mesalamine, Pentasa, Rowasa, Asacol, Asacol HD, Lialda, Canasa, Apriso, Delzicol

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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GENERIC NAME: mesalamine (5-aminosalicylic acid)

BRAND NAMES: Pentasa, Rowasa, Asacol, Asacol HD, Lialda, Canasa, Apriso, Delzicol

DRUG CLASS AND MECHANISM: Mesalamine is a drug used for treating ulcerative colitis and mild to moderate Crohn's disease. The exact mechanism of mesalamine is not known but is believed to be by reducing inflammation in the colon. Ulcerative colitis and other inflammatory diseases cause excessive production of chemicals, for example, prostaglandins, that produce inflammation in the colon. Prostaglandins are produced by the enzymes, cyclooxygenase and lipoxygenase. These enzymes are over-active in individuals with ulcerative colitis. Mesalamine may work by blocking the activity of cyclooxygenase and lipoxygenase, thereby, reducing the production of prostaglandins. Reduced production of prostaglandins decreases inflammation in the colon and the symptoms associated with ulcerative colitis. Available forms of mesalamine differ in their route of administration and how often they are administered. Mesalamine was approved by the FDA in December 1987.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes (rectal enema)

PREPARATIONS:

  • Tablets (delayed release): 800 mg (Asacol), 1.2 g (Lialda).
  • Capsules (extended or delayed release): 375 mg (Apriso); 250, 500 mg (Pentasa); 400 mg (Delzicol)
  • Rectal enema (Rowasa): 4 g per 60 mL.
  • Rectal suppositories (Canasa): 1000 mg.

STORAGE: The tablets, capsules, and enemas should be stored at room temperature, 15 C - 30 C (59 F - 86 F). The suppositories should be stored below 25 C (77 F) without freezing.

PRESCRIBED FOR: Mesalamine is used for the treatment of mild to moderately severe ulcerative colitis; some physicians may use it for Crohn's disease treatment (off-label use). The suppositories are limited to use in ulcerative colitis involving only the rectum (proctitis) and the enemas to colitis involving only the part of the colon close to the rectum (distal colitis) or proctitis. While the benefits of mesalamine can be seen within 3 to 21 days of starting therapy, it may take up to three to six weeks for the enemas and suppositories, six weeks for the tablets, and eight weeks for the capsules to have maximum effect.

Medically Reviewed by a Doctor on 10/29/2014

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