Biologic medications treat ulcerative colitis by reducing inflammation in your body. If other treatments have not helped to manage your symptoms, biologics may be an effective option.

Treatment for ulcerative colitis (UC) has two main goals: to help subdue your flare-ups and to reduce the number of flare-ups you have. Biologics are among the newest drugs available for treating UC. They can be beneficial for those who haven’t found relief yet.

Biologics are a class of genetically engineered drugs that are made from living organisms. They help suppress inflammation throughout your body by targeting proteins related to inflammation, such as cytokines.

Corticosteroids suppress your entire immune system. Biologics differ from corticosteroids and other common treatments because they specifically target problematic proteins.

Biologics are given as intravenous (IV) injections or as IV infusions (slow injections into a vein over a period of time). You’ll receive infusions at a doctor’s office or clinic. You might receive some injections at a doctor’s office, or you may be able to inject the medication yourself at home. The dosing schedule varies for each medication.

You can use biologics in combination with other treatments. Many people can manage UC with a combination of biologics, steroids, and lifestyle strategies.

The Food and Drug Administration (FDA) has approved eight biologic medications for treating UC.

Adalimumab (Humira)

This is a monoclonal antibody that blocks an inflammation-causing protein called tumor necrosis factor (TNF).The FDA originally approved it for treating moderate to severe rheumatoid arthritis. More recently, the FDA approved it to treat moderate to severe UC. However, it has other indications, including:

  • Crohn’s disease
  • plaque psoriasis
  • hidradenitis suppurativa
  • polyarticular juvenile idiopathic arthritis
  • ankylosing spondylitis

The drug is prescribed for adults whose UC has not responded to treatment with immunosuppressants.

Humira is given as an injection. You can give yourself these injections, or your doctor may give them to you.

The first dose is 160 milligrams (mg), and the second dose, given 2 weeks later, is 80 mg. Beginning 2 weeks after the second dose, you’ll take a 40-mg dose every other week.

Golimumab (Simponi)

Simponi may be suitable if you need to take corticosteroids to treat your UC or if your UC has not responded well to other medications.

You’ll receive this medication by injection, starting with a 200-mg dose and then a 100-mg dose 2 weeks later. You will then have a 100-mg injection every 4 weeks. You can give yourself these injections at home.

Guselkumab (Tremfya)

This medication blocks the activity of interleukin-23, a protein in your body that contributes to inflammation.

The first dose is 200 mg, which you’ll receive as an IV infusion over at least 1 hour. You’ll have another infusion at week 4 and another at week 8.

After that, you’ll take doses as injections according to one of these two schedules:

  • a 100-mg dose every 8 weeks, starting 8 weeks after the last infusion (week 16)
  • a 200-mg dose every 4 weeks, starting 4 weeks after the last infusion (week 12)

Your doctor might give you the first few injections and then show you how to inject the medication at home.

Infliximab (Remicade)

This medication is approved to treat moderate to severe UC in people who haven’t responded well to other treatments. It blocks the activity of TNF.

Infliximab is given as an IV infusion. You’ll receive your first dose at week 1, a second dose at week 2, and another at week 6. After that, you’ll receive doses every 8 weeks. The amount of medication you receive in each dose will depend on your weight. Each infusion will last at least 2 hours.

Mirikizumab (Omvoh)

This medication reduces inflammation by blocking the activity of interleukin-23.

The first dose is 300 mg, which you’ll receive as a 30-minute IV infusion. You’ll have another IV infusion at week 4 and another at week 8. After that, beginning at week 12, you’ll take two injections of 100 mg each (a total of 200 mg) every 4 weeks. Your doctor can show you how to give these injections at home.

Risankizumab (Skyrizi)

This drug blocks the activity of interleukin-23.

The first dose is 1,200 mg, given as an IV infusion that lasts at least 2 hours. You’ll receive the same dose at week 4 and again at week 8.

After that, beginning at week 12, you’ll take a 180-mg or 360-mg dose as an injection every 8 weeks. Your doctor will prescribe the dose that effectively treats your condition. They will show you how to inject the medication at home.

Ustekinumab (Stelara)

This drug reduces inflammation by blocking the activity of interleukin-12 and interleukin-23.

You’ll receive your first dose as an IV infusion. The amount of medication you receive in the first dose will depend on your weight. After that, you’ll receive a 90-mg dose every 8 weeks, regardless of how much you weigh.

Vedolizumab (Entyvio)

This medication is approved for use in those who cannot tolerate or have not responded to other treatments.

You’ll receive the first dose of 300 mg as a 30-minute IV infusion. You’ll receive the second dose in the same way at week 2.

After that, you’ll receive the drug according to one of the following schedules:

  • a 300-mg infusion at week 6 and then every 8 weeks
  • a 108-mg injection at week 6 and then every 2 weeks

Biologics may cause side effects. The most common side effects are skin redness or discoloration, itching, bruising, and pain at the injection site.

Other possible side effects include:

  • headache
  • chills
  • fever
  • hives
  • low blood pressure
  • breathing difficulties
  • rash
  • nausea
  • stomach pain
  • back pain

Biologics can interfere with your body’s ability to fight infection. Some serious infections have been reported with biologic use, including:

  • tuberculosis (TB)
  • sepsis
  • progressive multifocal leukoencephalopathy, which is a rare brain infection

You’ll need to be tested for TB and hepatitis B before you start biologic therapy.

Contact your doctor immediately if you have any symptoms of infection while taking one of these medications.

Biologics might increase your risk of developing certain cancers, including lymphoma. You should see a dermatologist for annual skin cancer screenings during biologic treatment. You should not take biologics if you have heart failure or liver disease.