Medication Options for Ulcerative Colitis

Medication is the first line of treatment for ulcerative colitis. Your doctor’s recommendation for which medication will work best for you is based on the severity of your disease, your overall health, and other individual factors.

There are six major classes of medication used to treat ulcerative colitis.

 

Aminosalicylates (5-ASA)

Aminosalicylates are medications that contain 5-aminosalicylic acid (5-ASA) and work in the lining of the gastrointestinal tract to decrease inflammation. Aminosalicylates work best in the colon and are often given orally in the form of delayed release tablets, or rectally as enemas or suppositories.

Aminosalicylates are thought to be effective in treating mild-to-moderate ulcerative colitis flares and can be useful as a maintenance treatment in preventing relapses of the disease.

Examples

  • Sulfasalazine

  • Mesalamine

  • Olsalazine

  • Balsalazide

Aminosalicylates

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Aminosalicylates Aminosalicylates are compounds that contain 5-aminosalicylic acid (5-ASA) and reduce inflammation in the lining of the intestine. Watch this video to learn more.

 

Corticosteroids

Corticosteroids suppress the immune system and are used to treat moderate to severely active ulcerative colitis. These drugs work non-specifically, meaning that they suppress the entire immune response, rather than targeting specific parts of the immune system that cause inflammation. These medications are available orally and rectally.

Corticosteroids have significant short and long-term side effects and should not be used as a maintenance medication. Because they cause the adrenal glands to slow or even stop producing the body’s natural cortisol, these medications cannot be stopped abruptly.  

If you cannot come off steroids without suffering a relapse of your symptoms, your doctor may need to prescribe other medications to help manage your disease.

Examples

  • Prednisone

  • Prednisolone

  • Methylprednisolone

  • Budesonide

Corticosteroids for IBD

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Corticosteroids for IBD Corticosteroids are powerful and fast-acting anti-inflammatory drugs that have been frequently used in the treatment of acute flare-ups of IBD. Watch this video to learn more.

 

Immunomodulators

This class of medication controls or suppresses the body’s immune system response so it cannot cause ongoing inflammation. Immunomodulators, which may take several months to begin working, are generally are used when aminosalicylates and corticosteroids haven’t been effective, or have been only partially effective.

These medications may be useful in reducing or eliminating the need for corticosteroids, and in maintaining remission in people who haven’t responded to other medications given for this purpose. Some immunomodulators are used to make other medications, such as biologics, work better.

Examples

  • Azathioprine

  • 6-mercaptopurine

  • Cyclosporine

  • Tacrolimus

Immunomodulators for IBD

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Immunomodulators for IBD Immunomodulators weaken or modulate the activity of the immune system. And are medications often used to treat people with IBD. Watch this video to learn more.

 

Janus Kinase (JAK) Inhibitors

Janus kinase (JAK) inhibitors suppress your immune system by blocking the JAK enzyme and preventing it from activating the specific immune system cells that cause inflammation. These medications, taken orally, are FDA approved to treat moderate-to-severe ulcerative colitis.

Example

Tofacitinib

 

Biologic/Biosimilar Therapies

Biologics are used to treat people with moderate-to-severe ulcerative colitis. Unlike other medications, biologics are protein-based therapies that are created out of material naturally found in life. These medications are antibodies that stop certain proteins in the body from causing inflammation.

Examples

  • Adalimumab

  • Golimumab

  • Infliximab

  • Vedolizumab

Biologics for IBD

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Biologics for IBD Biologics are antibodies grown in the laboratory that stop specific proteins in the body from causing inflammation. Their mechanisms of action are more precisely targeted to the factors responsible for IBD.

Biosimilars are nearly identical copies of other already approved biologic therapies. They have the same effectiveness and safety as the originally approved biological therapy, which is called the originator drug or reference product. Learn about recently approved biosimilars and other medications.

Examples

  • Infliximab-abda

  • Infliximab-dyyb

  • Infliximab-qbtx

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