Crohn Disease (cont.)
Senthil Nachimuthu, MD, BS
Francisco Talavera, PharmD, PhD
Often these medications are used together in various combinations, although they are also used alone. Like all drugs, these may have side effects that may require changing the dose or stopping the drug altogether.
Aspirin-like anti-inflammatory drugs
- Mesalamine (Asacol,
Rowasa, Canasa) tends to work best in Crohn's disease affecting mainly the
colon and to some extent the small intestine. Oral and rectal suppository
forms are available. Long-term use may delay relapse of the disease.
(Azulfidine) tends to work best in Crohn's disease affecting mainly the
colon. It does not work well in the small intestine. Long-term use
generally does not delay relapse. People on sulfasalazine should take folic acid.
Corticosteroids: These probably work the best of any drugs used to treat Crohn's disease because they exert both anti-inflammatory and immunosuppressant
effects. They can only be taken for short periods because of the many potentially severe side effects.
Immunosuppressants interfere with the development of
immunological responses. They are an alternative treatment for people whose
Crohn's disease has relapsed after steroid therapy.
- Infliximab (Remicade) is a monoclonal antibody that acts against tumor necrosis factor alpha, a natural product of the immune system that promotes
inflammation. Infliximab is used to treat moderately severe-to-severe Crohn's disease that does not get better with other medications. When given as an intravenous infusion,
its effects last for approximately 12 weeks. Repeated doses may be required.
- Azathioprine (Imuran) inhibits the immune response that causes inflammation.
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