Inflammatory Bowel Disease Center Common IBD Medications

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This is a brief summary of some of the medications used for these diseases. You can click on the links for more detailed information about certain medications. Please discuss specific medications with your doctor.

Medication Name

 

Classification

Benefits

Precautions

Budesonide
(Entocort) 

Corticosteroid

Reduces inflammation and relieves diarrhea, rectal bleeding, fever, pain in both forms of IBD. Also relieve "systemic" symptoms like joint pains, skin and eye lesions in some patients.

Fluid retention, facial "mooning", weight gain, acne, hair loss, sleeplessness. More serious side effects may occur. Side effects usually disappear when drug is withdrawn.

Prednisone/
Prednisolone 

Corticosteroid

Reduces inflammation and relieves diarrhea, rectal bleeding, fever, pain in both forms of IBD. Also relieve "systemic" symptoms like joint pains, skin and eye lesions in some patients.

Fluid retention, facial "mooning", weight gain, acne, hair loss, sleeplessness. More serious side effects may occur. Side effects usually disappear when drug is withdrawn.

Mesalamine (Asacol,
Canasa, Rowasa, Pentasa. Colazal,
Lialda,
Apriso) 

Aminosalicylates

Reduces inflammation in mild ulcerative colitis and Crohn's colitis or ileocolitis. In ulcerative colitis, may prevent relapse.

Occasional dizziness, headache, nausea, and vomiting. Take medicatin with food. May cause lowered sperm count, which is reversible when medication is stopped. Increased risk of developing pericarditis, pancreatitis, and exacerbation of colitis.

Sulfasalazine (Azulifidine) 

Aminosalicylates 

Reduces inflammation in mild ulcerative colitis and Crohn's colitis or ileocolitis. In ulcerative colitis, may prevent relapse.

Occasional dizziness, headache, nausea, and vomiting. Take medicatin with food. May cause lowered sperm count, which is reversible when medication is stopped. Increased risk of developing pericarditis, pancreatitis, and exacerbation of colitis. 

Cyclosporine (Neoral, Sandimmune 

Immunosuppressors

In Crohn's disease, may improve symptoms and close fistulas. In both forms of IBD, may permit gradual reduction of steroids. These agents are often used in patients who do not respond to other medications and may take several months to work. 

May cause decrease in white blood cells and platelets. Rare side effects include nausea, fever, rash, pancreatitis, and hepatitis. May slightly increase the risk of lymphoma. Not recommended for pregnant patients. Do not give with grapefruit juice. 

Tacrolimus (Prograf, FK-506) 

Immunosuppressors

In Crohn's disease, may improve symptoms and close fistulas. In both forms of IBD, may permit gradual reduction of steroids. These agents are often used in patients who do not respond to other medications and may take several months to work. 

May cause decrease in white blood cells and platelets. Rare side effects include nausea, fever, rash, pancreatitis, and hepatitis. May slightly increase the risk of lymphoma. Not recommended for pregnant patients. Do not give with grapefruit juice. 

6-mercaptopurine (6-MP)
Azathioprine
(Imuran) 

Immunosuppressors 

In Crohn's disease, may improve symptoms and close fistulas. In both forms of IBD, may permit gradual reduction of steroids. These agents are often used in patients who do not respond to other medications and may take several months to work. 

May cause decrease in white blood cells and platelets. Rare side effects include nausea, fever, rash, pancreatitis, and hepatitis. May slightly increase the risk of lymphoma. Not recommended for pregnant patients. Do not give with grapefruit juice. 

Methotrexate 

Immunosuppressors 

In Crohn's disease, may improve symptoms and close fistulas. In both forms of IBD, may permit gradual reduction of steroids. These agents are often used in patients who do not respond to other medications and may take several months to work. 

Lowering of white blood cells, increased risk of infection, increased risk of hepatitis (liver inflammation). 

Infliximab (Remicade)
Adalimumab
(Humira)
Certolizumab
(Cimzia) 

Biologic 

Reduction of signs and symptoms of Crohn's disease in patients with moderate to severley active disease who have had an inadequate response to conventional therapy; reduction in the number of draining entero-cutaneous fistulas; treatment of refractory ulcerative colitis. 

Use with caution if the patient has a history of Congenital Heart Failure (CHF), history of recurrent infections, or is allergic (infusion reaction to Remicade). Infliximab may increase the risk of contracting tuberculosis. Infliximab may slightly increase the risk of lymphoma. 

Metronidazole (Flagyl, Metric, Prostat) 

Antibiotic 

Prevents infection from bacteria. Begins working after three days. Treats general symptoms of Crohn's disease. Successful in closing perianal fistualas. 

Side effects may include dry mouth, metallic taste, tongue or mouth irritation, upset stomach, dizziness, vomiting, diarrhea, loss of appetite, numbness, and/or dark brown or reddish urine. 

Ranitidine (Zantac) 

Antiulcer/H2 Blocker 

Decreases the amount of acid made in the stomach. It is used to treat stomach ulcers, heartburn, stomach irritation, and gastroesophageal reflux. 

May cause headache, constipation, upset stomach, stomach pain, dizziness, fever, or diarrhea. 


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