Table: Drugs That Reduce Bowel Inflammation Caused by Ulcerative Colitis

Drugs That Reduce Bowel Inflammation Caused by Ulcerative Colitis

Drug	Some Side Effects	Comments
Aminosalicylates
Sulfasalazine	Common: Nausea, headache, dizziness, fatigue, fever, rash, and, in men, reversible infertility Uncommon: Inflammation of the liver (hepatitis), pancreas (pancreatitis), or lung (pneumonitis) and hemolytic anemia	Abdominal pain, dizziness, and fatigue are related to dose. Hepatitis and pancreatitis are unrelated to dose.
Balsalazide Mesalamine Olsalazine	Common: Fever and rash Uncommon: Pancreatitis, inflammation of the pericardium (pericarditis), and pneumonitis For olsalazine: Watery diarrhea	Most side effects seen with sulfasalazine may occur with any of the other aminosalicylates but much less frequently.
Corticosteroids
Prednisone	Diabetes mellitus, high blood pressure, cataracts, osteoporosis (decreased bone density), thinning of skin, mental problems, acute psychosis, mood swings, infections, acne, excessive body hair (hirsutism), menstrual irregularities, gastritis, and peptic ulcer disease	Diabetes and high blood pressure are more likely to occur in people who have other risk factors.
Budesonide	Diabetes mellitus, high blood pressure, cataracts, and osteoporosis	Budesonide causes the same side effects as prednisone but to a lesser degree.
Hydrocortisone (enema or foam)	Some of the drug is absorbed by the body, but even with long-term use, few people have serious side effects (unlike with corticosteroids such as prednisone).	Hydrocortisone enema or foam is mainly for ulcerative colitis affecting the rectum or large intestine near the rectum.
Immunomodulators
Azathioprine Mercaptopurine	Anorexia, nausea, vomiting, general feeling of illness, infection, cancer, allergic reactions, pancreatitis, low white blood cell count, bone marrow suppression, and liver dysfunction	Side effects that are usually dose dependent include bone marrow suppression and liver dysfunction. Interval blood monitoring is required.
Cyclosporine	High blood pressure, nausea, vomiting, diarrhea, kidney failure, tremors, infections, seizures, neuropathy, and development of lymphomas (cancers of the lymphatic system)	Side effects become more likely with long-term use.
Tacrolimus	Similar to cyclosporine	This drug is closely related to cyclosporine and shares a number of its side effects.
Biologic and related agents
Infliximab	Infusion reactions, infections, cancer, abdominal pain, liver dysfunction, and low white blood cell count	Infusion reactions are potentially immediate side effects that occur during the infusion (such as fever, chills, nausea, headache, itching, rash, hives, decreased blood pressure, or difficulty breathing). People should be screened for tuberculosis and hepatitis B before initiating treatment.
Adalimumab	Pain or itching at the injection site (hypersensitivity reactions), headache, infections, and cancer	Side effects are similar to infliximab except adalimumab is given under the skin (subcutaneously) and so does not cause infusion reactions. Other hypersensitivity reactions that occur at the injection site include rash and hives. More severe hypersensitivity reactions are possible.
Golimumab	When given subcutaneously, pain or itching at the injection site (hypersensitivity reactions), infections, and cancer	Side effects are similar to infliximab. When given subcutaneously, this drug does not cause infusion reactions. Other hypersensitivity reactions that occur at the injection site include rash and hives. More severe hypersensitivity reactions are possible.
Ozanimod	Upper respiratory tract infections, headache, liver inflammation	This drug should not be taken by people who take a monoamine oxidase inhibitor (MAOI—such as selegiline, phenelzine, and linezolid).
Tofacitinib	Diarrhea, increased cholesterol levels, headache, herpes zoster (shingles) infection, cold-like symptoms, rash, upper respiratory infection, and pulmonary embolism	People should be screened for tuberculosis before starting treatment.
Vedolizumab	Infections, hypersensitivity reactions, common colds	Very rare risk of progressive multifocal leukoencephalopathy Progressive Multifocal Leukoencephalopathy (PML) Progressive multifocal leukoencephalopathy is a rare infection of the brain that is caused by the JC (John Cunningham) virus. People with a weakened immune system are most likely to get the... read more (PML).
Ustekinumab	Injection site reactions (pain, redness, swelling), cold-like symptoms, chills, headache, tired feeling, diarrhea, lower back pain, painful urination, or rash or itching	This drug might increase the risk of cancer. Squamous cell carcinoma, a type of skin cancer, may occur. A disorder that causes the brain to swell (reversible posterior leukoencephalopathy syndrome) may occur.