There are several drugs a person with ulcerative colitis (UC) should avoid, as they may worsen symptoms. Examples include nonsteroidal anti-inflammatory drugs, some antibiotics, certain supplement ingredients, and some live vaccines.

UC is a form of inflammatory bowel disease (IBD). It causes a person’s immune system to react abnormally, leading to inflammation in the colon. These reactions may also cause ulcers on the colon’s inner lining.

A person with UC may experience some of the following symptoms:

These symptoms often appear during flare-ups. Flare-ups often occur before a period of remission, during which the person experiences few or no symptoms.

Taking the correct medication and avoiding certain medication mistakes can help a person lessen the frequency or severity of these flare-ups.

Read on to learn about drugs a person with UC should avoid or may wish to avoid, alongside tips on managing medication to help improve symptoms.

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Some medications can worsen symptoms of UC. A person with UC should avoid taking:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are common medications that people use to help relieve pain, inflammation, and fevers.

These drugs can cause flare-ups in people with UC. If a person with UC does want to take NSAIDs, it is important to speak with a doctor first.

NSAIDs that a person should avoid include:

Ibuprofen

Ibuprofen is a common NSAID that can cause flare-ups of UC symptoms. People use ibuprofen to help relieve the symptoms of fever and pain. Common ibuprofen brand names include:

  • Cuprofen
  • Advil
  • Brufen
  • Motrin

Naproxen

Naproxen (Aleve) is another NSAID that people use to help treat fever and pain.

Naproxen can worsenTrusted Source the symptoms of UC. One symptom that naproxen may worsen is gastrointestinal bleeding or perforation.

Aspirin

Aspirin is a common NSAID to help relieve minor aches, pains, and fevers. It can also work as an anti-inflammatory or a blood thinner.

There is mixed evidence regarding the effect aspirin has on people with UC. Some medical professionals state that aspirin can worsen the symptoms of UC.

However, according to a 2023 study, long-term aspirin use in people with UC is associated with a lower riskTrusted Source of in-hospital mortality and shorter length of stay.

A person with UC should speak with their doctor before taking aspirin.

Some antibiotics

Doctors use antibiotics to help treat bacterial diseases. Antibiotics work by destroying or slowing down the growth of bacteria.

If a person with UC uses antibiotics, they may experience a flare-up of symptoms.

Research from 2022 also suggests that antibiotic exposure may be associated with an increased risk of developing IBD, particularly among people ages 40 years and older.

A medical professional needs to be aware that a person has UC before prescribing antibiotics for an unrelated infection.

Some ingredients in supplements

Some supplements are very beneficial for people with UC. These include calcium, folic acid, and iron. However, some ingredients in supplements may worsen the symptoms of UC.

According to the Crohn’s and Colitis Foundation, people should avoid supplements that contain:

These ingredients may aggravate a person’s UC symptoms, particularly during a flare-up.

The Crohn’s and Colitis Foundation also adds that people should avoid taking any supplements on an empty stomach.

It is important for a person to check with a medical professional before taking any supplements, including:

  • herbal supplements
  • over-the-counter medications
  • complementary therapies

Some live vaccines

Live vaccines use a weakened version of the germ that causes a disease. This allows a person to build an immune response to the disease, which can then give a person protection against it.

However, if a person is taking medication to treat their UC that weakens their immune system, they may be at a slight risk of infection if they have a live vaccine. This is a low risk and only applies to a small number of live vaccines, including:

  • Chickenpox: If the person vaccinated for chickenpox develops a rash, they may be at risk of infection. They should cover up the rash and avoid face-to-face contact until it is dry and crusted.
  • Rotavirus for babies: It is important for a person to practice good hygiene after contact with babies for two weeks after rotavirus vaccination. This can include washing their hands well after changing a diaper and before preparing food.
  • Nasal spray flu for children: Only severely immunocompromised people are at risk with this vaccine. A person can discuss any concerns with a doctor.

The Canadian Association of Gastroenterology Clinical Practice Guidelines, which the American Gastroenterological Association endorses, recommend administering live vaccines for people with IBD who are not receiving immunosuppressive therapy.

If a person has UC, they should discuss any planned vaccines with a medical professional before proceeding.

It is important to remember that the COVID-19 vaccine does not contain a live or intact virus.

Other medications

A person with UC who takes medication for another condition should always inform their doctor of those circumstances. This is because other medications can sometimes interfere with their UC treatment.

For example, allopurinol is a medication that helps treat gout. It can increase the harmful effects of a UC medication called azathioprine.

A person with UC may be able to improve their symptoms and avoid more regular flare-ups with the following tips:

Take medication as a doctor has advised

Research shows that people with UC do not always continue to take their medications for as long as prescribed.

This may be due to having severe symptoms, high stress levels, a lack of confidence in managing their condition, or a difficult relationship with healthcare professionals.

However, it is important that a person with UC takes their medications as prescribed. This can help ease symptoms and prevent flare-ups from occurring.

Follow a recommended corticosteroid dose

Corticosteroids are common treatments for UC flare-ups. It is important that a person follows their exact dosage over time.

Doctors may prescribe a higher dose and reduce it gradually.

This is because if a person takes too much of a corticosteroid over a long period, it can put them at a greater risk of several problems, including heart problems and mood disorders.

It is important that a person gradually tapers off their use of corticosteroids. This is because instantly or rapidly stopping the course may be harmful.

Keep taking medication outside flare-ups

UC is a chronic condition that can affect people for life.

If a person is in remission, it is important that they do not assume their condition is “cured” and stop taking their medication. This is because treatment for UC often helps the person remain in remission.

What medications make ulcerative colitis worse?

Certain medications can exacerbate the symptoms of ulcerative colitis, including NSAIDs such as ibuprofen, antibiotics, and some live vaccines.

It’s important for a person to consult a healthcare professional before taking any new medications.

What’s the worst thing for ulcerative colitis?

The worst things for ulcerative colitis includeTrusted Source:

  • NSAIDs
  • stress
  • less nutritious diet choices

These factors can exacerbate symptoms and trigger flare-ups.

What is the safest medication for ulcerative colitis?

The safest medication for UC is typically aminosalicylates (5-ASA), such as sulfasalazine or mesalamine.

Doctors commonly use these for mild to moderate cases, and they have a favorable side effect profile compared to other treatments.

What is the drug of choice for ulcerative colitis?

The drug of choice for UC is typically an aminosalicylate, like mesalamine (5-ASA), for mild to moderate cases.

For more severe cases, doctors may prescribe corticosteroids, immunomodulators, targeted synthetic small molecules, or biologics.

Ulcerative colitis (UC) is a chronic condition that affects the colon. It causes inflammation, which can result in symptoms such as diarrhea, rectal bleeding, and abdominal pain.

A person with UC may wish to avoid some medications that may worsen their UC symptoms. These include some NSAIDs, such as ibuprofen, naproxen, and possibly aspirin. Some antibiotics may also exacerbate symptoms of UC.

A person with UC should avoid some supplements that can worsen symptoms. They may also wish to discuss planned vaccines with their doctor before receiving them.