Lab Monitoring While on Biologic Medications

Which tests are required · How often · What your results mean

Key Takeaways

Most biologics require tuberculosis (TB) and hepatitis B screening before starting
JAK inhibitors and IL-6 inhibitors require the most ongoing laboratory monitoring
IL-23 inhibitors and Dupixent require minimal or no routine lab monitoring
BiologicHealthPlus tracks your monitoring schedule and reminds you of due labs at each refill

Pre-Treatment Screening (Required Before Starting)

🔬 TB Screening

Required before starting most biologics. Usually a tuberculin skin test (TST/PPD) or QuantiFERON-Gold blood test. Latent TB must be treated before starting immunosuppressive therapy.

🩸 Hepatitis B

Hepatitis B surface antigen (HBsAg) and antibody testing required before most biologics. Reactivation of chronic hepatitis B can occur with immunosuppression.

📊 Baseline CBC

Complete blood count (CBC) establishes a baseline for white blood cell counts, platelets, and hemoglobin — particularly important for JAK inhibitors and TNF inhibitors.

🧪 Liver Function

Baseline liver function tests (LFTs) are required for many biologics, especially JAK inhibitors and medications metabolized hepatically.

Ongoing Monitoring by Drug Class

Drug Class	Examples	Key Ongoing Monitoring
JAK Inhibitors	Rinvoq, Xeljanz	CBC, LFTs, lipids at 4–8 weeks then every 3 months; watch for thrombosis
IL-6 Inhibitors	Actemra, Kevzara	ANC and platelets before each dose initially; lipid panel; LFTs
TNF Inhibitors	Humira, Enbrel	Periodic CBC and LFTs; watch for infection signs; no fixed lab schedule
IL-17 Inhibitors	Cosentyx, Bimzelx	No routine lab monitoring required; watch for oral candidiasis (Bimzelx)
IL-23 Inhibitors	Skyrizi, Tremfya	No routine lab monitoring required; minimal ongoing testing
IL-4/IL-13 (Dupixent)	Dupixent	No routine lab monitoring required; ophthalmologic exam if eye symptoms

Your prescribing physician (rheumatologist, gastroenterologist, or dermatologist) is responsible for ordering and reviewing all required monitoring labs. BiologicHealthPlus tracks your monitoring schedule, reminds you when labs are due at each refill, and coordinates with your prescriber's office to confirm labs have been completed before dispensing where required.

Abnormal lab results should be reported to your prescribing physician immediately. Depending on the abnormality, your doctor may temporarily hold, dose-reduce, or discontinue your biologic. For example, JAK inhibitors have specific dose-hold criteria for low neutrophil counts. BiologicHealthPlus pharmacists can help you interpret which results require immediate attention.

Yes. BiologicHealthPlus tracks monitoring requirements for every medication we dispense. We remind you of upcoming lab due dates during our refill outreach calls and follow up with your prescriber's office to confirm labs are current before processing certain fills. This helps prevent gaps in monitoring that could compromise your safety.

💬 Questions About Your Monitoring Schedule?

BiologicHealthPlus clinical pharmacists track your monitoring requirements and can explain exactly what labs you need and when.

Talk to a Pharmacist →

📚 Sources & Further Reading

Content developed with reference to leading health organizations, peer-reviewed research, and FDA prescribing information.

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Lab Monitoring GuidelinesACR

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Drug Approval DatabaseFDA

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Monitoring Biologic TherapyNIH/NCBI

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Therapeutic Drug MonitoringLab Tests Online

Medical Disclaimer: Educational content reviewed by the BiologicHealthPlus Clinical Team. Consult your healthcare provider for personalized advice. Last reviewed: August 2026.

Lab monitoring requirements are based on FDA-approved prescribing information and may be updated. Always follow your prescriber's monitoring schedule. Last updated: July 2026.