Rectal Medications, IV Drugs and Injections to Treat Crohn's Disease and Ulcerative Colitis

Several types of medications are available to treat IBD (e.g., Crohn's, colitis). Information about the medications represent the usual daily dosages for the treatment of these digestive disorders.

The precise effective dosage varies from person to person and depends on many factors. Do not make any changes to your medication without consulting your doctor. Instructions represent the typical way to take the medication. Your doctor's instructions may differ. Always follow your doctors recommendations.

Rectal Medications to Treat IBD

  • Aminosalicylate anti-inflammatory compounds
    • Canasa (mesalamine suppositories)—Insert one 1,000-mg suppository at bedtime. For best results, have a bowel movement before using and keep in your rectum for at least 2 hours.
    • Rowasa (mesalamine enema)—At bedtime, insert the tip of one bottle into your rectum and empty the bottle's contents. For best results, use after a bowel movement and hold the medicine in your rectum overnight.
  • Corticosteroid
    • Colocort (hydrocortisone enema)—At bedtime, insert the tip of one bottle into your rectum and empty the bottle's contents. For best results, use after a bowel movement and hold the medicine in your rectum for at least 1 hour (and preferably overnight).

Patients using Canasa should handle as little as possible, because heat from your hands can melt the suppository. Canasa and Rowasa may stain surfaces such as your clothing, floors or countertops.

Intravenous Medications to Treat IBD

  • Corticosteroid
    • (methylprednisolone)—requires administration by a health professional who will infuse the medication into your body through a needle placed in a vein in your arm
  • Monoclonal antibody
    • Remicade (infliximab)—You will go to your doctor every 8 weeks to receive the medication through a needle in a vein in your arm. This takes about 2 hours.
    • Tysabri (natalizumab)—You will go to an infusion center every 4 weeks to receive the medication through a needle in a vein in your arm. This takes about 1 hour.

Before receiving monoclonal antibody medications, your doctor will do a skin test to see if you have been exposed to tuberculosis (TB). If the test is positive, you will receive treatment for TB, because these medications can activate a latent (silent) TB infection. Tysabri increases the risk of progressive multifocal leukoencephalopathy, a serious brain infection. To receive this drug, you must be enrolled in a program that tracks safety information.

Injections to Treat IBD

  • Immunomodulator
    • (methotrexate)—Visit your doctor 1x/week for an injection.
  • Monoclonal antibody
    • Cimzia (certolizumab pegol)—You will go to your doctor to receive an injection; 400 mg every 2 weeks for first 3 doses, then every 4 weeks.
    • Humira (adalimumab)—You inject the medication under your skin via a single-use injection pen once every 2 weeks.

Patients receiving methotrexate should avoid alcohol, because it can cause dizziness. You will also be more sensitive to the sun, so wear sunscreen and avoid excessive sun exposure and sun lamps.

Publication Review By: H. Franklin Herlong, M.D.

Published: 30 Mar 2011

Last Modified: 22 Sep 2015