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IBD Drugs

GenericBrandRouteDrug ClassIndicationMechanism of ActionAdverse Effects
Mesalamine (5-ASA) PO Pentasa/Apriso/Asacol/Delzicol/Lialda PO Aminosalicylate Ulcerative Colitis Activates PPAR-γ and nuclear transcription factor to decrease proinflmmatory cytokines (eg. IL-1/TNF-α) Bone marrow suppression, skin rashes, headaches
Mesalamine (5-ASA) Suppository Canasa Suppository Aminosalicylate Ulcerative Colitis Activates PPAR-γ and nuclear transcription factor to decrease proinflmmatory cytokines (eg. IL-1/TNF-α) Bone marrow suppression, skin rashes, headaches
Mesalamine (5-ASA) Enema Rowasa Enema Aminosalicylate Ulcerative Colitis Activates PPAR-γ and nuclear transcription factor to decrease proinflmmatory cytokines (eg. IL-1/TNF-α) Bone marrow suppression, skin rashes, headaches
Sulfasalazine Azulfidine PO Aminosalicylate Ulcerative Colitis Activates PPAR-γ and nuclear transcription factor to decrease proinflmmatory cytokines (eg. IL-1/TNF-α) Bone marrow suppression, skin rashes, headaches
Prednisone Deltasone/Rayos PO Corticosteroid IBD (UC, CD) Activates glucocorticoid receptors/nuclear receptors; inhibits pro-inflammatory (interleukins/ cytokines; TNF-a) and expression of adhesion molecules (NF-κB) Hypertension, insomnia, peptic ulcer, pituitary/adrenal suppression (ACTH inhibition)
Budesonide Entocort EC/Uceris PO Corticosteroid IBD (UC, CD) Activates glucocorticoid receptors/nuclear receptors; inhibits pro-inflammatory (interleukins/ cytokines; TNF-a) and expression of adhesion molecules (NF-κB) Hypertension, insomnia, peptic ulcer, pituitary/adrenal suppression (ACTH inhibition)
Azathioprine Imuran PO Thiopurine (Immunosuppressive) IBD (UC, CD) Suppresses T-cell proliferation and DNA/RNA replication through inhibiting de novo purine synthesis Bone marrow suppression, infections, pancreatitis, hepatitis, lymphoma risk
Mercaptopurine Purinethol PO Thiopurine (Immunosuppressive) IBD (UC, CD) Suppresses T-cell proliferation and DNA/RNA replication through inhibiting de novo purine synthesis Bone marrow suppression, infections, pancreatitis, hepatitis, lymphoma risk
Methotrexate Trexall IM/SQ Antimetabolite (Immunosuppressive) Crohn's Disease competitively and reversibly inhibits dihydrofolate reductase and B-cell proliferation; ↓ thymidine and purine production to block DNA/RNA synthesis; stimulates adenosine release Bone marrow suppression, hepatotoxicity, alopecia, infections, malignancies, stomatitis; BW: Teratogenicity
Cyclosporine Neoral PO Caclineurin Inhibitor (Immunosupressive) Ulcerative Colitis binds to cyclophilin, forming a complex that inhibits calcineurin ∴ prevents activation of NFAT leading to decreased transcription of IL-2 (primarily), IL-3, and IFN-γ in T cells Nephrotoxicity, electrolyte imbalances, neurotoxicity, hepatotoxicity, hypertension, hyperglycemia, hyperkalemia, altered mental status
Infliximab Remicade IV TNF-α Inhibitor IBD (UC, CD) Prevents TNF-α stimulation of TNFR on immune cells (macrophages/T-helper cells) ∴ decrease release of proinflammatory cytokines, T-cell proliferation, and endothelial adhesion molecules Infusion reactions, antibodies to the antibodies BW: Infections, malignancy (lymphoma), TB risk
Adalimumab Humira SQ TNF-α Inhibitor IBD (UC, CD) Prevents TNF-α stimulation of TNFR on immune cells (macrophages/T-helper cells) ∴ decrease release of proinflammatory cytokines, T-cell proliferation, and endothelial adhesion molecules Antibodies to the antibodies BW: Infections, malignancy (lymphoma), TB risk
Certolizumab Cimzia SQ TNF-α Inhibitor Crohn's Disease Prevents TNF-α stimulation of TNFR on immune cells (macrophages/T-helper cells) ∴ decrease release of proinflammatory cytokines, T-cell proliferation, and endothelial adhesion molecules Antibodies to the antibodies BW: Infections, malignancy (lymphoma), TB risk
Golilumab Simponi SQ TNF-α Inhibitor Ulcerative Colitis Prevents TNF-α stimulation of TNFR on immune cells (macrophages/T-helper cells) ∴ decrease release of proinflammatory cytokines, T-cell proliferation, and endothelial adhesion molecules Antibodies to the antibodies BW: Infections, malignancy (lymphoma), TB risk
Vedolizumab Entyvio IV Integrin receptor antagonist IBD (UC, CD) Inhibits lymphocyte migration to inflamed endothelial tissue via blocking integrin adhesion molecules Hepatotoxicity, progressive multifocal leukoencephalopathy (PML) risk, hypersensitivy reaction, infections, rash, headache, arthralgias, nasopharyngitis, antibody development
Ustekinumab Stelara IV/SQ IL-12 + IL-23 Inhibitor IBD (UC, CD) Inhibits specific interleukins ∴ ↓ activation of NK cells & TH1 cells; ↓ TNF-α expression and T-cell differentiation & maturation Infections, nasopharyngitis, TB, malignancy, neutralizing antibodies risk
Guselkumab Tremfya IV/SQ IL-23 Inhibitor IBD (UC, CD) Inhibits specific interleukins ∴ ↓ activation of NK cells & TH1 cells; ↓ TNF-α expression and T-cell differentiation & maturation Infections, nasopharyngitis, TB, malignancy, neutralizing antibodies risk
Risankizumab Skyrizi IV/SQ IL-23 Inhibitor IBD (UC, CD) Inhibits specific interleukins ∴ ↓ activation of NK cells & TH1 cells; ↓ TNF-α expression and T-cell differentiation & maturation Infections, nasopharyngitis, TB, malignancy, neutralizing antibodies risk
Mirkizumab Omvoh IV/SQ IL-23 Inhibitor IBD (UC, CD) Inhibits specific interleukins ∴ ↓ activation of NK cells & TH1 cells; ↓ TNF-α expression and T-cell differentiation & maturation Infections, nasopharyngitis, TB, malignancy, neutralizing antibodies risk
Ozanimod Zeposia PO Sphingosine 1-Phosphate (S1P) Receptor Modulator Ulcerative Colitis Down regulates S1P₁ receptors on lymphocytes, blocking lymphocyte egress from lymph nodes and reducing immune cell migration to inflamed tissues Hepatotoxicity, dyspnea, infections, macular edema/vision changes, PML, PRES, bradycardia/AV block, orthostatic hypotension, hypertension, skin malignancies, lymphocytopenia
Etrasimod Velspity PO Sphingosine 1-Phosphate (S1P) Receptor Modulator Ulcerative Colitis Down regulates S1P₁ receptors on lymphocytes, blocking lymphocyte egress from lymph nodes and reducing immune cell migration to inflamed tissues Hepatotoxicity, dyspnea, infections, macular edema/vision changes, PML, PRES, bradycardia/AV block, orthostatic hypotension, hypertension, skin malignancies, lymphocytopenia
Tofacitinib Xeljanz PO Janus Kinase (JAK) Enzyme Inhibitor Crohn's Disease Selective JAK inhibitors that prevent further downstream effects to phosphorylate the STAT molecule ∴ no phosphorylated STAT (transcription factor); ↓ proinflammatory cytokines ↑Cholesterol; infections, nasopharyngitis, malignancy, CV events, thrombosis, treatment-related mortality
Upadacitinib Rinvoq PO Janus Kinase (JAK) Enzyme Inhibitor IBD (UC, CD) Selective JAK inhibitors that prevent further downstream effects to phosphorylate the STAT molecule ∴ no phosphorylated STAT (transcription factor); ↓ proinflammatory cytokines ↑Cholesterol; infections, nasopharyngitis, malignancy, CV events, thrombosis, treatment-related mortality
Metronidazole Flagyl PO/IV Anaerobic Antibiotic IBD (UC, CD) bactericidal activity of anaerobic bacteria Neurotoxicity; metallic tase; Abx resistance; disulfiram-reactions; peripheral neuropathy; stomatitis
Ciprofloxacin Cipro PO/IV Fluoroquinolone Antibiotic IBD (UC, CD) inhibits DNA gyrase and topoisomerase CV, CNS,Liver toxicity; poor glucose regulation; QTc prolongation BW: tendon rupture; myasthenia gravis
Created by: aleeciagene
 

 



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