Azathioprine AZA and 6-mercaptopurine (6MP)
These two medications are primarily used as maintenance treatment in Crohns’ disease, and have been used for over 25 years. They are also used in patients with ulcerative colitis whose symptoms persist despite the use of amniosalicylates (see above). These medications typically take 3-6 months to be effective.
Methotrexate is another immunomodulatory medication used as a maintenance therapy for Crohn’s disease. This medicine typically takes 4 weeks before it may be effective.
Cyclosporine (Gengraf ®, Neoral ®, Restasis ®, and Sandimmune ®) and Tacrolimus (Prograf ®)
Cyclosporine and tacrolimus are medications that may be used short term to induce a remission in Crohn’s or ulcerative colitis patients with severe symptoms and persistently active disease despite conventional treatments.