mesalamine, Pentasa, Rowasa, Asacol, Asacol HD, Lialda, Canasa, Apriso, Delzicol (cont.)

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GENERIC AVAILABLE: Yes (rectal enema)


  • 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.

DOSING: (see dosing instructions provided by manufacturer)

  • Lialda: 2.4-4.8 g once daily with food
  • Apriso: 1.5 g orally once daily
  • Pentasa: 1 g four times daily
  • Asacol: 800 mg two or three times daily
  • Asacol HD: 1.6 g 3 times daily
  • Delzicol: 800 mg 3 times daily (has replaced Asacol; also available in extended release tablets)
  • Rowasa: One rectal application (4 g per 60 mL enema) once a day, preferably at bedtime, and retained for approximately 8 hours.
  • Canasa: One suppository (1,000 mg) daily at bedtime. The suppository should be retained in the rectum for one to three hours or more if possible to achieve maximum benefit.

DRUG INTERACTIONS: Oral mesalamine formulations are associated with several drug interactions. Combining mesalamine with drugs that affect kidney function, for example, nonsteroidal antiinflammatory drugs (NSAIDs) or ibuprofen may increase the likelihood of reduced function of the kidneys. Concurrent use of mesalamine and 6-mercaptopurine or azathioprine (Imuran) may increase the likelihood of disorders of the blood cells, particularly reduced numbers of cells. Mesalamine may increase the blood thinning effect of warfarin (Coumadin).

Medically Reviewed by a Doctor on 10/29/2014

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