Management of Ulcerative Colitis: Medications

Your health care provider may prescribe medication to help control your ulcerative colitis symptoms and help improve your quality of life. It won’t cure ulcerative colitis, but it can help keep it from slowing you down. Work closely with your health care provider. You may have certain side effects or your symptoms may change. In this case, your medication or dosage may need to be changed.


These drugs can reduce inflammation and pain in the intestinal lining. They must be prescribed by your health care provider. The most common anti-inflammatories for ulcerative colitis are called 5-ASA compounds, or mesalamine. They help control symptoms over long periods of time. They may be taken as pills, but they also can be taken as an enema or suppository, inserted directly into the rectum.

Possible side effects of 5-ASA compounds

Your health care provider will explain the side effects and other details of any new medications. Call your health care provider if any side effects become severe.


Corticosteroids help reduce inflammation. Unlike 5-ASA compounds, they are most often taken for short periods only, with dosages gradually reduced. They also shouldn’t be taken during remission. (Remission is a long period without severe symptoms.)

Possible side effects of corticosteroids

Taken over time, corticosteroids can cause severe side effects. They also may put you at risk for diabetes.

Side effects may include:

  • Mood changes

  • Trouble sleeping

  • Weight gain

  • Puffy face or acne

  • Changes in body shape

  • Bone loss or fractures

  • High blood pressure

  • Eye problems

  • Facial hair (women)

  • Stretch marks


These medications cause your body's immune system to be less active. This can help reduce inflammation and calm your symptoms. They are taken as a pill by mouth. You may not feel their effects until you have taken them for a few months. But you can take them for a long time. You will need to have blood tests every few months to monitor your live and blood cell counts. 

Side effects may include:

  • Nausea

  • Body aches

  • Inflammation of the pancreas

  • Low white blood cell count

  • Liver problems

  • Low folic acid levels

  • Infection

  • Lymphoma

  • Non-melanoma skin cancer

Biologic agents

These kinds of medications help stop a chemical your  body makes, which causes inflammation. The chemical is called tumor necrosis factor or TNF. The medications are also known as anti-TNK monoclonal antibodies. The way you take a biologic agent depends on how the drug is given. It may be given intravenously (IV) every 2 to 8 weeks. It may be given through an injection (shot) as often as once a week. Or it may be given as a shot once a month. These drugs can put you at risk for infections, so tell your doctor if you have a chronic infection. Your doctor should also test you for tuberculosis and hepatitis B infection before giving you the medication.

Side effects may include:

  • Flushing, check pain, shortness of breath, hives, or a drop in blood pressure during IV treatment

  • Joint and muscle aches

  • Rash

  • Fever

  • Infection

  • Lymphoma

  • Skin cancers

  • Hepatotoxity

  • TNF-induced psoriasis


These may be used if you also have an infection due to Crohn's disease, such as an abscess. Antibiotics may be give as a pill taken my mouth. Stay out of the sun while taking them. Also, do not drink alcohol. it may cause severe reactions, such as nausea, vomiting, and breathing problems. Also, tell your doctor right away if you have numbness or tingling in your hands or if your bowel symptoms become worse.

Side effects may include:

  • Nausea

  • Diarrhea

  • Headaches

  • Dizziness

  • Dark urine

  • Loss of appetitie

  • Metallic taste in the mouth

  • Sensitivity to the sun




Handling side effects

You and your health care provider will discuss side effects. In most cases, side effects are easy to manage. But sometimes they can be so severe that you need to change medication. Call your health care provider if you’re having side effects that trouble you. Also call if you’re having any side effects that are unexpected.