Crohn Disease (cont.)

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.
  
  
• Sulfasalazine (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.

Antibiotics

• Metronidazole (Flagyl), besides acting as an antibiotic, has immunosuppressive and anti-inflammatory properties.
  
  
• Ciprofloxacin (Cipro)
  
  
• Cephalosporin, ampicillin, tetracycline, sulfonamide, and others

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.

• Prednisone (Deltasone, Orasone, Meticorten)
  
  
• Budesonide (Entocort EC)

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.