Medications That Reduce Bowel Inflammation Caused by Ulcerative Colitis
Medication | Some Side Effects | Comments |
|---|---|---|
Aminosalicylates | ||
| Common: Nausea, headache, dizziness, fatigue, fever, rash, and, in men, reversible infertility Uncommon: Inflammation of the liver (hepatitis), pancreas (pancreatitis), or lung (pneumonitis) and hemolytic anemia | Abdominal pain, dizziness, and fatigue are related to dose. Hepatitis and pancreatitis are unrelated to dose. |
| Common: Fever and rash Uncommon: Pancreatitis, inflammation of the pericardium (pericarditis), and pneumonitis For olsalazine: Watery diarrheaFor olsalazine: Watery diarrhea | Most side effects seen with sulfasalazine may occur with any of the other aminosalicylates but much less frequently.Most side effects seen with sulfasalazine may occur with any of the other aminosalicylates but much less frequently. |
Corticosteroids | ||
Prednisone Prednisone | Diabetes mellitus, high blood pressure, cataracts, osteoporosis (decreased bone density), thinning of skin, mental problems, acute psychosis, mood swings, infections, acne, excessive body hair (hirsutism), menstrual irregularities, gastritis, and peptic ulcer disease | Diabetes and high blood pressure are more likely to occur in people who have other risk factors. |
Budesonide Budesonide | Diabetes mellitus, high blood pressure, cataracts, and osteoporosis | Budesonide causes the same side effects as prednisone but to a lesser degree. Budesonide causes the same side effects as prednisone but to a lesser degree. |
Hydrocortisone (enema or foam)Hydrocortisone (enema or foam) | Some of the medication is absorbed by the body, but even with long-term use, few people have serious side effects (unlike with corticosteroids such as prednisone).Some of the medication is absorbed by the body, but even with long-term use, few people have serious side effects (unlike with corticosteroids such as prednisone). | Hydrocortisone enema or foam is mainly for ulcerative colitis affecting the rectum or large intestine near the rectum.Hydrocortisone enema or foam is mainly for ulcerative colitis affecting the rectum or large intestine near the rectum. |
Immunomodulators | ||
| Anorexia, nausea, vomiting, general feeling of illness, infection, cancer, allergic reactions, pancreatitis, low white blood cell count, bone marrow suppression, and liver dysfunction | Side effects that are usually dose dependent include bone marrow suppression and liver dysfunction. Interval blood monitoring is required. |
Cyclosporine Cyclosporine | High blood pressure, nausea, vomiting, diarrhea, kidney failure, tremors, infections, seizures, neuropathy, and development of lymphomas (cancers of the lymphatic system) | Side effects become more likely with long-term use. |
TacrolimusTacrolimus | Similar to cyclosporineSimilar to cyclosporine | This medication is closely related to cyclosporine and shares a number of its side effects.This medication is closely related to cyclosporine and shares a number of its side effects. |
Biologic and related agents | ||
Infliximab Infliximab | Infusion reactions, infections, cancer, abdominal pain, liver dysfunction, and low white blood cell count | Infusion reactions are potentially immediate side effects that occur during the infusion (such as fever, chills, nausea, headache, itching, rash, hives, decreased blood pressure, or difficulty breathing). People should be screened for tuberculosis and hepatitis B before initiating treatment. |
Adalimumab Adalimumab | Pain or itching at the injection site (hypersensitivity reactions), headache, infections, and cancer | Side effects are similar to those of infliximab except adalimumab is given under the skin (subcutaneously) and so does not cause infusion reactions.Side effects are similar to those of infliximab except adalimumab is given under the skin (subcutaneously) and so does not cause infusion reactions. Other hypersensitivity reactions that occur at the injection site include rash and hives. More severe hypersensitivity reactions are possible. |
GolimumabGolimumab | When given subcutaneously, pain or itching at the injection site (hypersensitivity reactions), infections, and cancer | Side effects are similar to those of infliximab. Side effects are similar to those of infliximab. When given subcutaneously, this medication does not cause infusion reactions. Other hypersensitivity reactions that occur at the injection site include rash and hives. More severe hypersensitivity reactions are possible. |
VedolizumabVedolizumab | Infections, hypersensitivity reactions, common colds | Very rare risk of progressive multifocal leukoencephalopathy (PML). |
UstekinumabUstekinumab | Injection site reactions (pain, redness, swelling), cold-like symptoms, chills, headache, tired feeling, diarrhea, lower back pain, painful urination, or rash or itching | This medication might increase the risk of cancer. Squamous cell carcinoma, a type of skin cancer, may occur. A disorder that causes the brain to swell (reversible posterior leukoencephalopathy syndrome) may occur. |
Small-molecule agents | ||
OzanimodOzanimod | Upper respiratory tract infections, headache, liver inflammation | People should be screened for tuberculosis before starting treatment. This medication should not be taken by people who take a monoamine oxidase inhibitor (MAOI—such as selegiline, phenelzine, and linezolid).This medication should not be taken by people who take a monoamine oxidase inhibitor (MAOI—such as selegiline, phenelzine, and linezolid). |
TofacitinibTofacitinib | Increased risk of elevated cholesterol levels, headache, herpes zoster (shingles) infection, and other infections Other rare side effects include increased risk of blood clot, heart attack, and stroke. | People should be screened for tuberculosis before and during treatment. |
UpadacitinibUpadacitinib | Increased risk of elevated cholesterol levels, headache, herpes zoster (shingles) infection, and other infections Other rare side effects include increased risk of blood clot, heart attack, and stroke. | People should be screened for tuberculosis before and during treatment. |