mesalamine, Lialda

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Pharmacy Author:

Omudhome Ogbru, PharmD

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.

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Medical and Pharmacy Editor:

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.

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GENERIC NAME: mesalamine

BRAND NAME: Lialda

DRUG CLASS AND MECHANISM: Mesalamine is an oral drug used for treating ulcerative colitis . Lialda is mesalamine in a form that is slowly released in the intestine so that it can be given just once-a-day. Other oral drugs containing mesalamine that are similar to Lialdainclude Asacol, Pentasa, and Apriso. Asacol and Pentasa, however,are given as multiple daily doses. Rowasa .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 (i.e., prostaglandins) that produce inflammation in the colon. Prostaglandins are produced by cyclooxygenase and lipoxygenase enzymes. These enzymes are over-active in individuals with ulcerative colitis. Mesalamine may work by blocking the activity of cyclooxygenase and lipoxygenase, therefore, reducing the production of prostaglandins. Reduced prostaglandin production reduces inflammation in the colon and other symptoms associated with ulcerative colitis. The FDA approved Lialda in January 2007.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 1.2 g

STORAGE: Store at room temperature, 15-25 C (59-77 F)

PRESCRIBED FOR: Lialda is used for inducing remission in patients with active, mild to moderate ulcerative colitis. In clinical studies which compared mesalamine against placebo for 8 weeks, more patients in the mesalamine group achieved remission.

DOSING: The recommended dose is 2.4 g or 4.8 g once daily with a meal. Tablets should be swallowed whole without breaking the coating.

DRUG INTERACTIONS: Specific drug interaction studies have not been conducted with Lialda. Other mesalamine medications have been associated with several drug interactions. Combining mesalamine with drugs that affect kidney function, for example, nonsteroidal antiinflammatory drugs (for example, ibuprofen), may increase the likelihood of kidney dysfunction. Concurrent use of mesalamine and 6-mercaptopurine or azathioprine (Imuran) may increase the likelihood of blood disorders. Mesalamine may increase the blood thinning effect of warfarin (Warfarin).

PREGNANCY: There are no adequate human studies of mesalamine use during pregnancy. Mesalamine is known to cross the placenta into the fetus, but animal studies revealed no evidence of harm to the fetus. Mesalamine should only be used during pregnancy if it is felt that the benefit of its use justifies the unknown risks.

NURSING MOTHERS: Mesalamine is excreted in breast milk. Mesalamine should only be used by nursing mothers if it is felt that the benefit of its use justifies the risk.

SIDE EFFECTS: The most common side effects are headache and flatulence. Hair loss and itching also may occur. Infrequent side effects include increased heart rate, acne, pancreatitis, back pain, fatigue, tremor, ear pain, and blood disorders. Kidney dysfunction has been associated with mesalamine. Kidney function should be evaluated prior to and periodically during mesalamine therapy. Mesalamine may cause an acute intolerance syndrome that resembles a flare of inflammatory bowel disease. Symptoms include cramping, acute abdominal pain, and bloody diarrhea. Fever, headache, itching, and rash also may occur. Symptoms usually subside once mesalamine is discontinued. Since mesalamine is related chemically to aspirin, individuals who are allergic to aspirin should not take mesalamine.

Reference: FDA Prescribing Information

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