Live Well with Ulcerative Colitis - Medications

Medicines usually are the treatment of choice for ulcerative colitis. They control or prevent inflammation in the intestines and help:

  • Relieve symptoms.
  • Promote healing of damaged tissues.
  • Put the disease into remission and keep it from flaring up again.
  • Postpone or prevent the need for surgery.

Medication Choices

The choice of medicine usually depends on the severity of the disease, the part of the colon affected, and whether complications are present.

  • Treatment of mild to moderate ulcerative colitis often begins with aminosalicylates (such as sulfasalazine or mesalamine). Aminosalicylates relieve inflammation in the intestines and help the disease go into remission. They may also keep the disease from becoming active again.
  • Corticosteroids may be added if symptoms continue. Corticosteroids relieve inflammation in the intestines.
  • For severe cases, stronger treatment with medicines that suppress the immune system (such as azathioprine [AZA], 6-mercaptopurine [6-MP], or cyclosporine), biologics (such as infliximab), and intravenous (IV) corticosteroids may be needed.

If you are pregnant or planning to become pregnant, talk to your doctor about which medicines might be okay to use for ulcerative colitis. Sometimes severe ulcerative colitis can harm your baby more than the medicines you are taking to keep it under control. Some medicines, though, should never be taken when you are pregnant. Your doctor can tell you which medicines are okay for you while you are pregnant or breast-feeding.

What To Think About

Aminosalicylates are the most common medicines used to treat ulcerative colitis. Most of the time, these medicines are all a person needs to keep the disease in remission (a period of time with no symptoms). When aminosalicylates do not work, corticosteroids are most often the next medicine tried. Corticosteroids will only be used long enough to stop the inflammation in your colon. After the inflammation goes down, aminosalicylates will most likely be used to keep you in remission.

If aminosalicylates are not strong enough to keep you in remission, or if corticosteroids don't work, your doctor may have you try different medicines. These medicines include immunomodulators, cyclosporine, and infliximab. All of these medicines control the immune response in your body and will reduce the inflammation in your intestine. The inflammation is what causes the symptoms of ulcerative colitis.

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