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Moderate to severe UC can be managed with treatment and healthy lifestyle changes.
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Regularly keeping track of your symptoms, along with how you're feeling and lifestyle habits (like diet and exercise), can help you and your healthcare providers determine your treatment plan.
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Use the options table below and download the discussion tool to help you talk to your doctor.

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Making sure your treatment plan is right for you
Whether you’ve just been diagnosed or have been living with moderate to severe UC for years, it’s important that your treatment plan works for you. Be sure to talk to your doctor about any changes or discomfort you are experiencing. Every case is different and there may be treatment options better suited to you. 
Drug options to consider
There is a variety of different categories of medications that can be used in the treatment of moderate to severe UC. This includes sulfasalazine and 5-ASA, corticosteroids and immunomodulators. The table below focuses on options that your doctor may suggest if you cannot tolerate certain treatments or have had an inadequate response to specific medications.
Active ingredient
tofacitinib
adalimumab
golimumab
infliximab
ustekinumab
vedolizumab
Products
PrXELJANZ®
PrHUMIRA®
Biosimilars:
PrABRILADA®
PrAMGEVITA®
PrHADLIMA®
PrHULIO®
PrHYRIMOZ®
PrIDACIO®
PrSIMPONI®
PrREMICADE®
Biosimilars: 
PrAVSOLATM
PrINFLECTRA®
​​​​​​​PrRENFLEXISTM
PrSTELARA®/
PrSTELARA® IV
PrENTYVIO®
How is it taken
Pill, taken orally
SC injection, given by nurse
​​​​​​​or myself 
SC injection, 
given by myself 
IV infusion, given by
​​​​​​​nurse 
IV infusion, given by nurse
followed by SC injection, 
given by myself
IV infusion, given by nurse
​​​​​​​followed by SC injection, 
given by myself
How often to take it
​​​​​​​(initially)
1 tablet twice daily for 8 weeks
2 injections, 2 weeks after first dose
1 injection, 2 weeks after first dose
1 infusion, 2 and 6 weeks
after first dose
1 IV infusion, followed by 1 SC injection 8 weeks later
2 IV infusions, 2 weeks apart
How often to take it
​​​​​​​(long-term)
1 tablet twice daily
1 injection every 2 weeks
1 injection every 4 weeks
1 infusion every 8 weeks
1 SC injection every 8 weeks
1 IV infusion, 6 weeks after first dose; 1 SC injection every 2 weeks
Possible side effects
Upper respiratory tract infection, nasopharyngitis, headache, diarrhea, nausea, indigestion, cough, dizziness, vomiting, back pain, joint pain, rash, muscle weakness/pain

Serious infections, lymphoma, other cancers and other serious conditions, blood clots that may cause death 
Injection site reaction, cough and cold symptoms, including sore throat, headache, rash, nausea, pneumonia, fever, abdominal pain

Allergic reactions, hepatosplenic T-cell lymphoma and other cancers which may result in death, lupus-like symptoms, rare cases of nervous system diseases, serious infections, blood problems such as anemia or low platelets
Flu, bronchitis, infection of soft tissues, sore throat, upper respiratory infection, sinus infection, runny nose, cold sores, abnormal liver tests, dizziness, numbness or tingling, high blood pressure, fever, hair loss and redness at the site of injection

Serious infections, lymphoma and other cancers which may result in death
Shortness of breath, rash, headache, abdominal pain, back pain, coughing, diarrhea, dizziness, fatigue, itchiness, pain, upper respiratory infections, upset stomach, and urinary tract infections

Serious infections, lymphoma and other cancers which may result in death; some patients have developed hepatosplenic T-cell lymphoma
Upper respiratory tract infections, infection of the nose and throat, dizziness, headache, sore throat, diarrhea, nausea, vomiting, itching, back pain, muscle aches, joint pain, feeling very tired, redness of the skin where the injection is given, pain where the injection is given, sinus infection
Nasopharyngitis, arthralgia, headache, nausea, fever, upper respiratory tract infection, fatigue and cough and injection site reactions
5-ASA = 5-aminosalicylic acid;
IV = intravenous; SC = subcutaneous.
A biosimilar biologic drug, or biosimilar, is a drug demonstrated to be highly similar to a biologic drug that has already been authorized for sale 
​​​​​​​​​​​​​(known as the reference biologic drug).
This is not a complete list of side effects. Talk to your doctor for complete medication information.
Your doctor will monitor your response to treatment and may adjust the dosage as needed.
Insurance coverage may vary between treatments. Your doctor or insurance provider can help you determine which treatments you are  eligible for.

Information valid as of March 2022.
Non-drug options to consider

See the following options available to you for your moderate to severe UC:

SURGERY

Surgery treatment for UC typically includes a total proctocolectomy (removal of the rectum and part or all of the colon) and ileoanal pouch anastomosis (creation of a J-pouch: a pouch shaped like the letter J from the end of the small intestine is created and attached to the rectum).

EXCLUSIVE ENTERAL NUTRITION (EEN)

EEN delivers daily nutrients to the body in liquid form. A soft, flexible tube called a nasogastric (NG) tube goes from your nose to your stomach to deliver the nutrients. Inserted at a hospital, your healthcare provider will explain how to continue feeds at home using the feeding pump, tubing, and any other equipment you need.

FECAL MATTER TRANSPLANT (FMT)

FMT is an experimental procedure of inserting stool from a healthy donor into a recipient to restore the normal microbiome (microorganisms that live in our body) in a recipient’s large bowel. Research is ongoing in this area.

Talking to your doctor
There are many different types of lifestyle adaptations and medications available to help treat moderate to severe ulcerative colitis (UC), so it’s important to keep your doctor up to date about your symptoms and also to let them know how you are feeling on your current treatment plan, and whether this plan aligns with your lifestyle and goals.
Check off the talking points below that are important to you, then bring them to your next appointment.
Understanding my UC treatment options
 Want to find out more about the different treatment options available?
If you suffer from moderate to severe UC and cannot tolerate certain medications, or have had an inadequate response to specific medications, fill out the questionnaire to prepare for your next appointment and find the best fit for you.
Question 1

I would like to understand my treatment options in more detail.

Understanding my UC treatment options
 Want to find out more about the different treatment options available?
If you suffer from moderate to severe UC and cannot tolerate certain medications, or have had an inadequate response to specific medications, fill out the questionnaire to prepare for your next appointment and find the best fit for you.
Question 2

I feel like I need to plan my life around my medications and it’s not always convenient.

Understanding my UC treatment options
 Want to find out more about the different treatment options available?
If you suffer from moderate to severe UC and cannot tolerate certain medications, or have had an inadequate response to specific medications, fill out the questionnaire to prepare for your next appointment and find the best fit for you.
Question 3

I would prefer to take my medication:

Understanding my UC treatment options
 Want to find out more about the different treatment options available?
If you suffer from moderate to severe UC and cannot tolerate certain medications, or have had an inadequate response to specific medications, fill out the questionnaire to prepare for your next appointment and find the best fit for you.
Question 4

It’s important for me to choose medications that fit with my lifestyle 
(e.g., easy storage, simple preparation).

Understanding my UC treatment options
 Want to find out more about the different treatment options available?
If you suffer from moderate to severe UC and cannot tolerate certain medications, or have had an inadequate response to specific medications, fill out the questionnaire to prepare for your next appointment and find the best fit for you.
Question 5

I’m unfamiliar with all the different treatment options and would like to discuss them.

Understanding my UC treatment options
 Want to find out more about the different treatment options available?
If you suffer from moderate to severe UC and cannot tolerate certain medications, or have had an inadequate response to specific medications, fill out the questionnaire to prepare for your next appointment and find the best fit for you.
Question 6

I want to learn more about specific drug options [select all that interest you]:

Understanding my UC treatment options
 Want to find out more about the different treatment options available?
If you suffer from moderate to severe UC and cannot tolerate certain medications, or have had an inadequate response to specific medications, fill out the questionnaire to prepare for your next appointment and find the best fit for you.

My next appointment:

Date:

Time:

Understanding my UC treatment options
 Want to find out more about the different treatment options available?
If you suffer from moderate to severe UC and cannot tolerate certain medications, or have had an inadequate response to specific medications, fill out the questionnaire to prepare for your next appointment and find the best fit for you.

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the discussion guide!

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