Ulcerative Colitis (cont.)
Summary of Medication Treatment
- Azulfidine, Asacol, Pentasa, Dipentum, Colazal, and Rowasa all contain 5-ASA
compounds which are topical anti-inflammatory ingredients. These
medications are effective in inducing remission among patients with mild to
moderate ulcerative colitis. They also are safe and effective in maintaining
remission.
- Pentasa is more commonly used in treating Crohn's ileitis because the
Pentasa capsules release more 5-ASA compounds into the small intestine than
the Asacol tablets. Pentasa also can be used for treating mild to moderate
ulcerative colitis.
- Rowasa enemas are safe and effective in treating ulcerative proctitis and
proctosigmoiditis.
- The sulfa-free 5-ASA compounds (Asacol, Pentasa, Dipentum, Colazal, Rowasa) have
fewer side effects than Azulfidine, which contains sulfa.
- In ulcerative colitis patients with moderate to severe disease and in
patients who fail to respond to 5-ASA compounds, systemic (oral) corticosteroids can
be used. Systemic corticosteroids (prednisone, prednisolone, cortisone, etc.)
are potent and fast-acting anti-inflammatory agents for treating Crohn's
ileitis, ileocolitis, and ulcerative colitis.
- Systemic corticosteroids are not effective in maintaining remission in
patients with ulcerative colitis. Serious side effects can result from
prolonged corticosteroid treatment.
- To minimize side effects, corticosteroids should be gradually reduced as
soon as disease remission is achieved. In patients who become corticosteroid
dependent or are unresponsive to corticosteroid treatment, surgery or
immunomodulator treatments are considered.
- Immunomodulators used for treating severe ulcerative colitis include
azathioprine/6-MP, methotrexate, and cyclosporine.
- Infliximab (Remicade) may be beneficial in controlling moderate to
severe ulcerative colitis and in decreasing the need for urgent removal of
the colon.
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