Medications for Inflammatory Bowel Disease

Aminosalicylate Medications

Common names include:

• Sulfasalazine (Azulfidine)
• Mesalamine (Asacol, Pentasa)
• Balsalazide (Colazal)
• Olsalazine (Dipentum)
• Rectal administration forms (Rowasa enema, Canasa suppository)

Aminosalicylate drugs help control inflammation in the colon. Precisely how they work is unknown. The active ingredient is released after bacteria in the bowel metabolize the drug.

Possible side effects include:

• Nausea and vomiting
• Heartburn
• Diarrhea
• Headache
• Skin rash

Corticosteroids

Common names include:

• Prednisone
• Methylprednisolone
• Budesonide (Entocort EC)

Corticosteroids reduce inflammation by suppressing the immune system. They are ordered for more severe episodes of inflammatory bowel disease. They may be taken by mouth, injected, or given by enema or suppository. Do not suddenly stop taking these medications. Follow your doctor’s instructions for tapering the dose.

Possible side effects include:

• Increased risk of infection
• Weight gain
• High blood pressure
• Mood swings and depression
• Osteoporosis
• Acne

Immune Modifiers

Common names include:

• Azathioprine (Imuran)
• 6-mercaptopurine (Purinethol)
• Methotrexate (Folex)

Immune modifiers block the immune response that helps produce inflammation. These drugs take a long time (months) to work and are usually started with another, more fast-acting drug.

Possible side effects include:

• Bone marrow suppression
• Increased risk of infection
• Nausea and vomiting
• Diarrhea

Antibiotic Medications

Common names include:

• Metronidazole (Flagyl)
• Ampicillin (Amoxil)
• Ciprofloxacin (Cipro)

Antibiotics are given to treat infections. In Crohn's disease and ulcerative colitis, the bowel wall is more susceptible to infection once the lining of the small or large intestine is damaged. Infections are caused when bacteria penetrate the bowel wall. Antibiotics may also be prescribed before bowel surgery. Take antibiotics with food to decrease stomach upset. It is very important that you finish the complete course of therapy. Do not stop taking the antibiotics even if you feel better. Do not drink alcohol while taking antibiotics.

Possible side effects include:

• Upset stomach
• Diarrhea
• Vaginal yeast infections
• Bacterial colitis

Biologic Therapy

Common name: infliximab (Remicade)

Infliximab has been approved to treat Crohn’s disease or ulcerative colitis that does not respond to other treatments. It also may be used to treat open, draining fistulas. Infliximab is a genetically engineered antibody that binds specifically to tumor necrosis factor and blocks its activity in the body. Infliximab is infused into a vein at prescribed intervals.

Possible side effects include:

• Difficulty breathing
• Hives
• Headache

Antidiarrheal Medications

Common names include:

• Diphenoxylate-atropine (Lomotil)
• Loperamide (Imodium)
• Codeine

These drugs are given to manage diarrhea during active episodes of the disease. They slow movement through the intestines. Although loperamide in liquid form is available without a prescription, the prescription-only capsule form is used for the treatment of inflammatory bowel disease.

Possible side effects include:

• Drowsiness
• Constipation