Medications
Medicines usually are the treatment of
choice for
Crohn's disease. They can control or prevent
inflammation in the intestines and help:
- Relieve symptoms.
- Promote healing
of damaged tissues.
- Put the disease into
remission and keep it from flaring up
again.
- Postpone the need for surgery.
Medication Choices
The choice of medicine usually depends on the severity of
the disease, the part of the intestines that is affected, and whether
complications are present.
- Treatment of mild to moderate Crohn's disease
often begins with
aminosalicylates (such as sulfasalazine or
mesalamine), which help prevent inflammation.
- Antibiotics (ciprofloxacin or
metronidazole) will probably be tried if
aminosalicylates don't help your symptoms. Antibiotics are also useful for some
complications of Crohn's disease and are used to treat
fistulas.
- Corticosteroids may
be added if symptoms continue. Corticosteroids usually stop symptoms and put
the disease in remission. But they are not used as long-term treatment to keep
symptoms from coming back.
- Stronger treatment with
medicines that suppress the immune system (such as
azathioprine [AZA], 6-mercaptopurine [6-MP], and methotrexate),
cyclosporine, and intravenous (IV) corticosteroids may
be needed for severe cases.
- Additional medicines, such as
tumor
necrosis factor (TNF) antagonists, may be used for people who develop
abnormal connections between the intestines and other organs (fistulas) or who
have severe Crohn's disease that does not respond to other medicines. These
medicines can be used to keep symptoms from coming back.
Other medicines that suppress the immune system are being
studied for Crohn's disease. These include CDP870, interleukins 10, 11, and 12,
tacrolimus, mycophenolate mofetil, and thalidomide.
What To Think About
Most of these medicines also can
be used in children.
Infliximab is approved by the U.S. Food and Drug
Administration (FDA) for use in children.
If you are pregnant,
talk to your doctor about which medicines might be okay to take for
Crohn's disease. Sometimes, severe Crohn's disease can
harm your baby more than the medicines you are taking to keep it under control.
Some medicines, though, should never be taken when you are pregnant. Your
doctor can tell you which medicines are okay for you while you are pregnant and
nursing.