Mesalamine

Brand names of mesalamine

  • Asacol
  • Mesasal
  • Novo-5 ASA
  • Pentasa
  • Quintasa
  • Rowasa
  • Salofalk

Mesalamine is an FDA approved medicament since December 1987 and is known for its anti-inflammatory qualities and hence is used to treat ulcerative colitis. When a part of the lining of the large intestine is either swollen or worn away then the condition is known as ulcerative colitis. Mesalamine is available as a delayed release tablet and a controlled release capsule, which are effective in treating ulcerative colitis in any part of the colon. It is also available in the form of suppositories and enemas which are used when inflammation is in the lower colon area only.

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Inflammation of the colon occurs when there is an excessive production of chemicals like prostaglandins because of ulcerative colitis and some other inflammatory conditions. Enzymes like cyclooxygenase and lipoxygenase produce prostaglandins and in patients who suffer from ulcerative colitis these enzymes become overactive. Mesalamine works by blocking the activity of these enzymes and so automatically prostaglandins production is reduced too and it follows therefore that the inflammation in the colon and other symptoms, like pain, associated with this disease will also be reduced. Mesalamine is available in various forms and so the manner and frequency of administering it varies according to the form of the medication.

Things you need to tell your physician before taking mesalamine

Before you begin this medication be sure to tell your doctor if you are allergic to mesalamine or are taking any other medications for ulcerative colitis like balsalazide (Colazal), olsalazine (Dipentum), salicylate pain relievers like aspirin, choline magnesium trisalicylate, choline salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doan's, others), salsalate, sulfasalalzine (Azulfidine).

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The doctor must also be aware of all prescription or non-prescription drugs you might be using or planning on using including herbal remedies, nutritional supplements and vitamins. Any non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Motrin), naproxen (Aleve or Naprosyn), digoxin (Lanoxicaps, Lonoxin) should also be mentioned if you are taking them. The doctor needs to adjust dosages and also check for any reactions that might occur with them.

In case the doctor advises enemas then you must inform him before that you are asthmatic or are allergic to sulfites, which are found naturally or used in food preservatives. Mention also any other preservatives or foods and dyes that may cause allergic reactions. Besides these if you are allergic to any other medicine and also any other ingredients that may be found in the various types of mesalamine you might take should all be told to the doctor. A list of ingredients is easily obtained from the pharmacist.

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Mesalamine sometimes causes reactions that are similar to the symptoms of ulcerative colitis. Call your doctor immediately if you experience stomach cramps or pain, fever, headache, weakness or if you have irritation and reddened eyes and also if you find blood in the diarrhea. It is difficult to know whether these symptoms are a reaction or a recurrence of symptoms of ulcerative colitis.

Communicate to the doctor if you have suffered from swellings in the pancreas or pancreatitis or if there is a swelling of the sac around the heart called pericarditis, also mention any liver or kidney disease. Tell your doctor if you have suffered from pyloric stenosis (when the stomach does not empty normally) particularly if delayed release tablets are prescribed.

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If you are pregnant or plan to get pregnant or are breast feeding tell the doctor and if you get pregnant while on mesalamine immediately call the doctor.

Usage

Mesalamine is used to treat ulcerative colitis which is an inflammatory disease of the bowels.

How to use mesalamine

Mesalamine is available as a delayed release tablet and also as a controlled release capsule to be taken in the mouth. The tablets are usually taken three times a day and must be swallowed whole and not chewed, crushed or split. The protective coating on the tablets must also not be broken. If you see the tablet shell or a part of the shell frequently in your stool notify your doctor as soon as possible.

The controlled release capsules are usually taken four times a day. In case you are not able to swallow the capsule whole then you can open the capsule and put all the beads inside into a small glass of water. Stir the beads in the water and drink the mixture immediately. This mixture must not be kept for use later on.

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Mesalamine is available as a suppository and an enema also which are used in the rectum only. As a suppository, mesalamine is used once to thrice a day, but the enema is used only once at bedtime. Enemas and suppositories may cause stains on the clothing, flooring and fabric, so you must take adequate precautions.

You must take or use mesalamine exactly as directed by the doctor and do not use too less or too much of it or too often. Read the prescription labels carefully and what is not understood the pharmacist or doctor can explain on asking. If you miss a dose take it as soon as you remember but not too close to your regular scheduled dose or your dose will get doubled.

After a few days or weeks of treatment you will begin to feel better but do not stop the medicine until the prescription is completed and only stop after consulting with the doctor. All appointments with the laboratory and the doctor must be followed strictly as the doctor may want you to undergo certain laboratory tests prior to or during treatment.

How mesalamine works

The exact course of action is uncertain, although it seems that mesalamine inhibits the production of the metabolites of arachidonic acid, particularly leukotrienes and prostaglandins which cause digestive tract inflammation.

Side effects

Serious
Common
  • dizziness
  • runny or stuffy nose
  • mild abdominal cramping, mild diarrhea
  • headache
  • sneezing
Less common

Possible interactions

Herbal medicines like aloe, buckthorn berry or bark, cascara sagrada bark, rhubarb root and senna should be shunned by people with ulcerative colitis. Also flaxseed, peppermint oil and psyllium husk which are indicated for irritable bowel syndrome as they have commission E monograph. This condition is not the same as ulcerative colitis and neither have they been tested for it. Foods can decrease mesalamine levels and so you must follow prescribed diet.

Storage instructions

The medicine must be kept in the same container it came in. The lid should be tightly closed and should be kept where children cannot reach it. It can be stored at room temperature, away from excess heat, light and moisture so the bathroom is not a suitable place for storing it.

Mesalamine suppositories can be stored in the refrigerator but should not be frozen. Once the foil packaging of the enemas is opened all the bottles should be used up as directed by the doctor.

Any medicine that is outdated or no longer needed must be thrown away and disposed off safely according to the advice of the pharmacist.

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