Side Effects of IBD Medication

Quincy AdamUC Learn

Inflammatory bowel disease (IBD) varies in its intensity from one patient to the next, and symptoms can vary, too.

Because of this, there are many medications on the market which treat the symptoms of IBD. Patients must understand what these drugs can do, not only in order to make informed choices but to monitor the effects the drugs are having on their body and modify treatment if necessary.

  • Anti-inflammatory drugs address the inflammation of the GI tract which is the core of all IBD symptoms. They are typically prescribed during a flare up and are taken only as long as needed to keep inflammation at bay.
    • Corticosteroids – such as prednisone – are commonly used to quickly control certain symptoms of UC and Crohn’s disease. Steroids come in the form of creams/foams (for mild symptoms), pills (for moderate to severe) and also IV (for severe or extensive). Steroids can cause side effects such as weight gain, facial swelling, sweating, insomnia, and more, especially if used for long periods of time. However, they are usually only prescribed and taken until people go into remission – a period with no activity of symptoms.
    • Oral 5-aminosalicylates are prescribed when IBD affects the colon. Sulfasalazine (Azulfidine®) and mesalamine (Pentasa®, Asacol®, Lialda®, Apriso®, Delzicol®) can either be administered orally, via suppositories or enemas, depending on how serious inflammation has become and how directly the medication needs to be administered. Side effects such as nausea, vomiting and loss of appetite, combined with their lessened effectiveness than what was past believed, makes them a less popular class of medication.
  • Antibiotics suppress the immune system and can help heal damage done by IBD inflammation. Flagyl® and Cipro® are the most commonly prescribed, and their side effects can include upset stomach, loss of appetite, diarrhea and vomiting. Cipro® can also cause patients to feel an urgent need to urinate, as well as vaginal itching and/or discharge.
  • Immunosuppressors are used to treat IBD since Crohn’s and ulcerative colitis are autoimmune disorders. These medications subdue or suppress the immune system in order to lessen inflammation. These medications may help patients achieve remission. Because side effects can be serious, these drugs are usually prescribed if anti-inflammatories aren’t working.
    • Azathioprine (Imuran®) and mercaptopurine (6-MP, Purinethol®) are the most commonly prescribed for IBD. Side effects can be serious, as the immune system is less able to fight off infection. So lowered resistance to infection is a real concern, as are liver inflammation, skin cancer and lymphoma. In light of this, patients should maintain frequent follow-ups with their doctor along with having regular blood tests performed.
  • Biologic therapies are reserved for patients who have don’t respond well to other types of medication. These medications may help patients achieve remission. They are intended to target specific cells or molecules in the body, and leave patients open to infection; therefore, they should not be given to a patient who currently has an infection.
    • Infliximab (Remicade®) is administered intravenously every two to eight weeks by a healthcare professional. Stomach upset, headache, back pain and flushing can occur.
    • Adalimumab (Humira®) is administered at home by the patient via an injection under the skin, but can also be given by a medical professional. Common side effects are relatively mild, ranging from injection site irritation to joint pain, soreness, nausea and headache.
    • Certolizumab (Cimzia®) is a medication which can be administered either by a healthcare professional or at home via an injection under the skin. Side effects can include headache, respiratory infections, nausea and injection site reactions.
    • Natalizumab (Tysabri®) is administered via intravenous infusion every four weeks, and has been associated with the rare but serious infection progressive multifocal leukoencephalopathy (PML). More common side effects include fatigue and headache.

Along with medication to relieve symptoms, pain medication may also be prescribed in cases of severe flare-up. Keep in mind that many over-the-counter medications can cause further trouble (such as increased bleeding) and should be used only when consulting a physician. In fact, no medication should be taken without first consulting a doctor.

Even with their side effects, IBD medications are necessary to keep symptoms under control and, hopefully, achieve remission. When used with care, they can greatly add to the quality of life for IBD patients. Be sure to discuss any medications you are taking with your doctor, as well as any side affects you may be experiencing.

Of course, if you are taking any of these medications and are experiencing serious issues, call 911 right away.

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