Side Effects of Ulcerative Colitis Medications

Coping with the side effects of any medication can be a difficult task. We take medicines to feel better, not to deal with other problems that may occur while we are on a schedule of treatment. The best way to manage the side effects of any course of therapy is to have a high-quality relationship with your doctor and to know as much as you can about your disease. Knowledge can be a very powerful tool. Learning about the medications that are available to treat your condition will help you to make more informed decisions in your course of treatment.

Ulcerative Colitis, depending on its severity, can be treated either by surgery or a schedule of medications that are intended to induce remission, periods of time in which the disease is not active or where symptoms are minimal. Surgical treatments are usually reserved for those with severe cases of colitis where other courses of conventional therapy have either failed or are not as effective as expected to be. The drugs that are used to treat colitis are broken down into four standard groups.

• 5-ASA Compounds (aminosalicylic acid):

5-ASA compounds, also known as mesalamine, are anti-inflammatory agents that are meant to decrease inflammation in the colon. These drugs need to be in direct contact with the inflammation in order to be effective. 5-ASA compounds that come in pill form include Asacol, Pentasa, and Colazal. The efficiency of these medications is dose-related. Because they are swallowed they must first pass through the stomach where they are modified and can lose some of their efficacy. Other drugs include Canasa and Rowasa which come in the form of enemas and suppositories.

The most common side effects of 5-ASA compounds include mild headache, abdominal discomfort and stomach cramps, diarrhea, gas, and nausea. These side effects usually subside as the body adjusts to the new medication.

• Corticosteroids:

The most common corticosteroid used in treating ulcerative colitis is prednisone. Corticosteroids, unlike mesalamine, do not need to be in direct contact with the inflamed tissue in order to be useful. Because these drugs are fast-acting a patient will experience their benefits within days of beginning a course of therapy. One of the disadvantages of corticosteroids is their inability to maintain remission. Although a patient will feel relief from their symptoms much more quickly than with other drugs, they are not as valuable in maintaining periods of remission as some of these other medications.

Side effects of corticosteroids depend on the dosage and duration of treatment. Common side effects include water retention in the face, known as "moon face," weight gain and high blood pressure, weakness in the muscles, thinning of the bones (osteoporosis), an increase in body hair, cataracts, depression, and insomnia. Because steroids are not as effective in maintaining remission as other medications they are usually used over shorter periods of time. Most side effects begin to subside nearly immediately once the drugs are discontinued.

• Immunomodulators:

Immunomodulators include drugs such as Imuran (azathioprine), 6-MP (mercaptopurine), Methotrexate, and Purinethol. The goal of these drugs is to alter the immune system by weakening or suppressing its effects. Immunomodulators are usually used as a last resort or when other conventional methods of therapy have not been successful. Because these medications change the way the immune system functions, the body becomes more susceptible to infection and is at a higher risk for developing undesirable side effects.
The side effects of these treatments include inflammation of the liver (hepatitis), inflammation of the pancreas (pancreatitis), and toxicity or suppression of the bone marrow. Once a patient has experienced a side effect such as pancreatitis the medication should be discontinued and should not be used as a course of treatment again. 6-MP has also shown to decrease the sperm count in men and increase the chances of vaginal bleeding and miscarriage in women.

• Biologics:

A biologic drug used to treat moderate to severe cases of ulcerative colitis is Remicade (infliximab). This medication is administered through intravenous (IV) infusion over a period of about three hours. During therapy a a patient's vitals will be monitored approximately every fifteen minutes. The goal of therapy is to reduce inflammation in the lining of the colon.

The most common side effects of this treatment are increased abdominal pain, nausea, vomiting, diarrhea, headache, and generalized weakness. Some effects that may occur shortly after administration include difficulty breathing, rash, fever, and chills. These may be indicative of an allergic reaction and treatment should be discontinued.

Sources:

www.healthopedia.com
www.medicinenet.com
www.webmd.com
www.drugs.com
Crohn's and Colitis Foundation of America