Help us improve our information
We need your help to improve our information to better support people with Crohn’s and Colitis. Fill in our short survey to let us know what we're doing well and how we can better meet your needs.
Last reviewed: October 2023
Next review date: October 2026
This information is for anyone who is taking an immunosuppressant for Crohn’s or Colitis. It is also for people who are thinking about starting an immunosuppressant. This information will help you understand:
This information is about immunosuppressants in general. Different immunosuppressants weaken your immune system by different amounts, and in different ways. We also have information about the individual medicines used to treat Crohn’s or Colitis. This explains the risks and benefits of each medicine in more detail.
We need your help to improve our information to better support people with Crohn’s and Colitis. Fill in our short survey to let us know what we're doing well and how we can better meet your needs.
Immunosuppressants are effective treatments for Crohn’s and Colitis. They can help to get your symptoms under control and keep them under control. For many people, taking an immunosuppressant can improve their quality of life.
Immunosuppressants used to treat Crohn’s and Colitis include:
5-ASAs (aminosalicylates) are not immunosuppressants.
Immunosuppressants affect the way your immune system works. This means you may be at risk of complications associated with a weakened immune system. This includes infections. You can still fight off infections, but not quite as well as other people.
Not all immunosuppressive medicines affect the immune system in the same way. Some affect the immune system more than others, which may put you at greater risk from infection. Or your immunosuppressant might have a greater risk of certain types of infections. Your risk from infection increases as you get older. It is greater if you are under-nourished or obese, if you have certain other illnesses, or if you are in a flare-up. The risk is also greater if you are taking more than one immunosuppressant.
Some immunosuppressants can also slightly increase your risk of developing some types of cancer, in particular skin cancers. This risk is very small.
Even though your risk of complications may be higher it should not stop you from living life as before. Here we suggest some practical things you can consider doing to keep safe and reduce your risk.
You can reduce your general risk of infection through good hygiene.
It is a good idea to wash your hands often with soap and water, or use an alcohol-based hand gel. In particular:
Try to avoid close contact with people who have a serious infection. If this is not possible, some experts recommend taking extra care with hand washing. You could also consider wearing a mask if the person has a respiratory infection.
Some foods can make you unwell from infections such as listeria or salmonella. You can reduce your risk of this through good food hygiene and sensible food choices.
Make sure you prepare, handle, and store food safely
Consider your risk of infection before eating the following foods:
There is little evidence about taking probiotics whilst on an immunosuppressant, but it is generally considered safe.
Your IBD team will make sure your vaccines are up to date before you start an immunosuppressant. Let them know if you are planning to have any vaccines, or you have had a vaccine recently. They will also check:
You may also be eligible for:
These are all ‘non-live’ vaccines and are safe for you to have.
You should not have any ‘live’ vaccines while you are taking an immunosuppressant
In the UK live vaccines include:
Before you start an immunosuppressant, think about any vaccines that you might need in the future. For example, if you are planning to travel. You might be able to have these before you start treatment.
Close contacts of people who are immunosuppressed should also be up to date with their vaccines. This reduces the risk of spreading infection. If someone you live with has had a live vaccine, they could pass on the infection for up to 2 weeks after. But this risk is very low. If your child is due to receive the live nasal flu vaccine, you can ask for them to have the non-live vaccine instead.
Plan your trip in advance. If you can, try to plan your trip at least 6 to 8 weeks before you go. If you are travelling for more than 3 months, allow a bit longer if you can. This gives you time to get travel advice, order medicines and arrange any vaccines you might need.
To reduce your risk while travelling:
IBD passport has useful advice and information on travelling with Crohn’s or Colitis.
See Travelling with Crohn's or Colitis for more information on planning your trip.
If you are taking an immunosuppressant, you may be slightly more at risk of skin reactions, and in rare cases skin cancer.
To reduce your risk:
Some immunosuppressants make your skin more sensitive to the sun. Exposure to the sun can cause a severe reaction that looks and feels like sunburn. Exposed skin may develop a rash, redness, swelling, blisters, red bumps, or oozing wounds. If the reaction is severe the skin can become infected. Immunosuppressants that can make your skin more sensitive include azathioprine and methotrexate.
Check your skin regularly and contact your GP if:
People with a weakened immune system are at increased risk of skin infections.
There is likely to be a small risk of skin infection with procedures such as tattooing, body piercing and cosmetic surgery.
To reduce your risk, consider the following:
In general, laser hair removal is considered safe.
Animals can carry diseases that could make you unwell. Some animals may be more high risk. This includes:
If you have a weakened immune system, you can still enjoy interacting with animals.
Follow the tips below to stay safe and healthy:
Keep your pet’s routine vaccinations up to date.
The kennel cough vaccine for dogs is a modified live vaccine. It contains a weakened form of the bacteria that causes kennel cough. If your dog needs a kennel cough vaccine, it can be a good idea to:
There is no agreement as to how long you should avoid your dog after it has had a kennel cough vaccine. The product information for the vaccine says that people who have a weakened immune system should avoid contact with vaccinated dogs for up to 6 weeks after vaccination. But the company that makes the vaccine also says that the vaccine is not likely to represent a major risk. And that the risk would be greater if your dog got kennel cough. You may want to discuss precautions or other options with your vet. You could also discuss concerns with your GP or IBD team.
Swimming in open water, such as lakes, rivers, natural pools, and the sea can help your physical and mental health. But it can increase the risk of infections such as tummy bugs and lung, skin, ear, or eye infections.
To reduce your risk of infection:
If you think you might have an infection, contact your GP, IBD team or NHS 111.
Signs of an infection include:
Who you contact will depend on your local service. But if your symptoms are severe and you need urgent help then contact NHS 111.
Search our Find an IBD nurse specialist page to find your local specialist service.
We follow strict processes to make sure our information is based on up-to-date evidence and easy to understand.
Please email us at evidence@crohnsandcolitis.org.uk if:
You can also write to us at Crohn’s & Colitis UK, 1 Bishop Square, Hatfield, AL10 9NE, or contact us through our Helpline: 0300 222 5700
Use this tool to understand more about potential treatment options that suit your needs. The tool is designed to help you:
We know it can be difficult to live with, or support someone living with these conditions. But you’re not alone. We provide up-to-date, evidence-based information and can support you to live well with Crohn’s or Colitis.
Our helpline team can help by:
Providing information about Crohn’s and Colitis.
Listening and talking through your situation.
Helping you to find support from others in the Crohn’s and Colitis community.
Providing details of other specialist organisations.
Please be aware we’re not medically or legally trained. We cannot provide detailed financial or benefits advice or specialist emotional support.
Please contact us via telephone, email or LiveChat - 9am to 5pm, Monday to Friday (except English bank holidays).
If you need specific medical advice about your condition, your GP or IBD team will be best placed to help.
Would you like to save the changes made to this page?
Your details were successfully saved.