Common Rx Drugs

(Under Construction) Commonly Prescribed Drugs, Side Effects, Symptoms and Warnings

Anti-inflammatory drugs
Anti-inflammatory drugs are often the first step in the treatment of inflammatory bowel disease. They include

·                                 Sulfasalazine (Azulfidine). Although this drug isn't always effective for treating Crohn's disease, it may be of some help for Crohn's that affects the colon. It has a number of side effects, including nausea, vomiting, heartburn and headache. Don't take this medication if you're allergic to sulfa medications.

·                                 Mesalamine (Asacol, Rowasa). This medication is less likely to cause side effects than sulfasalazine, but possible side effects include nausea, vomiting, heartburn, diarrhea and headache. You take it in tablet form or use it rectally in the form of an enema or suppository, depending on which part of your colon is affected. This medication is generally ineffective for disease involving the small intestine.

·                                 Corticosteroids. Corticosteroids can help reduce inflammation anywhere in your body, but they have numerous side effects, including a puffy face, excessive facial hair, night sweats, insomnia and hyperactivity. More-serious side effects include high blood pressure, diabetes, osteoporosis, bone fractures, cataracts, glaucoma and an increased susceptibility to infections. Long-term use of corticosteroids in children can lead to stunted growth.

Also, these medications don't work for everyone with Crohn's disease. Doctors generally use corticosteroids only if you have moderate to severe inflammatory bowel disease that doesn't respond to other treatments. A newer type of corticosteroid, budesonide (Entocort EC), works faster than do traditional steroids and appears to produce fewer side effects. Entocort EC is effective only in Crohn's disease that involves the lower small intestine and the first part of the large intestine.

Corticosteroids aren't for long-term use. But, they can be used for short-term (three to four months) symptom improvement and to induce remission. Corticosteroids also may be used with an immune system suppressor — the corticosteroids can induce remission, while the immune system suppressors can help maintain remission.

Antibiotics
Antibiotics can reduce the amount of drainage and sometimes heal fistulas and abscesses in people with Crohn's disease. Researchers also believe antibiotics help reduce harmful intestinal bacteria and suppress the intestine's immune system, which can trigger symptoms. However, there's no strong evidence that antibiotics are effective for Crohn's disease. Frequently prescribed antibiotics include:

·                                 Metronidazole (Flagyl). Once the most commonly used antibiotic for Crohn's disease, metronidazole can cause serious side effects, including numbness and tingling in your hands and feet and, occasionally, muscle pain or weakness. If these effects occur, stop the medication and call your doctor.

·                                 Ciprofloxacin (Cipro). This drug, which improves symptoms in some people with Crohn's disease, is now generally preferred to metronidazole. A rare side effect of this medication is tendon rupture

medications
In addition to controlling inflammation, some medications may help relieve your signs and symptoms. Depending on the severity of your Crohn's disease, your doctor may recommend one or more of the following:

·                                 Anti-diarrheals. A fiber supplement, such as psyllium powder (Metamucil) or methylcellulose (Citrucel), can help relieve mild to moderate diarrhea by adding bulk to your stool. For more severe diarrhea, loperamide (Imodium) may be effective. Use anti-diarrheals with caution and only after consulting your doctor.

·                                 Laxatives. In some cases, swelling may cause your intestines to narrow, leading to constipation. Talk to your doctor before taking any laxatives, because even those sold over-the-counter may be too harsh for your system.

·                                 Pain relievers. For mild pain, your doctor may recommend acetaminophen (Tylenol, others). Avoid aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve). These are likely to make your symptoms worse.

·                                 Iron supplements. If you have chronic intestinal bleeding, you may develop iron deficiency anemia. Taking iron supplements may help restore your iron levels to normal and reduce this type of anemia once your bleeding has stopped or diminished.

·                                 Nutrition. Your doctor may recommend a special diet given via a feeding tube (enteral nutrition) or nutrients injected into a vein (parenteral nutrition) to treat your Crohn's disease. This can improve your overall nutrition and allow the bowel to rest. Bowel rest can reduce inflammation in the short term. However, once regular feeding is restarted, your signs and symptoms may return. Your doctor may use nutrition therapy short term and combine it with other medications, such as immune system suppressors. Enteral and parenteral nutrition are typically used to get people healthier for surgery or when other medications fail to control symptoms. Your doctor may also recommend a low residue or low-fiber diet if you have a narrowed bowel (stricture) to try to reduce the risk of a blockage. A low residue diet is one that's designed to reduce the size and number of your stools.

·                                 Vitamin B-12 shots. Vitamin B-12 helps prevent anemia, promotes normal growth and development, and is essential for proper nerve function. It's absorbed in the terminal ileum, a part of the small intestine often affected by Crohn's disease. If inflammation of your terminal ileum is interfering with your ability to absorb this vitamin, you may need monthly B-12 shots for life. You'll also need lifelong B-12 injections if your terminal ileum has been removed during surgery.

·                                 Calcium and vitamin D supplements. You may need to take a calcium supplement with added vitamin D. This is because Crohn's disease and steroids used to treat it can increase your risk of osteoporosis. Ask your doctor if a calcium supplement is right for you.