Which Medications Can Treat Ulcerative Colitis?

Medically Reviewed By Jennie Olopaade, PharmD, RPH
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Many medications can treat ulcerative colitis (UC). Five of the main categories of drugs are corticosteroids, aminosalicylates, biologics, immunosuppressive drugs, and targeted synthetic small molecules. These medications help decrease inflammation or suppress the immune system to relieve UC symptoms. Your doctor will choose the proper medication based on your individual health and the severity of your UC.

Read on to learn more about common UC medications and their possible side effects.

Find out about the symptoms and causes of UC.

Corticosteroids

An assortment of pills
Marc Tran/Stocksy United

Corticosteroids, or steroids, can help treat moderate to severe UC. According to the Crohn’s and Colitis Foundation, they work by nonspecifically suppressing the immune system. This means that they affect the entire immune response as opposed to moderating specific parts of the immune system that cause inflammation.

Corticosteroids for UC may come in oral or topical forms. Some examples of common corticosteroids include:

Due to the risk of side effects, doctors may only prescribe corticosteroids for short periods.

Side effects

High doses and long-term use of corticosteroids can cause side effects. According to researchers, up to 90% of people who take corticosteroids for more than 2 months experience adverse effects.

Some potential side effects of corticosteroid use include:

  • adverse effects on bone health
  • adrenal suppression, which impairs the production of cortisol
  • drug-induced diabetes
  • myopathy, or impaired muscle function
  • eye issues, such as glaucoma or cataracts
  • additional gastrointestinal problems, such as gastritis or abdominal distention

People may need to gradually stop taking corticosteroids instead of stopping them all at once.

Aminosalicylates

Aminosalicylates work in the gastrointestinal tract to reduce inflammation. They contain 5-aminosalicylic acid, which interferes with the production of inflammatory agents in the body.

Doctors may prescribe aminosalicylates for people with mild to moderate UC. These medications, which are generally safe and have limited dosage-related side effects, come in oral or topical forms.

Common aminosalicylates include:

  • mesalamine (Lialda, Apriso)
  • sulfasalazine
  • olsalazine
  • balsalazide

Side effects

Some possible side effects of aminosalicylate use include:

Biologics

Biologics contain antibodies that block the activity of certain inflammatory proteins. Doctors may prescribe them for people with moderate to severe UC.

Some common biologics include:

These medications come from biological sources instead of being fully synthetic. Therefore, people taking biologics may require additional monitoring for certain side effects.

Side effects

Potential side effects of biologics use may include:

  • increased risk of infection
  • allergic reactions
  • vision issues
  • nerve issues such as numbness or tingling

Immunosuppressive drugs

If corticosteroids or aminosalicylates are ineffective, doctors may prescribe immunomodulators to treat UC. These medications suppress the immune system to reduce inflammation and may take several months to improve symptoms.

Common examples of immunosuppressive drugs include:

Side effects

Immunosuppressive drugs may cause side effects, including:

  • increased risk of infection
  • headaches
  • nausea or vomiting
  • diarrhea
  • impaired liver or kidney function

Targeted synthetic small molecules

Targeted synthetic small molecules decrease inflammation by affecting specific parts of the immune system. They come in oral form and may be beneficial for people with moderate to severe UC.

Due to their structure, small molecule drugs may diffuse more efficiently in the body. However, as their effects do not last very long, people with UC may need to take them orally 1–2 times per day.

Some common targeted synthetic small molecules include:

Side effects

People taking targeted synthetic small molecule drugs may experience certain side effects, including:

  • increased risk of infection
  • increased cholesterol levels
  • anemia
  • kidney or liver dysfunction

Frequently asked questions

These are several other common questions people may ask about UC medications. Jennie Olopaade, Pharm.D., R.Ph., has reviewed the answers.

What is the best medication for ulcerative colitis?

Your doctor will help determine the best medication to treat your UC based on your individual health and the severity of your condition. Everyone is different, and a class of medications that works for one person may not work for others.

Can medications cure ulcerative colitis?

There is currently no known way to cure UC. However, the National Institute of Diabetes and Digestive and Kidney Diseases states that some people may achieve remission with the right medication or combination of medications.

Are there oral medications for ulcerative colitis?

Some medications, including corticosteroids and aminosalicylates, come in oral forms. Some UC medications can also come in topical formulations.

Summary

Ulcerative colitis may be manageable with certain medications or combinations of medications. These drugs may include corticosteroids, aminosalicylates, biologics, immunosuppressive drugs, and targeted synthetic small molecules.

Some of these medications can help treat UC flare-ups, while others can help people with UC achieve and maintain long-term remission.

Contact your doctor to determine the appropriate medication for you. A doctor can also help you understand possible side effects.

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Medical Reviewer: Jennie Olopaade, PharmD, RPH
Last Review Date: 2022 Sep 8
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