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These medicines may relieve symptoms and inflammation in the intestines and help IBD go into remission (a period without symptoms). They also may help prevent the disease from becoming active again.
Aminosalicylates usually are the first medicines used to treat inflammatory bowel disease (IBD). These medicines have been used to treat IBD for more than 30 years.
These medicines are effective for mild to moderate ulcerative colitis and mild Crohn's disease. Their use depends on the type of medicine (oral or topical) and whether it treats disease that is active or in remission.
Treatment for mild to moderate ulcerative colitis often begins with sulfasalazine. Sulfasalazine works 40% to 80% of the time to make ulcerative colitis symptoms better or keep them from coming back.1 But it cannot be used by people who are allergic to or cannot tolerate sulfa drugs.
Mesalazine and olsalazine do not contain sulfa. So they may be used to treat mild to moderate ulcerative colitis if you cannot take sulfasalazine.
Mesalazine enemas are effective in treating symptoms of mild to moderate distal (left-sided) ulcerative colitis and in maintaining remission.1 Mesalazine suppositories are preferred for people who have proctitis. The combination of a mesalazine pill (oral) and a mesalazine enema, foam, or suppository (topical) works better to treat left-sided colitis than either oral or topical mesalazine by itself.1
These medicines can be used to maintain remission in ulcerative colitis.
Aminosalicylates do not seem to keep symptoms from coming back when a person is in remission caused by drugs (like corticosteroids). But aminosalicylates sometimes keep symptoms from coming back in people who have had surgery.2 Some people are allergic to sulfa drugs and cannot take sulfasalazine.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call 911 or other emergency services right away if you have:
Call your doctor right away if you have:
Call your doctor right away if you have:
Common side effects of all these medicines include:
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
Sulfasalazine can make your skin more sensitive to the sun.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
- Friedman S, Lichtenstein GR (2006). Ulcerative colitis. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 803–817. Philadelphia: Saunders Elsevier.
- Akobeng AK, Gardener E (2005). Oral 5-aminosalicylic acid for maintenance of medically-induced remission in Crohn's disease. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.
- Friedman S, Lichtenstein GR (2006). Crohn's disease. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 785–801. Philadelphia: Saunders Elsevier.
Last Revised: April 8, 2012
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.