Medications for Ulcerative Colitis: Types, Side Effects, and Effectiveness

Are you experiencing frequent tummy pain, recurring diarrhea, etc.? If yes, you are suffering from ulcerative colitis, which is a long-term condition that occurs when the colon and rectum get inflamed. There’s no cure for UC, however, with medication it can be managed. Learn about the medications for ulcerative colitis treatment in this article. But if you’re experiencing chronic constipation or constipation along with other bowel changes, you should visit your healthcare professional for treatment. You can contact us by visiting our clinic or visiting our website at


Medications for ulcerative colitis

While there’s no cure for ulcerative colitis (UC), doctors prescribe medications to manage its symptoms and long-term flare-ups. It includes:

Anti-inflammatory medications

This is the first line of treatment for UC and is recommended for most people. It includes:

  1. Amino salicylates:

These medications are also known as 5-ASAs and are used to manage UC symptoms by reducing inflammation in the colon. It is recommended for people with mild to moderate UC to prevent flare-ups or lower the number of flare-ups. It is generally taken in oral form or a suppository (a capsule that’s inserted through the rectum, where it dissolves), or through an enema, (where fluid is pumped into the large intestine).

Its usage depends on the severity and extent of your condition. If you have mild to moderate ulcerative colitis, then it may be offered in a suppository or enema form. If your symptoms don’t improve after 4 weeks, then the doctor may advise you to take supplementary 5-ASA in tablet or capsule form as well.

Here are the common forms of amino salicylates that doctors may prescribe:

  • Mesalamine
  • Sulfasalazine
  • Olsalazine
  • Balsalazide

These medicines rarely cause any side effects, but some people may experience symptoms like:

  • Headaches
  • Feeling sick
  • Tummy pain
  • Rash
  • Diarrhea
  • Abdominal pain, cramps, and discomfort
  1. Corticosteroids:

These medications are used to decrease your body’s overall immune system response and reduce inflammation in your body. It is prescribed to treat moderate to severe active UC. It can be taken orally or rectally. It can be used with or instead of 5-ASAs to treat a flare-up if 5-ASAs alone are not effective. However, like 5-ASAs, it can’t be used for long-term treatment to maintain remission because it can cause some serious side effects such as weakened bones (osteoporosis) and cloudy patches in the lens of the eye (cataracts) in its long-term usage. If you can’t stop the steroids without suffering from relapse symptoms, then your doctor may need to prescribe other medications to manage your disease.

Here are the common forms of corticosteroids that doctors may prescribe:

  • Prednisone
  • Prednisolone
  • Methylprednisolone
  • Budesonide

Side effects of short-term use of corticosteroids include:

  • Acne
  • Weight gain
  • Increased appetite
  • Mood changes, such as becoming more irritable
  • Difficulty sleeping
  • Constipation
  • Acne
  • Bloating
  1. Immune system suppressors

These medications are also used to reduce inflammation along with suppressing the immune system response which causes inflammation. It is also known as immunomodulator drugs or immunomodulators. For some people, a combination of these medications works better than one medicine alone. It includes:

  • Azathioprine and Mercaptopurine:

These immunosuppressants are used to treat inflammatory bowel disease (IBD). It’s usually taken in combination with medications called biologics. Both medicines come in the oral form, however, mercaptopurine is also available in a liquid suspension besides tablets. These medications require close monitoring by the provider because their side effects can affect your liver and pancreas.

  • Cyclosporine:

This medication is only used for people who don’t respond well to other medications. However, due to serious side effects, it’s not recommended for long-term use.

  • Small molecule medications:

These recently developed orally delivered agents are called small molecules to treat IBD, and include:

  • Tofacitinib
  • Upadacitinib
  • Ozanimod

These medications may be effective if other medications don’t work. It can increase the risk of shingles infection and blood clots. Even recently, the US Food and Drug Administration (FDA) issued a warning about tofacitinib, that preliminary studies show the risk of serious heart-related problems and cancer from this medication. So, if you take tofacitinib for UC, don’t stop immediately but consult with your healthcare provider.

Here are the common side effects you can expect with immunomodulators including:

  • Headache
  • Nausea
  • Vomiting
  • Diarrhea
  • Mouth sores
  • Tiredness
  • Low blood cell levels
  1. Biologics

These medications are genetically designed in a lab from a living organism to treat moderate to severe ulcerative colitis. These medicines can reduce intestine inflammation by targeting proteins the immune system uses to cause inflammation. It is also used when symptoms can’t be managed with treatments such as 5-ASA drugs, corticosteroids, or immunomodulators. These medicines are given in the hospital by infusion through a drip in your arm every 4 to 12 weeks (about 3 months), or as an injection every 1 to 4 weeks. Your treatment team sees how you respond to treatment and if your symptoms are under control for a year or more, they recommend stopping the medication.

Here are the main types of biologics used to treat ulcerative colitis, including:

  1. Infliximab, adalimumab, and golimumab: These medications are known as tumor necrosis factor (TNF) inhibitors, which can neutralize the protein produced by the immune system that causes inflammation. It is recommended for people with severe ulcerative colitis who don’t respond to or can’t tolerate other treatments.
  2. Vedolizumab: This medication is used to treat people with UC who don’t respond or can’t tolerate other treatments. It works by blocking inflammatory cells from getting to the site of inflammation.
  3. Ustekinumab: This medication is approved for treating UC in people who don’t respond or can’t tolerate other treatments. It blocks different proteins that cause inflammation.

Here are the most common side effects of biologics you can expect, including:

  • Headache
  • Fever
  • Chills
  • Nausea
  • Hives or rash
  • Increased infections

Other medications

In case you need additional medication to manage specific symptoms of UC, your healthcare provider may recommend one of these medications, including:

  1. Anti-diarrheal medications: For severe diarrhea, loperamide may be recommended. If you have UC, don’t take anti-diarrheal medications without consulting with your healthcare provider. These medications may increase the risk of an enlarged colon.
  2. Pain relievers: For mild pain, your provider may prescribe acetaminophen, but not ibuprofen, naproxen sodium, and diclofenac sodium, which can worsen symptoms and increase the severity of the disease.
  3. Antispasmodics: Sometimes healthcare providers may recommend antispasmodic therapies to manage cramps.
  4. Iron supplements: In case you have chronic intestinal bleeding, you may develop iron deficiency anemia and be treated with iron supplements.


Medications for ulcerative colitis are good options for managing the condition and lowering the risk of flare-ups. Depending on the severity and symptoms, your healthcare provider prescribes the medication or a combination to see what works for you. In case you experience any side effects from the medications, then ask your doctor to change the medication or dosage.


If you need help with ulcerative colitis, visit our endocrinology clinic in Brooklyn to get professional medical help. Call us to book your appointment today. You can schedule an appointment with Doral Health and Wellness Gastroenterology Center’s best gastro doctors in Brooklyn. If you are looking for treatments, you can also talk to our specialists and inquire with them. To schedule an appointment, please visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212 or call 1-347-384-5690.