GENERIC NAME: mesalamine
BRAND NAMES: Pentasa; Rowasa; Asacol
DRUG CLASS AND MECHANISM: Mesalamine is a derivative of
salicylic acid and is thought to be the active component of
sulfasalazine
(Azulfidine), a combination of a sulfa drug and salicylic acid.
Mesalamine
works as an antiinflammatory agent in treating ulcerative
colitis and
Crohn's disease. Its benefit is believed to be due to a topical
effect on
the inflamed bowel. Following rectal administration of
mesalamine (by
enema or suppository), only 15% of a dose is absorbed.
Following oral
administration, 28% of a dose is absorbed. Mesalamine was
approved by the
FDA in December 1987.
PRESCRIPTION: yes
GENERIC AVAILABLE: no
PREPARATIONS: sustained-action gelatin capsules
(Pentasa)
containing 250mg; enteric coated tablets containing 400mg;
rectal enema
(Rowasa) containing 4 grams per 60 mL enema; rectal
suppositories (Rowasa)
containing 500mg.
STORAGE: The tablets, capsules, and enemas should be
kept at
room temperature, 15-30°C (59-86°F). The
suppositories should be
stored between 19-26°C (66-79°F).
PRESCRIBED FOR: Mesalamine is used for the treatment
of mild to
moderately severe colitis. The suppositories are limited to use
in
proctitis, the enemas to distal colitis (colitis involving only
the part
of the colon close to the rectum) or proctitis.
DOSING: The enema is inserted rectally, generally once
daily at
bedtime. It should be retained for at least 8 hours. The bottle
should be
shaken well prior to use. The protective sheath must be
removed. Many
physicians recommend that the patient lie on his/her left side
with the
lower leg extended and the upper (right) leg flexed forward for
balance
for ease of administration.
The suppositories are often given twice daily; each should be
retained
for 1 to 3 hours or longer.
The 400mg delayed release (enteric-coated) tablets (Asacol) are
generally taken 3 times a day. The sustained-action capsules
(Pentasa) are
generally taken 4 times a day during the acute phase, in order
to induce
remission.
While the benefits of mesalamine can be seen within 3 to 21
days of
starting therapy, it may take up to 3 to 6 weeks for the enemas
and
suppositories, 6 weeks for the tablets, and 8 weeks for the
capsules to
have maximum effect.
DRUG INTERACTIONS: There are no known drug interactions
with any
of the mesalamine products.
PREGNANCY: There are no adequate studies of mesalamine
in
pregnant women; however, studies in animals suggest no
important effects
on the fetus. Therefore, mesalamine may be used in pregnancy if
the
physician feels that it is necessary. It also should be noted
that there
is no effect of mesalamine on sperm count as there is with
sulfasalazine
(Azulfidine).
NURSING MOTHERS: Mesalamine is
excreted in small amounts in breast milk. No side effects have been reported in nursing
infants whose
mothers have taken mesalamine. Since the possibility of side
effects
always exists, physicians must weigh the potential risks of
mesalamine on
the infant against the benefits for the mother.
SIDE EFFECTS: Mesalamine is
usually well-tolerated. Adverse effects that have been reported in large studies
include: headache, abdominal pain, diarrhea,
nausea,
and dizziness. None of these
effects,
however, were reported more frequently with mesalamine than
with placebo.
Infrequently, patients may be intolerant of mesalamine,
experiencing
cramping, abdominal pain, bloody diarrhea, and sometimes fever or rash. In
such cases, the medication is stopped. Mesalamine enemas
contain sulfites
and should be avoided in persons who are sensitive to sulfites.
Last Editorial Review: 12/31/1997
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From the Doctors at MedicineNet.com  |
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