From the Guidelines
Blood tests should be done weekly for the first 4 weeks when taking Nustendi, followed by regular monitoring reducing to a minimum of once every 3 months for the duration of therapy, including full blood count (FBC) and liver function tests (LFTs) 1. This is because Nustendi, like azathioprine, requires monitoring for toxicity, and the British National Formulary recommends weekly FBCs for the first 4 weeks, followed by reduced frequency of monitoring.
- The monitoring should include:
- Full blood count (FBC) to check for signs of infection, bruising, or bleeding
- Liver function tests (LFTs) to check for hepatotoxicity
- Patients with hepatic or renal impairment, or those taking higher dosages, may require more frequent monitoring, such as weekly blood tests until the maintenance dose is achieved 1.
- It is also important for patients to report any signs of infection, unexpected bruising or bleeding, or jaundice, and for doctors to consider acute pancreatitis in patients with acute abdominal pain and/or severe vomiting, and measure serum amylase levels if necessary 1.
- More recent studies, such as the 2022 American College of Rheumatology guideline, recommend monitoring via CBC counts, LFTs, and renal function tests within the first 1-2 months of usage and every 3-4 months thereafter for methotrexate, which may be relevant for Nustendi treatment 1. However, the most recent and highest quality study specifically relevant to Nustendi is not available, so the 2004 guidelines for prescribing azathioprine in dermatology are used as a reference 1.
From the FDA Drug Label
In patients without advanced chronic kidney disease who are predisposed to hypocalcemia and disturbances of mineral metabolism (e. g. history of hypoparathyroidism, thyroid surgery, parathyroid surgery, malabsorption syndromes, excision of small intestine, treatment with other calcium-lowering drugs), assess serum calcium and mineral levels (phosphorus and magnesium) 10 to14 days after Prolia injection Monitor serum calcium weekly for the first month after Prolia administration and monthly thereafter
Blood Test Timing:
- For patients without advanced chronic kidney disease, blood tests to assess serum calcium and mineral levels should be done 10 to 14 days after Nustendi injection.
- For patients with advanced chronic kidney disease, weekly blood tests are recommended for the first month after Nustendi administration, and monthly thereafter 2.
From the Research
Blood Tests While Taking Nustendi
There is no direct information available on when to do blood tests while taking Nustendi. However, we can look at the general guidelines for blood tests and their importance in monitoring health conditions.
Importance of Blood Tests
- Blood tests are useful in screening for serious disorders and monitoring health conditions 3.
- They can help diagnose and manage conditions such as chronic kidney disease (CKD) 4, 5, 6.
- Blood tests can also help monitor the progression of CKD and detect any potential complications 6.
Monitoring Health Conditions
- Regular blood tests can help monitor kidney function and detect any changes or abnormalities 4, 5, 6.
- They can also help monitor liver function and detect any potential liver damage 7.
- Blood tests can help identify potential risk factors for CKD, such as high blood pressure and diabetes 5, 6.
When to Do Blood Tests
- The frequency of blood tests depends on the individual's health condition and medical history 6.
- Blood tests may be done regularly to monitor kidney function and detect any changes or abnormalities 4, 5, 6.
- They may also be done to monitor the effectiveness of treatment and adjust the treatment plan as needed 5, 6.