IBD Medication Guide

Use the filters below to find medications that fit your preferences and criteria. This information is not intended to replace advice from your healthcare team, but rather to supplement it and make you better equipped to play an informed role in your inflammatory bowel disease treatment plan. Click on an individual medication to learn more about how it works, along with information about use in specific groups, including children, pregnant/breastfeeding women, and older individuals.

Extra Information

What are the different diseases?

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease is defined by inflammation in the digestive tract. It causes many debilitating symptoms, including diarrhea, rectal bleeding, abdominal pain, and extra-intestinal complications. There are several types of IBD, but the two most common are Crohn’s disease and ulcerative colitis. Canada has among the highest prevalence of IBD reported in the world, at approximately 0.8%, or 322,600 individuals.

Crohn’s Disease

Crohn’s disease is a chronic inflammatory bowel disease that can affect any area of the gastrointestinal tract, from the mouth to the anus, either in continuity or as isolated areas. The inflammation can involve the inner mucosal lining, up to the full thickness of the bowel wall. Diarrhea, rectal bleeding, abdominal pain, fever, malnutrition, and weight loss are common symptoms.

Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory bowel disease consisting of fine ulcerations in the inner mucosal lining of the large intestine. Inflammation starts at the lower end of the colon, just above the anus, and extends upward in a continuous manner, to variable distances. Diarrhea, rectal bleeding, abdominal pain, and anemia are common symptoms.

Ulcerative Proctitis

Ulcerative proctitis is a mild form of ulcerative colitis. It consists of fine ulcerations in the inner mucosal lining of the large intestine that do not penetrate the bowel muscle wall and reach no more than about 20 cm (8″) into the colon. Rectal bleeding and diarrhea are common symptoms. Most medications for IBD do not have a specific indication for ulcerative proctitis. However, your physician might prescribe one of the medications listed below off label.

Microscopic Colitis

In microscopic colitis, the inflammation is too small to detect during colonoscopy, and requires microscope analysis of a tissue sample (biopsy) to confirm. Abdominal pain and watery diarrhea are common symptoms. Most medications for IBD do not have a specific indication for microscopic colitis. However, your physician might prescribe one of the medications listed below off label.

What are the different drug classes?

Conventional Therapies

5-Aminosalicylic Acid (5-ASA)

5-ASA helps to settle acute inflammation and keep the inflammation inactive when used for maintenance treatment. 5-ASA medication is generally safe and well tolerated for long-term use, but tends to only be effective in treating mild-moderate IBD. They are available in oral and rectal formulations.

Antibiotics

Antibiotics are typically used in the short-term to treat bacterial infections that might result in the compromised gut of individuals with IBD.

Corticosteroids

Corticosteroids are a type of steroid hormone that are anti-inflammatory and immunosuppressive. However, they are only recommended for short-term treatment and can have many negative side effects, including osteoporosis, increased blood sugar, weight gain (particularly in the face and abdomen), blurry vision, mental health symptoms, and more. These are available in oral, rectal, and intravenous infusion formulations.

Immunomodulators

Immunomodulators, or immunosuppressants, are drugs that reduce inflammation by modifying the way that the immune system works. They tend to be safer to use long-term than corticosteroids, but also have many side effects and can make you more susceptible to infection. There are older forms of immunomodulators as well as several newer, more specialized classes, which you can learn about below (biologics, biosimilars, JAK-inhibitors, and S1P-receptor modulators).

Advanced Therapies

Biologics (originators)

Biologics are large molecule medications made from specifically developed proteins that selectively block molecules involved in the inflammatory process. They are newer medications that tend to be very effective. These are available in intravenous infusion and subcutaneous injection formulations.

Biosimilars

Biosimilars are medications that have the same INN as an originator biologic. However, unlike most generic medications, biosimilars are just similar to the originator biologic, not identical. These are available in intravenous infusion and subcutaneous injection formulations.

JAK-Inhibitors

JAK-inhibitors are a newer class of immunomodulators that target inflammation. They typically work faster than biologics, pose no risk for immunogenicity, and are easy and convenient to take since they are in pill form. These are available in oral formulations.

S1P-Receptor Modulators

S1P inhibitors are a newer type of immunomodulators that act as a receptor agonist, sequestering lymphocytes to peripheral lymphoid organs and away from their sites of chronic inflammation. These are available in oral formulations.

What are the different methods of administration?

Intravenous Infusion

This method can only be administered by a healthcare provider. It involves piercing a vein with a needle then inserting a small plastic tube (cannula) that is attached to a bag filled with medication. The medicine slowly enters the blood stream over the course of 30 minutes to several hours. Medications in this format typically need to be taken just once every 4-8 weeks.

Oral

Medications taken by mouth. These can include pills, capsules, and liquids. Medications in this format typically need to be taken daily.

Rectal

Medications taken through the anus. These can include liquids (enemas or foam enemas) or capsules (suppositories). Medications in this format typically need to be taken daily.

Subcutaneous Injection

Medications delivered via injection through the skin into fatty tissue. Medications in this format typically need to be taken every few weeks.

What is an INN?

An International Non-proprietary Name (INN) is a name for an active ingredient or medication that is the same across countries and brands.

What is off-label use of medications?

Health Canada reviews and approves medications for use in Canada for specific indications (diseases or disorders) based on safety, efficacy, and quality (SEQ). When a healthcare professional prescribes medication for an approved indication, it is done on-label. However, many drugs have off-label uses outside of these approved indications. Off-label refers to any use of a drug beyond what Health Canada has reviewed and authorized to be marketed in Canada and as indicated on the product label. Many drugs have off-label use due to new evidence arising from real-world use and because manufacturers might not submit a request for a new indication. Medications can be used safely off-label and with good results, when taken under the guidance of a qualified healthcare professional.