Gastroenterology Specialty Medications

Each medication is FDA-approved for its own conditions and age groups, and the gastroenterologist determines which is appropriate.

• Crohn's disease, intravenous: Entyvio, Remicade and its biosimilars Inflectra (infliximab-dyyb), Avsola (infliximab-axxq) and Renflexis (infliximab-abda), Stelara (ustekinumab) and its biosimilar Yesintek (ustekinumab-kfce), Skyrizi (risankizumab-rzaa), Tremfya (guselkumab) and Omvoh (mirikizumab-mrkz). Remicade is also approved for adults whose Crohn's disease has formed draining fistulas.
• Ulcerative colitis, intravenous: Entyvio, Remicade and its biosimilars, Stelara, Skyrizi, Tremfya and Omvoh.
• Crohn's disease and ulcerative colitis, subcutaneous: Humira (adalimumab) for both; Cimzia (certolizumab pegol) for Crohn's disease; Simponi (golimumab) for ulcerative colitis, as injections only, because its intravenous form, Simponi Aria, is not approved for that use; and Zymfentra (infliximab-dyyb), which lets adults continue infliximab under the skin after starting it intravenously. Entyvio, Stelara, Skyrizi, Tremfya and Omvoh also have subcutaneous forms.
• Crohn's disease and ulcerative colitis, by mouth: Rinvoq (upadacitinib) for both and Xeljanz (tofacitinib) for ulcerative colitis, each after TNF blocker treatment as its label specifies; Zeposia (ozanimod) and Velsipity (etrasimod) for ulcerative colitis.
• Irritable bowel syndrome with diarrhea (IBS-D), hepatic encephalopathy and travelers' diarrhea: Xifaxan (rifaximin), an antibiotic that acts in the gut. In hepatic encephalopathy it lowers the chance that overt episodes return; in travelers' diarrhea it is for noninvasive strains of E. coli.
• Exocrine pancreatic insufficiency (EPI): Creon (pancrelipase), a pancreatic enzyme medication.
• Nutrition when the gut cannot be used: parenteral nutrition (TPN and PPN), prescribed in conditions including short bowel syndrome, bowel obstruction, Crohn's disease and ulcerative colitis. See parenteral nutrition (TPN) at home.

Remicade, Humira and Stelara are also approved for some children with Crohn's disease or ulcerative colitis, and Simponi for some children with ulcerative colitis; ages differ by label.

When the gastroenterologist approves home therapy, MedRx Infusion delivers the infusion with its supplies and sends a skilled, trusted and licensed nurse from an accredited nursing agency to administer it, monitoring vital signs and any reaction while it runs. The prescriber can instead have the medication delivered to the office and given there. See biologic infusions at home.

The subcutaneous forms are given by the patient or a caregiver after training, and a nurse can teach the injection technique. Tablets and capsules are shipped to the patient's door. The prescriber determines where each medication is given.

1. The prescriber's office completes the Gastroenterology referral form (PDF), or fills it in online on the Quick Referral page and prints it, then faxes it to (844) 671-2601 with recent clinical notes, laboratory results and tests. Offices can also call (844) 671-2600.
2. The form records the diagnosis with its ICD-10 code, the medications already tried, allergies, height, weight and the date of a negative TB test, and whether the medication is to be given in the patient's home or the prescriber's office.
3. MedRx's intake team verifies benefits and obtains prior authorization when the plan requires it, acting on the authorization the prescriber signs on the form.
4. The medication and its supplies are delivered to the patient's door at no charge. Next-day delivery is available; timing varies by location.
5. A MedRx pharmacist is available 24 hours a day, 7 days a week, for patients and the prescriber's office.

Health plans often require prior authorization for the biologics and oral IBD medications on this page. Sending recent clinical notes, laboratory results and the treatment history with the prescription helps that request move faster, and MedRx's intake team checks coverage before the first delivery.

When out-of-pocket costs are a barrier, MedRx helps patients find and apply for copay assistance, grants and other financial aid. The manufacturers also run support programs, such as EntyvioConnect, J&J withMe (Remicade, Stelara and Tremfya), Skyrizi Complete, Humira Complete, Rinvoq Complete and Zeposia 360 Support; each medication's page names its program.

• Infusions for Crohn's disease and ulcerative colitis: Entyvio, Remicade, Stelara, Skyrizi, Tremfya and Omvoh.
• Injections and tablets for Crohn's disease and ulcerative colitis: Humira, Cimzia, Simponi, Rinvoq, Xeljanz, Zeposia and Velsipity.
• Other digestive conditions: Xifaxan and Creon.
• Nutrition: parenteral nutrition (TPN) at home.

Each has its own page: what it is approved for, how it is given, and how to start. See every medication we fill.