An oral tablet for ulcerative colitis that calms gut inflammation
Etrasimod
A once-daily tablet used to treat moderately to severely active ulcerative colitis by calming the immune attack on the bowel.
What is Etrasimod?
Etrasimod is an oral medicine used to treat moderately to severely active ulcerative colitis, a long-term condition where the lining of the large bowel becomes inflamed and ulcerated. It is a type of medicine called an S1P-receptor modulator, which works by keeping certain immune cells from travelling to the gut, so the inflammation settles. It is taken as a once-daily tablet. An important safety point is that it can slow the heart rate, especially when treatment first starts, so a heart-rhythm check (an ECG) is often done beforehand. It also needs eye checks, raises the risk of infections, and means avoiding live vaccines.
Education and reference only. This is a plain-language guide to Etrasimod — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Etrasimod is a tablet used to treat ulcerative colitis, an inflammatory bowel disease in which the immune system attacks the lining of the large bowel, causing diarrhoea, bleeding, urgency and pain. It belongs to a group of medicines known as S1P-receptor modulators, which reduce the number of certain immune cells that reach the gut. It is used when the condition is moderately to severely active, often after other treatments have not worked well enough or are not suitable. It is taken by mouth once a day and is prescribed and monitored by a specialist team.
How it works
Etrasimod works by trapping certain white blood cells, called lymphocytes, inside the lymph nodes so that fewer of them travel through the bloodstream to the bowel. With fewer of these immune cells reaching the gut lining, the ongoing inflammation that drives ulcerative colitis is reduced and the bowel can heal. Because the same receptors it acts on are found in the heart, the medicine can briefly slow the heart rate, particularly with the first doses, which is why the heart is checked before starting and why the medicine is begun carefully.
Company & origin
Originated / developed by: Specialist manufacturer.
A newer oral medicine used in the UK to treat moderately to severely active ulcerative colitis, taken once a day as a tablet.
Practical use
How to take Etrasimod
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take one tablet by mouth once a day, at about the same time, with or without food.
- Have the heart-rhythm check (ECG) and any other tests your team asks for before you start.
- Do not have live vaccines while taking it, and try to be up to date with vaccines before starting.
- Tell your team promptly about any signs of infection, changes in your vision, or symptoms such as dizziness or a slow heartbeat.
- Use effective contraception as advised, and do not stop the medicine suddenly without specialist advice.
Weighing it up
Advantages & disadvantages of Etrasimod
Advantages
- An effective once-daily tablet for moderately to severely active ulcerative colitis.
- Taken by mouth rather than by injection or infusion.
- Offers another option when other treatments have not worked well enough or are not suitable.
Disadvantages
- Can slow the heart rate, especially at the start, so a heart check is needed beforehand.
- Raises the risk of infections, requires avoiding live vaccines, and needs eye and liver monitoring.
- Needs effective contraception because of a risk to a developing baby.
Practical use
Good to know
The most important thing to understand with etrasimod is its effect on the heart: because it acts on receptors found in the heart as well as the immune system, it can slow the heart rate, especially when treatment first starts, so a heart-rhythm tracing (an ECG) and a check of your heart history are usually done before you begin. Because it dampens part of the immune system, it raises the risk of infections, so any signs of infection should be reported and you should not have live vaccines while taking it. It can also cause swelling at the back of the eye (macular oedema), so eye checks are arranged, particularly if you have diabetes or a history of eye problems. Liver blood tests can rise, so these are monitored, and effective contraception is needed because of a risk to a developing baby. Tell your team about all your other medicines, as some can add to the heart-slowing effect.
Who should not take it / use with caution
- People who have had a serious allergic reaction to etrasimod should not take it.
- It is not used in pregnancy, and effective contraception is needed during treatment and for a time afterwards.
- It is used with great caution, or avoided, in people with certain recent heart problems, heart-rhythm disorders or serious infections.
Monitoring
- A heart-rhythm check (ECG) and review of your heart history before starting.
- Eye checks for swelling at the back of the eye, especially in people with diabetes or eye problems.
- Blood tests for liver function and blood counts, and watching for signs of infection.
Side effects
- A slow heart rate, particularly when treatment is first started.
- Headache, dizziness or a higher chance of infections such as colds or urinary infections.
- Less commonly, swelling at the back of the eye (macular oedema) or raised liver blood tests.
Key interactions
- Medicines that also slow the heart, such as beta-blockers and some heart-rhythm drugs, can add to the heart-slowing effect.
- Other medicines that suppress the immune system can increase the risk of infection when combined.
- Some medicines can change etrasimod's levels in the body, so tell your team about everything you take.
Available as: Tablets taken by mouth.
Answers
Etrasimod: frequently asked questions
What is etrasimod used for?
It is used to treat moderately to severely active ulcerative colitis, calming the immune attack on the bowel by keeping certain immune cells from reaching the gut.
Why do I need a heart check before starting?
Etrasimod can slow the heart rate, especially with the first doses, so a heart-rhythm tracing (an ECG) and a check of your heart history are usually done before you begin.
Can I have vaccinations while taking it?
You should not have live vaccines while on etrasimod; it is best to be up to date with your vaccines before starting, and your team can advise on others.
Why are eye checks needed?
It can cause swelling at the back of the eye (macular oedema), so eye checks are arranged, particularly if you have diabetes or a history of eye problems.
Do I need contraception?
Yes. Etrasimod can harm a developing baby, so effective contraception is needed during treatment and for a time after stopping, as your team advises.
Authoritative sources
- BNF
- NICE CKS
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