A Not-So-Daunting Transition to a New Medication

After managing ulcerative colitis with 5-ASA medications for nearly a decade, I recently took a significant step in my treatment plan by starting Zeposia, an oral medication (S1P receptor modulator). So far, so good.

In my final year of medical school, I had more flexibility in my schedule, which allowed me to focus more on my health. I was diligent about working out and maintaining a balanced diet. Despite my best efforts, I began noticing troubling signs of a new flare-up: streaks of blood in my stool.

Challenging timing for a flare

Naturally, I was consumed with questions about what I might have done wrong to reach this point of deteriorating health. However, I found some solace in knowing that I was taking good care of myself at this time. It just became clear that my 5-ASA medications were no longer as effective as they had been. A subsequent colonoscopy confirmed my concerns: a severely inflamed colon. To manage the flare-up, my gastroenterologist prescribed a course of steroids as a temporary measure.

The timing of this flare was particularly challenging. I was preparing to graduate, relocate, and start my residency, which meant my insurance was about to change, and I needed to find a new gastroenterologist. The prospect of starting a new medication during this transitional period made me quite nervous. While steroids provided me with temporary relief, they were never intended to be a long-term solution.

Reviewing options with my doctor

Before moving, I had an in-depth discussion with my gastroenterologist about various treatment options. We thoroughly reviewed all available medications, weighing their pros and cons, especially considering my upcoming job. Frequent visits to an infusion center would have been difficult due to the demanding hours of residency. My gastroenterologist recommended Zeposia, a once-daily pill.

This recommendation, combined with our detailed discussion, made me feel informed and comfortable about my next steps.

Adjusting

At my new gastroenterology appointment, my new specialist and I decided that Zeposia was the best course of action. Starting this medication involved a cautious approach. I began with a 7-day starter pack at a lower dosage to monitor for potential side effects, particularly concerning a slower heart rate. After a week without any issues, I transitioned to the standard dosage. During this time, I continued to take steroids and my 5ASAs while waiting for Zeposia to fully take effect, which can take several weeks.

Transitioning to Zeposia has been a bit of an adjustment, but the once-daily oral pill integrates well into my routine. As I start tapering off steroids and reducing my 5-ASA dosage, it's still too early to fully determine the medication's effectiveness. Though, I am hopeful.

Symptom control

Navigating this transition has been a valuable learning experience. After switching from a medication I took for a decade, I am relieved to find that the sky hasn't fallen. The steroids have temporarily eased my flare-up, and I feel confident in the steps I've taken to ensure the best possible care for my health. The potential for improved symptom control with Zeposia gives me optimism about the future and the ability to manage my condition more effectively.