Information About

Mesalazine
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anti-inflammatory agents
   
gastroenterology
   
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Mesalazine ( BP ), also known as '''Mesalamine''' ( USAN ) or '''5-aminosalicylic acid''' (5-ASA), is an Anti-inflammatory Drug used to treat inflammation of the digestive tract ( Crohn's Disease ) and mild to moderate Ulcerative Colitis . Mesalazine is a bowel-specific drug that is metabolized in the gut and has its predominant actions there, thereby having fewer systemic side effects. Chemically, Mesalazine is 5-amino-2-hydroxybenzoic acid. Mesalazine's Empirical Formula is C7H7NO3 and its Molecular Weight is 153.14.

It is sold in the U.S. under the names:
  • CANASA: Rectal Suppository with 500 mfg of mesalamine in a base of Hard Fat NF.

  • ROWASA: Rectal suppository and Suspension Enema .

  • PENTASA: Suspension enema, 250mg, and 500mg tablets.

  • ASACOL: Suspension enema and 400mg tablets



KNOWN SIDE EFFECTS

  • Cramping

  • Sudden severe stomach pain

  • Bloody diarrhea

  • Fever

  • Severe headache

  • Rash

  • Nausea

  • Hepatic impairment

  • Agranulocytosis , Aplastic Anaemia , Neutropenia , Thrombocytopenia - any sore throats, bruising or excessive bleeding should be reported to the prescribing physician and a Full blood count (rbc and wbc) as well as liver function test be performed

  • Myocarditis

  • Methaeoglobinaemia


Dosing depends on preparation- the UK guidelines from the British National Formulary are:
Asacol: 400mg tablets- 6 tablets daily for an acute attack, tablets for prophylaxis. Not recommended for children

NB- preparations that lower stool pH (such as Lactulose , a laxative) will affect the binding of Mesalazine in the bowel and will therefore reduce its efficacy.

Pentasa 4g daily for an acute attack, 1.5g daily for prophylaxis

Further sources of information- British National Formulary, Davidsons Practice of Medicine, Oxford Textbook of Medicine, most other text books of medicine.