Need-to-Know Side Effects of Ulcerative Colitis Medications

Like most medication, treatments forulcerative colitis (UC)can come with a number of side effects. It's important to know what these side effects are and how to differentiate them from your UC symptoms so you can communicate any problems to your doctor and have yourtreatment planupdated as needed.

自从inflammatory bowel diseases (IBDs), includingulcerative colitis，是个性化的，专家表示，重要的是要注意为一个患者工作的治疗可能无法为另一名工作。

“这就是为什么这疾病的患者对他们有许多不同的治疗方案，”教育，支持和倡导副总裁Laura Wingate说克罗恩和结肠炎基金会. “Their healthcare providers will customize treatment to the individual’s needs based on type and severity of the disease.”

Ashwin Ananthakrishnan, MBBS, a gastroenterologist who specializes in inflammatory bowel diseases at Massachusetts General Hospital in Boston, says thatserious side effects对于任何溃疡性结肠炎的任何疗法都很罕见。但他们可以发生，他敦促患者“总是向他们的医生报告新的症状，特别是如果持续超过几天，或严重。”

Here's a list of commonulcerative colitis drugs和their side effects.

Anti-Inflammatory Drug Side Effects

Anti-inflammatory drugs called aminosalicylates, or compounds that contain 5-aminosalicylic acid (5-ASA), are often the first step intreatment of ulcerative colitis. These drugs help the body limit inflammation in the intestines, among other effects, and may come in pill, enema, orsuppository形式。一些常用的药物及其副作用包括这些品种：

• 氮氟胺（苏氟碱）Side effects are uncommon but can include headache, nausea, loss of appetite, stomach pain, vomiting,rash, fever, and decreased white blood cell count. While harmless, it can also cause yellowing of the skin (黄疸). Men may experience decreased sperm production and function while takingsulfasalazine, butfertilitywill return to normal after the drug is stopped.
• Lialda（Mesalamine）Side effects may include腹痛和cramps, diarrhea, gas, nausea, hair loss, headache, and dizziness. Some studies show that takingMesalamine.可能与肾有关的问题,那么人呢with kidney disease should use caution before taking the drug.
• Dipentum (Olsalazine)Diarrhea is the most common side effect of olsalazine, but the risk can be reduced by taking the medication with food. Less common side effects include headache, rash, itching, joint pain, fatigue, and rarely, hair loss.
• Colazal (Balsalazide)Side effects may include headaches and腹痛和, less commonly, trouble sleeping, dry mouth, muscle orback pain, nausea, diarrhea, vomiting, fever, and cold symptoms like stuffy nose,sore throat, and sneezing.

In rare instances, 5-ASA drugs have been linked to inflammation of thepancreas(pancreatitis) and inflammation of the heart or tissue surrounding the heart (myocarditis和心包炎, respectively).

Doctors may prescribe another class of powerful anti-inflammatory drugs called皮质类固醇for treatment of acute IBD flare-ups. Still, they're not recommended for long-term use because of problematic side effects, includingfluid retention和swelling of the lower legs, increased risk of infection, high blood pressure, weight gain, acne, thinning skin and easier bruising, mood swings,insomnia,cataracts,glaucoma,high blood sugarlevels, and weakened bones orosteoporosis.

Immune System Suppressor Side Effects

Immune system suppressors weaken the activity of theimmune systemto decrease the inflammatory response. Some of the commonly used drugs, and their side effects, include these options:

• Imuran (Azathioprine)Infrequently reported side effects include headache, nausea, vomiting, diarrhea,skin rash, and hair loss. Even less common side effects are pancreatitis and increased risk of infection or bleeding. This drug may increase therisk of lymphoma和skin cancer. Use ofazathioprinecan also rarely lead to a serious brain infection. You should contact your doctor right away if you develop problems with muscle movement, speech, thought, or vision — these symptoms may come on gradually but quickly worsen.
• Neoral (Cyclosporine)Common side effects may include decreased kidney function, shaking or tremors, increased risk of infections, increasedcholesterol levels, sleep troubles, headache, nausea, high blood pressure, swollen gums, excessive hair growth, female fertility impairment, abdominal pain, diarrhea, nausea, leg cramps, numbness and tingling, dizziness, flushing, and increasedrisk of lymphoma.
• Zeposia (Ozanimod)Upper respiratory tract infections were a common reported side effect during clinical trials. Less common side effects included elevated liver enzymes, low blood pressure upon standing, frequent andpainful urination, back pain, headaches, and high blood pressure.
• Xeljanz (Tofacitinib)Common side effects of this Janus kinase inhibitor include skin rash,shingles, high blood pressure, abnormalblood tests, headache, fever, nausea, diarrhea, vomiting, and cold symptoms like congestion, sneezing, and sore throat. In September 2021, the食品和药物管理局（FDA）添加了一个黑匣子警告to this medicine for increasedrisk of heart attack，中风，癌症，血栓和死亡 - 后者即使在较低剂量上也是如此。

Biologic Therapy Side Effects

A newer type of therapy that is injected into the body,biologicsare drugs derived from living cells or organisms like bacteria and yeast, and they stop certain proteins in the body from causing inflammation. Areview published in January 2015 in the journalGut and Livernotes that “the introduction of biologics for the treatment of IBD has changed the treatment paradigm for moderate to severe ulcerative colitis.” In the United States, the FDA has approvedRemicade(英夫利昔单抗),Humira (adalimumab),Simponi (golimumab),Entyvio (vedolizumab), andStelara（Ustekinumab）to treat ulcerative colitis.

RELATED:The Pros and Cons of Biologics for Ulcerative Colitis

While the benefits of biologic therapy typically far outweigh the risks in patientsliving with ulcerative colitis, there are some side effects to keep in mind:

• Redness
• 瘙痒
• Bruising
• Pain or swelling at the injection site
• Headache
• Fever or chills
• Hives和other rashes

Biologics may also hinder the body’s ability to fight infections and have been associated with a small but measurable increased risk oflymphoma. In very rare instances, the use of biologics has been linked to changes in liver function.

Important Tips for Starting Any New Ulcerative Colitis Medication Regimen

To keep track of your symptoms and the potential side effects of treatment, you may want to keep a diary, and be sure to report any changes to your doctor. These symptom lists are not exhaustive, but sources likeMedlinePlusfrom the National Library of Medicine can provide additional information for individual drugs.

You should seek immediate medical attention if you develop signs of anallergic reaction: difficulty breathing,hives, or swelling of the face, lips, tongue, or throat.

Finally, Wingate points out that a patient’s therapeutic needs may change over time. “What works now may not work at another stage of one’s disease,” she says. It's crucial for patients to continuously discuss their condition with their gastroenterologist over time, so they can work together to decide which course of therapy is best and balance the benefits and risks of each treatment.