Ulcerative colitis approved drugs: Types and benefits Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe Ulcerative colitis approved drugs What to knowMedically reviewed by Philip Ngo, PharmD — By Danielle Dresden on September 22, 2022Ulcerative colitis (UC) is a chronic condition with no known cure. However, medications, such as anti-inflammatories and immunosuppressants, can help people achieve and maintain remission or live with minimal or no symptoms. This information comes from the Crohn’s and Colitis Foundation. A note about sex and gender Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. UC is one form of inflammatory bowel disease (IBD), alongside Crohn’s disease. Gastroenterologists can prescribe various medications and treatments according to a person’s disease activity and the severity of their condition. This article reviews the different medications for treating UC. It also describes the five main types of approved drugs for the condition, how they work, and their different uses and precautions. Anti-inflammatory drugs Share on PinterestJeffrey Hamilton/Getty ImagesThese drugs are available in prescription and over-the-counter (OTC) formulations. Aminosalicylates are a type of anti-inflammatory medication. They decrease pathways in the body that create inflammation-causing substances, helping decrease inflammation in the gastrointestinal tract. Doctors frequently prescribe the treatment class known as 5-aminosalicylic acid (5-ASA) for mild to moderate IBD. They may administer these as a suppository or recommend that people take them orally. Examples of aminosalicylates include: Sulfasalazine Medical professionals prescribe this medication to maintain the remission period between acute episodes of UC. Manufacturers sell this drug under the brand name Azulfidine. The Food and Drug Administration (FDA) approves sulfasalazine for UC but not Crohn’s disease. Precautions There are some important considerations a person should be aware of before taking this medication. These include:possible side effects such as nausea and heartburna lower sperm count in malestheir unsuitability for people allergic to sulfa drugsreduced folic acid levels Additionally, people who wish to become pregnant should discuss taking folate supplements with their care providers. Mesalamine Doctors administer this drug in an oral capsule or as a suppository or enema. This drug has approval from the FDA, and people may be able to purchase this drug under the following brand names:Asacol HDPentasaLialdaAprisoDelzicol Precautions Medical professionals will be cautious when prescribing this to individuals with preexisting liver disease or renal impairment to not worsen their condition. Learn more about mesalamine and its costs. Olsalazine Doctors use this medication to help maintain remission and those who have an intolerance to sulfasalazine. This drug’s brand name is Dipentum. Precautions Medical professionals will not prescribe this drug if a person is allergic to medications containing salicylates, such as aspirin or mesalamine. Balsalazide Doctors use this medication to treat mild to moderate active signs of UC in people older than 5 years. Manufacturers sell this medication under the name Colazal. Precautions Medical professionals will avoid prescribing balsalazide if a person is allergic to medications containing salicylates. Experts recommend doctors use this medication with caution in people with a history of kidney disease. Side effects of 5-ASA drugs Most people can take these drugs without the risk of serious adverse effects. Doctors recommend routine kidney function tests to detect 5-ASA-related nephrotoxicity, which refers to a deterioration in kidney function. Other potential side effects of the above drugs include:diarrheaheadachesabdominal discomfortnausea and vomitingloss of appetiterashfever A person should discuss the possible benefits and precautions of each drug with a doctor before starting a course of treatment. Other anti-inflammatories OTC nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve joint pain or fever from UC. Examples of these medications include:aspirinibuprofennaproxen However, people should use them with caution, as there is a potential risk of them causing flares. Contrary to this belief, a 2019 literature review did not reveal a consistent link between NSAIDs and UC flares. However, people with IBD should still consult a doctor before taking this medication to determine possible causes of flares. Additionally, a research paper stated that a low dose of aspirin to help prevent coronary artery disease (CAD) and stroke does not seem to cause flares in people with IBD. Therefore, these individuals may still be able to take low dose aspirin to help prevent CAD. Read on for more about UC flares. Corticosteroids Corticosteroids are a well-established treatment for IBD and provide short-term relief of symptoms. Doctors prescribe these drugs to ease inflammation in the colon or flare-ups of UC. However, 20–30% of people with acute symptoms of IBD will not respond to corticosteroids. Doctors commonly prescribe the following corticosteroids for IBD:Prednisone: Doctors administer this as an oral tablet. Budesonide: People take this orally, and unlike prednisone, this drug clears the liver more quickly, reducing the risk of side effects.Hydrocortisone: When doctors administer these through a suppository, it reduces inflammation of the:anusrectumsigmoid colon Hydrocortisone acetate: People take this by applying a rectal foam that helps deliver medication to the colon and rectum.Methylprednisolone: Doctors deliver this medication through an enema, which takes it higher in the colon, reducing inflammation and lowering the risk of side effects. Side effects of corticosteroids However, people should not use corticosteroids over the long term because they can cause the following side effects:greater susceptibility to infectionweakened bones, or osteoporosisinsomniahigh blood pressurehigh blood sugarmood swingscataractsgrowth of facial hairgrowth issues in childrenweight gaindeveloping a round or moon-shaped face Corticosteroids can also cause short-term side effects, including:upset stomachsleeping issuesbehavioral changes A person should consult a doctor to determine their dosage of corticosteroids to avoid and prevent possible side effects. Immunosuppressants Doctors refer to these drugs as immunosuppressants or immunomodulators. They target IBD inflammation by managing the body’s immune system response. Medical professionals generally prescribe them:when aminosalicylates and corticosteroids have not workedto reduce the use of corticosteroidsto help someone stay in remission longer It can take up to 3 months to see results from immunomodulators. The following are common immunomodulators:methotrexate: oral or injectablecyclosporine: oral or IV injectionazathioprine: off-label oral drug6-mercaptopurine: oral drugtacrolimus: off-label oral and IV options Precautions Doctors will closely monitor people on immunomodulators for side effects, such as issues with bone marrow or irritation of the liver or pancreas. Targeted therapies This class of-approved drugs are specially-formulated antibodies that aim to target proteins that cause inflammation. Doctors also refer to these drugs as biologics. Multiple kinds of medications are available in each category:Anti-tumor necrosis factor agents: This type of biologic blocks a protein that causes inflammation and promotes intestinal healing. Doctors typically administer them by IV on a maintenance schedule of every 8 weeks after an initial dose of three. Examples include:Humira (adalimumab)adalimumab-atto (Amjevita)golimumab (Simponi)Remicade (infliximab)Integrin receptor antagonists: This biologic prevents inflammation by keeping the cells that cause it from getting into tissues. Doctors primarily use it in people who have not responded well to other treatments. Examples include Tysabri (natalizumab) and Entyvio (vedolizumab).Interleukin-12 and -23 antagonist: This type of biologic targets specific proteins that are key factors in inflammation. An example includes Stelara (ustekinumab). Side effects of biologics Potential side effects from biologics include:a higher risk of infection because of how biologics affect the immune systempain or itching at the injection siteallergic reactionsheadachefeverchillsrasha potential for a higher risk of lymphomaa potential for liver problemsskin problemsjoint pain People can consult a doctor to discuss possible side effects and risks of these medications before starting treatment. Learn more about biologics for ulcerative colitis. Janus kinase JAK inhibitors Experts have recently developed a new treatment for UC using JAK inhibitors. This therapy involves small molecule compounds that break down in the gastrointestinal tract. Once the body breaks them down, the bloodstream absorbs the molecules through the intestines and targets the immune system to reduce the response that triggers UC. Additionally, JAK inhibitors can help treat:rheumatoid arthritispsoriatic arthritisankylosing spondylitis There are several different types of this therapy, including: Xeljanz Xeljanz (tofacitinib), an oral medication similar to Zeposia, is a small molecule drug that works by blocking enzymes that play a role in inflammation. The Food and Drug Administration (FDA) approved this drug in UC in 2018. However, the agency recognizes that this medication may increase a person’s risk of infection and cardiovascular problems. Therefore, healthcare professionalswill consider the benefits and risks for an individual before starting or continuing therapy. In 2019, the FDA also approved upadacitinib (Rinvoq). This medication can treat chronic and progressive inflammatory conditions such as UC. Zeposia Zeposia is a brand name for ozanimod. Doctors prescribe this drug to help people with moderate to severe UC who have not responded well to other treatments. In clinical studies from 2022, people were generally able to take Zeposia with limited side effects. Data showed taking ozanimod significantly improved rates of clinical remission. Additionally, early studies showed that even with long-term use, ozanimod did not seem to produce many side effects. However, more research needs to determine its effectiveness across further trials and larger samples. Side effects of molecular therapy Other potential side effects include:upper respiratory tract infectionsheadachediarrheashinglesblood clotshigh cholesterolreactivated infections, such as hepatitis B and C Doctors will monitor cholesterol levels and screen for reactivated infections. People can discuss other possible adverse effects with a healthcare professional to determine the benefits and risk factors. Summary Doctors cannot cure UC, but treatment can help a person achieve remission and prevent flares of symptoms. Many medications can treat UC, such as anti-inflammatories, immunosuppressants, biologics, and molecular therapy. However, they all have limitations as they can cause side effects, which may make them unsuitable for long-term use. People with UC can work with their gastroenterologist to find the most suitable treatment. Last medically reviewed on September 22, 2022Ulcerative ColitisMedically reviewed by Philip Ngo, PharmD — By Danielle Dresden on September 22, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageManaging an ulcerative colitis flareMedically reviewed by Saurabh Sethi, M.D., MPH Ulcerative colitis is a chronic bowel disease with symptoms that flare up and die down. Here, learn how to manage and prevent these flares.READ MORERisks of leaving ulcerative colitis untreatedMedically reviewed by Cynthia Taylor Chavoustie, MPAS, PA-C Ulcerative colitis is an inflammatory bowel disease that can vary in severity. If people leave it untreated, symptoms can gradually get worse and may…READ MORENatural remedies for managing ulcerative colitisMedically reviewed by Saurabh Sethi, M.D., MPH Some natural remedies, including probiotics, dietary changes, and lifestyle practices, may relieve the symptoms of ulcerative colitis. Read on to…READ MOREUlcerative colitis and fever: What to knowMedically reviewed by Saurabh Sethi, M.D., MPH Fever is the body’s inflammatory response, so it may be a symptom of ulcerative colitis (UC). However, various UC complications can also produce a…READ MOREInflectra dosage Inflectra is used to treat certain autoimmune conditions. Find out what the recommended dosages are, how the drug is administered, and more.READ MORE