1.5.3 Steroid-sparing treatment for inflammatory bowel disease

ChoiceDrugDosage
1st choiceAzathioprine tablets 25mg, 50mgDose: 2-2.5mg/kg daily
Or
Mercaptopurine 50mg tablets, 20mg/ml oral suspensionDose: 1-1.5mg/kg daily

Prescribing Notes

  • Azathioprine or mercaptopurine can be used on specialist advice in selected patients with steroid dependent inflammatory bowel disease as a steroid-sparing agent. These drugs require blood monitoring in line with shared care protocols. See Shared Care Guidelines on the Interface Pharmacy website for further information.
  • Methotrexate may be an option for such patients who cannot tolerate azathioprine or mercaptopurine.

Caution

  • ‘Mercaptopurine’ has a similar name to ‘mercaptamine’. Practices and community pharmacists are encouraged to take steps to minimise the risks associated with this, e.g. when selecting these medicines for prescribing from GP clinical system ‘pick lists’. See  the Medicines Safety bulletin for further information.