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Grand Strand Medical Center
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South Strand Medical Center
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Medications for Inflammatory Bowel Disease

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Medications are prescribed to help control inflammation and other symptoms.

Prescription Medications

Aminosalicylates (5-ASA)

  • Sulfasalazine
  • Mesalamine
  • Balsalazide
  • Olsalazine
  • Rectal administration forms (Rowasa enema, Canasa suppository)

Corticosteroids

  • Prednisone
  • Methylprednisolone
  • Budesonide

Immune Modifiers

  • Azathioprine
  • 6-mercaptopurine
  • Methotrexate

Antibiotics

  • Metronidazole
  • Ampicillin
  • Ciprofloxacin

Biologic Therapy

  • Infliximab
  • Adalimumab
  • Certolizumab pegol

Antidiarrheals

  • Diphenoxylate-atropine
  • Loperamide
  • Codeine
Aminosalicylates

Common names include:

  • Sulfasalazine
  • Mesalamine
  • Balsalazide
  • Olsalazine
  • 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

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:

Immune Modifiers

Common names include:

  • Azathioprine
  • 6- mercaptopurine
  • Methotrexate

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
Antibiotics

Common names include:

  • Metronidazole
  • Ampicillin
  • Ciprofloxacin

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 names include:

  • Infliximab
  • Adalimumab
  • Certolizumab pegol

These drugs have been approved to treat Crohn’s disease that does not respond to other treatments. This medication is a TNF-inhibitor, a genetically engineered antibody that binds specifically to tumor necrosis factor (TNF) and blocks its activity in the body. Infliximab is infused into a vein at prescribed intervals. Adalimumab and certolizumab can be given at home.

Possible side effects include:

Antidiarrheals

Common names include:

  • Diphenoxylate-atropine
  • Loperamide
  • 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

Special Considerations

When you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.

When to Contact Your Doctor

Contact your doctor if:

  • You develop side effects from your medications
  • Your medications do not bring relief of symptoms
  • You develop:
    • Fever
    • Bleeding
    • Worsening abdominal pain or diarrhea

Revision Information

  • Reviewer: Daus Mahnke, MD
  • Review Date: 09/2015 -
  • Update Date: 09/17/2014 -
  • Crohn's disease in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 17, 2015. Accessed October 1, 2015.

  • IBD. American Gastroenterological Association website. Available at: http://www.gastro.org/patient-care/conditions-diseases/ibd. Accessed October 1, 2015.

  • Types of medications. Crohn's & Colitis Foundation of America website. Available at: http://www.ccfa.org/resources/types-of-medications.html. Accessed October 1, 2015.

  • Ulcerative colitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 21, 2015. Accessed October 1, 2015.

  • 12/3/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Zabana Y, Domènech E, Mañosa M, et al. Infliximab safety profile and long-term applicability in inflammatory bowel disease: 9-year experience in clinical practice. Aliment Pharmacol Ther. 2010;31(5):553-600.