include significant bone marrow suppression, severe liver dysfunction, or pancreatitis. Always report any unusual bleeding, bruising, fatigue, jaundice, or abdominal pain immediately.
Alternatives include other thiopurines like azathioprine (if mercaptopurine is poorly tolerated), or biologics such as infliximab, adalimumab, or vedolizumab. Your doctor will consider your specific condition, response to previous treatments, and any potential risks or contraindications when choosing the best alternative.
Biologics target specific parts of the immune system, potentially offering a faster response than thiopurines, but they carry risks of infection and other side effects. Careful monitoring is necessary. Your doctor will discuss these risks and benefits thoroughly.
Another option is corticosteroids, used to induce remission quickly. However, long-term use isn’t recommended due to significant side effects. They should only be considered for short-term management or as a bridge to other therapies.
Surgical options, such as colectomy, might be considered in cases of severe, treatment-resistant ulcerative colitis. This should always be discussed extensively with your physician as it involves removal of all or part of the colon.
