Medications and Treatment

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The recommendations below are based on the latest available evidence for people living with IBD. It may change over time as new information becomes available and/or the risk of COVID-19 changes.

This page contains information on: 
Do Not Stop IBD Medications 
Ibuprofen and Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
Risk of COVID-19 and IBD Medications 


Do not discontinue your IBD medications, unless recommended to do so by your medical health care practitioner. If you get COVID-19, discuss with your doctor whether to stop or hold your medications. Never stop steroids suddenly unless instructed by your doctor.

If your biologic infusion or injection must be delayed because you have COVID-19, or because you are isolated because you are a close contact on someone with COVID-19, contact your physician to reschedule your medication. For more information on infusion clinics and access to biologic or biosimilar medications, please visit our Infusion Clinics page

Watch the 1-minute video below for important guidelines about taking your IBD medication during the COVID-19 pandemic.



Non-steroidal anti-inflammatory drugs (NSAIDs) are often used for pain, inflammatory conditions, and to reduce fever, including ibuprofen (Advil®, Motrin®) and naproxen (Aleve®).

The association of these drugs with COVID-19 infection and complications is controversial, and Health Canada has stated that there is no association between NSAIDs and COVID complications.

However, NSAIDs have also been associated with flare-ups of IBD, and therefore all IBD patients (whether taking immunosuppressive medications or not) should avoid starting these medications if possible.

Watch the 2-minute video below for expert recommendations on using NSAID medications during the the COVID-19 pandemic (as of March 19 2020). 


Risk of covid-19 and medications 

If you are on immunosuppressive medications, you may be at increased risk for infection and serious complications of COVID-19.

Immunosuppressive and biologic medications include:

  • Steroids: prednisone (Deltasone), methylprednisolone, hydrocortisone (Hydrocort, Cortate). For more information about steroids and COVID-19, click here

  • Immunomodulators: azathioprine (Imuran), 6-mercaptopurine (Purinethol), methotrexate

  • Anti-TNF biologics: infliximab (Remicade®, Inflectra®, RenflexisTM), adalimumab (Humira®), golimumab (Simponi®)

  • Anti-IL12/23 biologics: ustekinumab (Stelara®)

  • Anti-leukocyte migration biologics: vedolizumab (Entyvio®)

  • JAK inhibitor small molecules: tofacitinib (Xeljanz®). For more information about JAK Inhibitors, click here

The following IBD treatments do not suppress your immune system:

  • 5- aminosalicylates (5-ASA's): mesalamine, mesalazine (Asacol®, Mezavant®, Pentasa®, Salofalk®), sulfasalazine (Salazopyrin®)

  • Locally acting steroids: budesonide (Entocort®), budesonide MMX (Cortiment®), steroid enemas

  • Enteral nutrition (formula feeds) or dietary therapies
  • Probiotics

Watch the 7-minute video below to hear experts provide an update on trends we've seen among people who are taking IBD medication and have been diagnosed with COVID-19

To find out if you're at risk of COVID-19 severe disease and what you should do, please visit our Are You at Risk page


JAK Inhibitors

The inhibitors that are being used, or immune modulators, are not generally being tested earlier in the disease, when ramping up the immune response might actually be a good thing to inhibit the virus. It's all about timing. You want some inflammation, some ramp up of your immune system, but maybe not as much at the beginning as you want five to seven days after infection. Therefore, most clinical trials are concentrating on that time point.

So are you protected if you're already on an immune modulator from getting very severe disease? We don’t know the answer yet. There may be some risk with some of the JAK kinase inhibitors of actually developing slightly more moderate disease if you are already on them beforehand. But if you only start taking a JAK inhibitor after your infection, it might be a benefit.

Watch the 1-minute video below for expert recommendations on using JAK inhibitor medications during the the COVID-19 pandemic. 



While steroids may also be a risk factor for severe complications of COVID-19, the data at this time is preliminary. If you are taking steroids for IBD treatment, never stop them suddenly unless instructed by your doctor. Similarly, do not start using steroids on your own if you think you are having a flare of your IBD.

If you are prescribed steroids for your IBD who is not a gastroenterologist or IBD specialist, the need for these medications should be confirmed if possible with your gastroenterologist or IBD specialist.

Watch the 1-minute video below for expert recommendations on using steroid medication during the COVID-19 pandemic. 


Dr Benchimol and Dr Kaplan photos

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Last Updated: October 8, 2020

  • Canada has among the highest incidence rates of Crohn's and colitis in the world.
  • 1 in 140 Canadians lives with Crohn’s or colitis.
  • Families new to Canada are developing these diseases for the first time.
  • Incidence of Crohn’s in Canadian kids under 10 has doubled since 1995.
  • People are most commonly diagnosed before age 30.