Medications for Crohn’s Disease continued...
About half the time, these drugs can cause a recurrence of symptoms when a person stops taking them. For this reason, they are given at the lowest dosage for the shortest amount of time.
There is a newer type of corticosteroid that targets just the intestine rather than the entire body. This drug has fewer side effects and is being used to treat people with mild to moderate Crohn’s.
- How given: Orally by mouth, as an IV, or rectally as enemas or suppositories.
- How they work: by interfering with the body’s ability to start and maintain inflammation. They also help suppress the immune system.
- Possible side effects: high blood pressure, high blood sugar, weight gain, acne, mood swings, insomnia, increased risk of infection, facial hair, weakened bones (osteoporosis), dizziness, depression, anxiety, psychiatric symptoms (psychosis, or losing touch with reality), bulging eyes, rounded face, upset stomach.
Immunomodulators, drugs that suppress the immune system, are usedfor people with moderate to severe Crohn’s disease who:
- Have not responded to treatment with aminosalicylates or corticosteroids
- Often need treatment with corticosteroids and/or who cannot come off corticosteroids without developing a flare-up of symptoms
- Have side effects from corticosteroids
Immunomodulators are often used with corticosteroids to help improve the body’s response to medication during a flare-up of the disease. They help reduce dependency on corticosteroids. They also help maintain remission. Immunomodulators can take as long as three months to work or longer.
- How given: most often by mouth, but they can also be used topically or by injection.
- How they work: these medicines modify the body’s immune system response to help prevent ongoing inflammation.
- Possible side effects: nausea, vomiting, diarrhea, loss of appetite, mouth sores, headache, rash, fever, back or joint pain, increased risk of infection, acne, drowsiness, insomnia, burning or tingling of hands or feet, itching, stomach pain, dizziness, and increased facial hair growth.
Biologics are the newest class of therapies used to treat people with moderate to severe Crohn’s disease. They are used in people who have not responded to treatment with aminosalicylates, antibiotics, corticosteroids, or immunomodulators.
- How given: injection under the skin or by an IV
- How they work: These therapies are engineered to target specific proteins involved in inflammation. Because they don’t affect the entire immune system, they tend to have fewer side effects. However, certain side effects can be serious.
Possible side effects: Redness, swelling, itching, pain, rash, or bruising at the injection site. Other side effects include upper respiratory or sinus infections, headache, nausea, urinary tract infections, depression, tiredness, diarrhea, stomach pain, joint pain, sore throat, back pain, and weight gain. More serious side effects include an increased risk of serious infections and lymphoma, cancer of the lymphatic system. Other serious side effects include heart failure, serious allergic reactions, a lupus-like syndrome, blood disorders, and a nerve condition that causes weakness and numbness.
