When is it time to switch medications?

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I've been on Remicade since 2013, after being diagnosed with Crohn's Disease in 2012. The entire three years I've been on Remicade have been a roller coaster of ups and downs. Half the time it works, half the time it doesn't work. When it does work, it usually only lasts about four weeks out of the eight weeks that it should be working for.

Last year however, from around March to August, Remicade worked amazingly! I had never felt better. I felt healthy and normal. The medicine was working for nearly seven of the eight weeks. I was able to get out of the house, eat more food, and I was so much happier. However, for the last year or so, Remicade has been dismal in it's effects. I've been sick constantly.

My doctor INSISTS that Remicade is working. He keeps saying that my symptoms are being caused by "something else". He says that if Remicade wasn't working, I'd be having constant diarrhea. However, I've always dealt with constipation more so than diarrhea after starting Remicade. So, when the constipation kicks in, that's when I assume Remicade isn't doing it's job so well.

Family and friends have been pressuring me for a while to just switch to Humira. But I'm not ready to just give up on Remicade, mostly due to the chance that I wouldn't be able to go back to it due to antibodies forming if I stop. I'm also not a fan of shots. Besides, deciding to go on Remicade was a big decision in itself, given the side effects and reactions people can have to it. I was terrified. I cried during my first infusion, and I'm not sure I could mentally handle the stress of switching medications now.

My doctor recently upped my dosage to 500 mg from 400 mg. My last infusion felt like it worked quite a bit better, but the effects only lasted for around three weeks.

My questions are: When, if you have changed medicines, did you? What made you decide to move on and try something new? Was it a scary decision? How did it pan out for you? And what advice could you possibly give on that whole process?

Thank you! Hope everyone is doing well!
 
Hi. I had to give up Cimzia because even though it was good it stopped working after a while. I developed an allergy to Remicade. Stelara never helped. Everyone is different on how they respond to medications. I am wondering if you need a second opinion. Keep in touch.
 
I wouldn't switch if it's working. if you try Humira and it doesn't work then you might not be able to go back to Remicade because when you stop taking it you can develop antibodies. Did your doctor order an Anser-IFX test to measure your trough levels right before infusion? You may need a higher dose (10+mg/kg) or a shorter interval between infusions.
 
I would talk to your doctor first. I was diagnosed at the end of 2015. I take Humira. Was taking it every two weeks, now I take it weekly, with another immune suppressant Azathioprine (2 tablets a day). Humira worked wonderfully for about 2 months or so, then it like tampered off and I wasn't getting worse but I wasn't getting better either. I'm actually contemplating switching to Remicade or Entyvio or seeing if I can get in a research thing that's in stage 3 using antibiotics. My condition is moderate so he is pretty much leaving it up to me. Maybe with the discovery of the fungus this past month or so, better treatments will come available quickly. Wish you luck.
 
I would talk to your doctor first. I was diagnosed at the end of 2015. I take Humira. Was taking it every two weeks, now I take it weekly, with another immune suppressant Azathioprine (2 tablets a day). Humira worked wonderfully for about 2 months or so, then it like tampered off and I wasn't getting worse but I wasn't getting better either. I'm actually contemplating switching to Remicade or Entyvio or seeing if I can get in a research thing that's in stage 3 using antibiotics. My condition is moderate so he is pretty much leaving it up to me. Maybe with the discovery of the fungus this past month or so, better treatments will come available quickly. Wish you luck.
Best wishes to you
 
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