When are anti-TNF agents contraindicated in the treatment of inflammatory bowel disease (IBD)?

Updated: Apr 10, 2020
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Most aminosalicylates do not have substantial interactions with non-IBD agents. The side effects of corticosteroids may be exacerbated in the older population, particularly in those with diabetes, accelerated bone loss, and cataract formation. The anti-TNF agents are generally contraindicated in patients with congestive heart failure (CHF) but can be used once the CHF is controlled. The immune-modifying agents have a clinically important interaction with allopurinol, as allopurinol tremendously increases the serum levels of mercaptopurine and azathioprine to the point where these agents can quickly manifest toxicity.

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