This can often be a lifelong disease associated with multiple complications and may require surgery. Side effects of the medications commonly used to treat it are listed below.
Remicade, Humira, Cimzia, Simponi: Life threatening infections including fungal infections, Listeria (infection of brain), Legionella, TB, hepatitis B reactivation, lymphoma and fatal hepatosplenic T cell lymphoma. It can also cause other life threatening cancers. Other side effects include CHF, anemia, skin rashes, serious neurological problems, sensitivity to the sun, worsening lupus, and sarcoidosis. Moreover, it should be avoided during pregnancy and lactation. There is a higher chance of infections such as listeria, legionella and PCP pneumonia especially if on multiple immunosuppressing medications. Moreover, if they are likely to be exposed to TB or fungal infections due to job or travel, these medications SHOULD NOT be used and they should reconsider travel choices
While on these medications, we recommend:
- Yearly flu shot.
- Evaluation for hepatitis A and B immunity. You should get immunized against both.
- Varicella titers and vaccination if not immune.
- Yearly PPD or Gold TB Quantiferon Test.
- Immunization against Pneumonia.
- Call your physician IMMEDIATELY if you develop fever.
- Monitoring for osteoporosis in patients with IBD.
- Gardasil vaccination (for men and women between the ages 9-26) to lower risk of cervical cancer, especially in patients with IBD. Annual dermatology evaluation. There's a higher risk of melanomas (aggressive skin cancer) in patients on these medications as well as Imuran.
Imuran: This medication can cause life threatening drop in blood counts. You WILL NEED blood tests frequently — initially every week or other week to later on once every 2-3 months INDEFINATELY. Moreover, it can cause liver problems, pancreatitis, fever, and a higher chance of cancers like lymphomas. Imuran causes a higher risk of non melanoma skin cancer. They need yearly dermatology evaluation.
Mesalamine (like Lialda, Asacol, Apriso, colazal etc) : Generally very safe. Some patients may develop inflammation of the liver, lungs, kidneys.
Prednisone: Anxiety, insomnia, irritability, cataracts or glaucoma, facial swelling, high blood sugar, increased risk of infections, changes in body fat distribution, skin changes (acne, stretch marks, slow healing), osteoporosis (weakened bones and possible fractures), avascular necrosis of joints, joint pain, muscle weakness, and weight gain.