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Medications for Crohn's Disease Explained
Sulfasalazine (Azulfidine®) is one of the most commonly used drugs for Crohn's disease. It contains a substance that helps control inflammation. While sulfasalazine can be effective for treating Crohn's disease and maintaining remission, side effects can occur with the drug. Common side effects with this medication include:
Sulfasalazine was the first aminosalicylate used to treat Crohn's disease, helping not only to treat symptoms but to maintain remission in people with mild to moderate cases of the condition. However, sulfasalazine can cause undesirable side effects in a number of people, so researchers developed a new type of aminosalicylate that removed the part of sulfasalazine responsible for the side effects. These new medicines are known as 5-aminosalicylates, or 5-ASAs for short.
These Crohn's medications are used to treat those who do not benefit from sulfasalazine or who cannot tolerate it. Similar to sulfasalazine, 5-aminosalicylates help relieve inflammation in the digestive tract, which helps to treat the signs and symptoms of mild to moderate Crohn's disease.
There are several types of 5-aminosalicylates, including:
These medicines come in several forms, including pills, enemas, and rectal suppositories. Overall, the 5-ASA drugs have fewer side effects than sulfasalazine. Up to 90 percent of people who cannot take sulfasalazine can take another aminosalicylate.
Doctors may recommend corticosteroids, such as prednisone or budesonide EC (Entocort EC®), to reduce inflammation and other symptoms of Crohn's. Corticosteroids are most commonly used to help control "flare-ups" of Crohn's disease rather than during remission maintenance.
Like aminosalicylates, there are many types of corticosteroids and different ways to take them. During periods of severe inflammation, people with Crohn's disease may receive corticosteroids through an IV and at higher doses. The healthcare provider will then typically lower the dosage as Crohn's symptoms improve.
Examples of side effects that may occur with corticosteroids include:
- Increased risk for infection
- Weight gain
- Increased blood sugar levels
- Thinning of the bones (osteoporosis)
- High blood pressure
- Personality changes.
Most corticosteroids and aminosalicylates are not specifically approved for treating Crohn's disease. Using an approved drug for an unapproved indication is commonly referred to as an "off-label" use.