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My Daughter Has Crohns Disease And She Recently Started Stelara

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Posted on Fri, 7 Dec 2018
Question: My daughter has crohns disease and she recently started stelara in September. Her family doctor put her on fluoxetine about a month ago and all of the sudden she has been vomiting not sure why. She doesnt feel sick to her stomach everything just comes right up and then goes back to eating and drinking when she is done.
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Answered by Dr. Ramesh Kumar (41 minutes later)
Brief Answer:
Adding an anti emetic for few days would help.

Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice,
Firstly i am sorry to hear about her problem.
Persistent nausea and vomiting are one of the most common side effect encounterrd by using Ustekinumab.Secondly fluoxetine being a SSRI acts as a add on on this gut irritation.SSRI's are harsh on gut with nausea and gut upset as a common side effect.
Initially when she was just on ustekinumab gut was able to tolerate it but on adding a SSRI things got worse.
However i don't think its any thing serious.Just add a anti emetic prokinetic medication for few days till her body adapts to it.Domperidone 10 mg thrice would be ok but you have to ask your primary to add this as its not over counter.
Till then any over the counter anti emetic could be taken by her 1 hour before taking these medications.

I hope she would be relieved.
Follow ups are welcome.
Thanks!
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2912 Questions

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My Daughter Has Crohns Disease And She Recently Started Stelara

Brief Answer: Adding an anti emetic for few days would help. Detailed Answer: Hello and Welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advice, Firstly i am sorry to hear about her problem. Persistent nausea and vomiting are one of the most common side effect encounterrd by using Ustekinumab.Secondly fluoxetine being a SSRI acts as a add on on this gut irritation.SSRI's are harsh on gut with nausea and gut upset as a common side effect. Initially when she was just on ustekinumab gut was able to tolerate it but on adding a SSRI things got worse. However i don't think its any thing serious.Just add a anti emetic prokinetic medication for few days till her body adapts to it.Domperidone 10 mg thrice would be ok but you have to ask your primary to add this as its not over counter. Till then any over the counter anti emetic could be taken by her 1 hour before taking these medications. I hope she would be relieved. Follow ups are welcome. Thanks!