Ulcerative Colitis Treatment-Mayo Clinic
Need-to-Know Side Effects of Ulcerative Colitis Medications
Knowing the potential side effects of your medication and reporting any changes to your doctor is a key part of treating ulcerative colitis.
By Ashley Welch
Medically Reviewed by Justin Laube, MD
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Like most medication, treatments for ulcerative colitis can come with a number of side effects. It's important to know what these side effect are, and how to differentiate them from your UC symptoms, so you can communicate any problems to your doctor and have your treatment plan updated as needed.
Since inflammatory bowel diseases (IBDs), including ulcerative colitis, are individual by nature, experts say it’s important to note that treatments that work for one patient may not work for another.
“That is why it is so critical that patients with these diseases have many different treatment options available to them,” says Laura Wingate, vice president of education, support, and advocacy at the Crohn’s & Colitis Foundation of America (CCFA). “Their healthcare providers will customize treatment to the individual’s needs based on type and severity of the disease.”
Ashwin Ananthakrishnan, MPH, a doctor of gastroenterology who specializes in inflammatory bowel diseases at Massachusetts General Hospital in Boston, says that serious side effects are rare with any of the therapies for ulcerative colitis. But they can occur, and he urges patients to “always report new symptoms to their doctor, particularly if persistent for more than a couple of days, or severe.”
Here's a list of common ulcerative colitis drugs and their side effects:
Anti-inflammatory Drug Side Effects
Anti-inflammatory drugs called aminosalicylates, or compounds that contain 5-aminosalicylic acid (5-ASA), are often the first step in treatment of ulcerative colitis. These drugs interfere with the body's ability to control inflammation. Some of the commonly used drugs, and their side effects, include:
Corticosteroids are powerful, fast acting anti-inflammatory drugs for treatment of acute IBD flare-ups. Still, they're not recommended for long-term use because of problematic side effects, including increased risk of infection, high blood pressure, weight gain, acne, mood swings, insomnia, cataracts, high blood sugar levels, and weakened bones or osteoporosis.
Immune System Suppressors Side Effects
Immune system suppressors weaken the activity of the immune system in order to decrease the inflammatory response. Some of the commonly used drugs, and their side effects, include:
Biologic Therapy Side Effects
A newer type of therapy that is injected into the body, biologics are human-made antibodies (grown in a lab) that stop certain proteins in the body from causing inflammation. A review published in January 2019 in the journal Gut and Livernotes that “the introduction of biologics for the treatment of IBD has changed the treatment paradigm for moderate-to-severe ulcerative colitis.” In the United States, the FDA has approved Remicade (infliximab), Humira (adalimumab), Simponi (golimumab), and Entyvio (vedolizumab) to treat ulcerative colitis.
While the benefits of biologic therapy typically far outweigh the risks in patients living with ulcerative colitis, some side effects to keep in mind include:
- Pain or swelling at the injection site
- Fever or chills
- Hives and other rashes
Biologics may also hinder the body’s ability to fight infections, and have been associated with a small but measurable increased risk of lymphoma. In very rare instances, the use of biologics has been linked to changes in liver function.
In order to keep track of your symptoms and the potential side effects of treatment, you may want to keep a diary, and be sure to report any changes to your doctor.
Finally, Wingate points out that a patient’s therapeutic needs may change over time. “What works now may not work at another stage of one’s disease,” she says. It's crucial for patients to continuously discuss their condition with their gastroenterologist over time, so they can work together to decide which course of therapy is best and balance the benefits and risks of each treatment.
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