DRUG THERAPY FOR CROHN’S DISEASE
AMINOSALICYLATES are anti-inflammatory drugs used to treat the symptoms of inflammatory bowel diseases including Crohn’s. They are typically used in mild to moderate cases.
Sulfasalazine (Azulfidine®, Azulfidine® EN-tabs®) – an anti-inflammatory drug used to treat the symptoms of ulcerative colitis and Crohn’s Disease including intestinal inflammation, diarrhea, rectal bleeding, and abdominal pain. It is normally taken orally 4 times per day at evenly spaced intervals. Side effects may include diarrhea, headache, nausea, loss of appetite, upset stomach, vomiting, stomach pain, rash, fever,decreased white blood cell count, and temporary male infertility.
Mesalamine (Asacol®HD, Pentasa®, Lialda®, Apriso™, Delzicol™) is an anti-infammatory drug used to treat the symptoms of ulcerative colitis and Crohn’s Disease including intestinal inflammation, diarrhea, rectal bleeding, and abdominal pain. It is taken orally in delayed or extended release tablets or capsules. It may also be administered in enema or suppository forms (Rowasa® or Canasa®). Side effects may include.muscle or joint pain, nausea, vomiting, heartburn, constipation, diarrhea, gas, dry mouth, itching, sweating, acne, abdominal pain and cramps, hair loss, headache, and dizziness, decreased kidney function, and pancreatitis.
Olsalazine (Dipentum®) is an anti-inflammatory drug used to treat the symptoms of ulcerative colitis and Crohn’s Disease including intestinal inflammation, diarrhea, rectal bleeding, and abdominal pain. It is usually taken twice per day in capsule form. Upset stomach, bloating, loss of appetite, blurred vision, Diarrhea, headache, rash, joint pain, fatigue, hair loss (rare), pancreatitis (rare), and pericarditis (rare).
Balsalazide (Colazal™) is an anti-inflammatory drug used to treat the symptoms of ulcerative colitis and Crohn’s Disease including intestinal inflammation, diarrhea, rectal bleeding, and abdominal pain. It is usually taken orally three times per day in capsule form. Side effects may include headache, abdominal pain, upset stomach, loss of appetite, diarrhea, constipation, vomiting, joint pain, insomnia, fatigue, gas, runny nose. muscle or back pain, coughing, and urinary tract infection.
CORTICOSTEROIDS are synthetic drugs which resemble cortisol, a hormone produced by the adrenal gland. The drugs are both anti-inflammatory and immunosuppressant, and are used in the treatment of acute symptoms. Corticosteroids may cause the adrenal glands to slow or stop the production of cortisol and may also stunt growth in children with long-term use.
Prednisone (Deltasone®) is a corticosteroid drug used to treat the symptoms of inflammation and immune response in a wide variety of health conditions. It is used for initial treatment and acute flare-ups in Crohn’s Disease. It is usually taken in tablet or liquid form. Side effects may include headache, dizziness, insomnia, extreme mood swings, bulging eyes, thinning skin, skin rashes or blotches,swollen face, slowed healing of cuts and bruises,increased hair growth, fatigue, sweating, irregular menstruation, decreased libido, and heartburn..muscle twitching, shaking, numbness, burning, or tingling in the face, arms, legs, feet, or hands, upset stomach, vomiting, irregular heartbeat, weight gain, and vision problems.
Methylprednisolone (Medrol®) is a corticosteroid drug used to treat the symptoms of inflammation and immune response in a wide variety of health conditions. It is usually taken in tablet form. Side effects may include headache, dizziness, insomnia, extreme mood swings, skin rashes, thinning skin, swollen face, slowed healing of cuts and bruises, irregular menstruation, depression, anxiety, upset stomach, vomiting, and vision problems.
Hydrocortisone (Cortef® ) is a corticosteroid drug used to treat the symptoms of inflammation and immune response in a wide variety of health conditions. It may be taken as a tablet or an oral suspension. Side effects may include headache, dizziness, insomnia, extreme mood swings, skin rashes, thinning skin, swollen face, slowed healing of cuts and bruises, irregular menstruation, depression, anxiety, upset stomach, vomiting, and vision problems.
Budesonide (Entocort® EC or UCERIS™), Is used to decrease inflammation of the intestinal tract in patients who have Crohn’s disease. The drug targets the ileum,cecum, and ascending colon. It is usually taken once per day in capsule form. Side effects may include headache, dizziness, runny nose, sneezing, coughing, nausea, indigestion, abdominal pain, gas, vomiting, fatigue, back pain, skin rash, fever, and vision problems.
IMMUNOSUPPRESSIVE DRUGS are used to inhibit immune response. They are used in both organ transplantation and the treatment of autoimmune diseases such as rheumatoid arthritis, ulcerative colitis, and Crohn’s.
Azathioprine (Imuran®, Azasan®) is usually taken orally in tablet form once or twice per day. Side effects may include headache, nausea, vomiting, diarrhea, rash, fever, weakness, and muscle pain. According to Medline Plus, a service of the U.S. National Library of Medicine of the National Institutes of Heath (NIH), “Azathioprine may increase your risk of developing certain types of cancer, especially skin cancer and lymphoma (cancer that begins in the cells that fight infection).” http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682167.html
6-mercaptopurine (6-MP, Purinethol®), is a purine antagonist. It is used to fight acute lymphocytic leukemia by stopping cancer cell growth; it is used to treat ulcerative colitis and Crohn’s by suppressing the immune system. It is usually taken orally in tablet form once per day. Symptoms may include headache, nausea, vomiting, diarrhea, darkening of the skin, hair loss, rash, sore throat, fever, abdominal swelling, diarrhea, pale skin, and weakness. This drug may lower your ability to fight infections and may increase the risk of developing cancer.
Cyclosporine A (Sandimmune®, Neoral®) and tacrolimus (Prograf®), are immunosuppressants used to prevent organ transplant complications, to treat symptoms of rheumatoid arthritis, and to treat fistulas in Crohn’s. Cyclosporine is usually taken in capsule or liquid form two times per day. Side effects may include headache, diarrhea, gas, decreased kidney function, hepatitis, increased risk of infections, diabetes, increased cholesterol levels, sleep problems, acne, mild tremor, high blood pressure, swollen gums, tingling of the fingers and feet, increased facial hair, and increased risk of lymphoma and skin cancer. These drugs may lower your ability to fight infections.
Natalizumab (Tysabri) is an immunomodulator used for both Crohn’s Disease and MS. It is usually administered as an infusion once every four weeks. Side effects may include headache, fatigue, joint pain, urinary tract infection, respiratory infection, gastroenteritis, vaginitis, depression, pain in extremity, abdominal discomfort, diarrhea, gas, constipation, and rash, depression, tooth pain, cold sores, and night sweats. This drug may lower your ability to fight bacterial, viral, or fungal infections.
ANTIBIOTICS are used to inhibit the growth of bacteria and other organisms.
Metronidazole (Flagyl®) is an antibiotic used to treat the intestinal tract. It is usually taken orally in pill form two to three times per day. Side effects may include nausea, vomiting, loss of appetite, a metallic taste, diarrhea, dizziness, headaches, discolored urine, numbness or tingling of the hands and feet, fever, and joint pain.
Ciprofloxacin (Cipro®) is a fluoroquinolone antibiotic used to treat bacterial infections. It is usually taken in tablet, extended release, or oral suspension form. Side effects may include headaches, nausea, vomiting, diarrhea, abdominal pain, rash, and restlessness. Taking ciprofloxacin increases the risk of developing tendinitis
BIOLOGICS are therapeutic treatments which use genetically modified proteins. Genetic material from a protein is colonized within and later collected from a bacteria or yeast culture. They work by inhibiting or neutralizing tumor necrosis factor (TNF), which can cause inflammation as part of an immune response.
Adalimumab (Humira®), and Golimumab (Simponi®) are administered with subcutaneous Injections. These treatments block or inhibit TNF in order to reduce inflammation. Side effects may include redness, itching, bruising, pain, or swelling at the injection site, nausea, headache, fever, chills, difficulty breathing, low blood pressure, hives, stomach pain, back pain, rash, nausea, cough, and runny nose. This drug may lower your ability to fight bacterial, viral, or fungal infections.
Certolizumab pegol (Cimzia®) is administered with subcutaneous Injections. This treatment blocks or inhibits TNF in order to reduce inflammation. Side effects may include redness, itching, bruising, pain, or swelling at the injection site, nausea, headache, sudden weight gain, hot flashes, difficulty breathing,, hives, stomach pain, back pain, rash,, and loss of appetite, muscle weakness. Certolizumab pegol may lower your ability to fight bacterial, viral, or fungal infections.
Infliximab (Remicade®), Is made using a 75% human 25% mouse protein sequence. It is administered by IV over a two-hour period every two to eight weeks. Infliximab blocks TNF-alpha in order to reduce inflammation in patients who suffer from Crohn’s Disease, ulcerative colitis, and rheumatoid arthritis. It is administered by IV over a two-hour period every two to eight weeks. Side effects may include fever, stomach pain, nausea, tiredness, cough, runny nose, shortness of breath, swelling of your ankles or feet, or sudden weight gain. reactivation of HBV, jaundice, dark brown urine, right-sided abdominal pain, fever, fatigue, bruising, paleness. numbness, tingling, vision problems, seizures.hives, difficulty breathing, chest pain, high or low blood pressure, swelling of face and hands, fever, chills, shortness of breath, joint pain, rash on the cheeks or arms that gets worse in the sun, psoriasis, and oral or vaginal yeast infections. Infliximab may lower your ability to fight bacterial, viral, or fungal infections.
ANTIMETABOLITES slow the replication of cancer and other cells by interfering with enzymes that are necessary for DNA synthesis.
Methotrexate (formerly Amethopterin) is used in the treatment of certain neoplastic diseases, severe psoriasis, and adult rheumatoid arthritis. It slows the growth of skin cells and is prescribed to treat cancer, psoriasis, and autoimmune diseases in order to slow cancer cell growth, skin cell growth, or inhibit immune response. The use of methotrexate carries some serious risks. According to Medline Plus, a service of the U.S. National Library of Medicine of the National Institutes of Heath (NIH), “Methotrexate may cause very serious, life-threatening side effects. You should only receive methotrexate injection to treat life-threatening cancer, or certain other conditions that are very severe and that cannot be treated with other medications. Talk to your doctor about the risks of receiving methotrexate injection for your condition.” http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682018.html
Sources:
http://www.ccfa.org/resources/types-of-medications.html
http://www.mayoclinic.org/diseases-conditions/crohns-disease/basics/treatment/con-20032061
http://www.nlm.nih.gov/medlineplus/druginformation.html
http://www.remicade.com
http://nursingpharmacology.info/Anticancer/classes2a.htm