Adverse effects of IBD

*Amino-salicylates
Sulfasalazine: adverse effects
-GI: Nausea, vomiting

-Renal: renal stones

-Hypersensitivity: Skin rash

-General: Headache

Olsalazine: adverse effects

-Diarrhoea in 10 % cases

Mesalazine: adverse effects

-Renal damage

*Glucocorticoids: adverse effects

-Prednisolone & budesonide (oral)

-Hydrocortisone (oral & IV)

-Hypertension, hyperglycemia, peptic ulcer, infections

-Adrenal suppression

-Stop treatment with gradually decreasing doses

*Immune-suppressive drugs
Azathioprine: Adverse effects
-Bone-marrow suppression (leukopenia, anemia &
thrombocytopenia).

-GI-upset (nausea, vomiting, diarrhoea).

-Skin rash.

Methotrexate : Adverse effects

-Bone-marrow suppression, GI-upset, alopecia, infection

-Leucovorin (folinic acid) is given to prevent toxicity

Infliximab & Adalimumab: Adverse effects

-Can cause myelosuppression & infections

-Drug reaction: fever, urticaria, chest pain & dyspnea

-Infliximab: Slow IV infusion every week or 2 week

-Adalimumab: Subcutaneous injection every week