- Ulcerative Colitis Slideshow Pictures
- Inflammatory Bowel Disease Slideshow
- Take the Ulcerative Colitis Quiz
What is mesalamine, and how does it work (mechanism of action)?
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.
What are the side effects of mesalamine?
The most common side effects of mesalamine are:
Infrequent side effects include:
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 (Crohn's disease or ulcerative colitis) with cramping, abdominal pain, and bloody diarrhea. Fever, headache, itching, and rash also may occur. Symptoms usually subside once mesalamine is discontinued.
Mesalamine enemas contain sulfites and should be avoided in persons who are sensitive to sulfites.
What is the dosage for mesalamine?
(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 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.
Which drugs or supplements interact with mesalamine?
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).
Is mesalamine safe to take if I'm pregnant or breastfeeding?
There are no adequate human studies of mesalamine 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.
What else should I know about mesalamine?
Generic forms of mesalamine are available for mesalamine rectal and suppository.
You need a prescription from your doctor or other health care professional for this medication.
Mesalamine is available as:
- 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, SfRowasa): 4 g per 60 mL.
- Rectal suppositories (Canasa): 1000 mg.
Pentasa, Rowasa, Asacol HD, Lialda, Canasa, Apriso, SfRowasa, and Delzicol are the brand names available for mesalamine in the US.
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.
Quick GuideUlcerative Colitis Symptoms, Causes, and Treatment
Mesalamine (Pentasa, Rowasa, SfRowasa, Lialda, Canasa, Apriso, Delzicol) is a medication prescribed for ulcerative colitis and mild to moderate Crohn's disease. Side effects, drug interactions, warnings and precautions, and safety during pregnancy information should be reviewed prior to taking this medication.
Multimedia: Slideshows, Images & Quizzes
Ulcerative Colitis Quiz: Diet, Symptoms & Treatment
What is ulcerative colitis and what risks are associated with suffering over the long term? Take this Ulcerative Colitis Quiz to...
Crohn's Disease Quiz
What causes Crohn's disease? What are the symptoms of Crohn's disease? How is Crohn's treated? Take this quiz to get the facts...
Ulcerative Colitis Symptoms, Causes, and Treatment
Ulcerative Colitis is a form of inflammatory bowel disease and is slightly different than Crohn's disease. Your diet can impact...
Inflammatory Bowel Disease (IBD) Causes, Symptoms, Treatment
What is inflammatory bowel disease? IBD can include Crohn's disease and ulcerative colitis. Learn more about testing, treatments,...
Crohn's Disease Causes, Symptoms, Diet
What is Crohn's disease? Get more information on this digestive disorder and how Crohn's can affect your diet. Learn more about...
Related Disease Conditions
Colitis (Symptoms, Types, and Treatments)
Colitis refers to inflammation of the inner lining of the colon. Symptoms of the inflammation of the colon lining include...
Ulcerative Colitis Diet
An ulcerative colitis diet plan can help a person with the disease avoid foods and drinks that trigger flares. There also are...
Crohn's Disease (Symptoms, Causes, Diet, Treatment, Life Expectancy)
Crohn's disease is a chronic inflammatory disease, primarily involving the small and large intestine, but which can affect...
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding....
Microscopic Colitis (Lymphocytic Colitis and Collagenous Colitis)
Microscopic colitis (lymphocytic colitis and collagenous colitis) is a disease of inflammation of the colon. Microscopic colitis...
Inflammatory Bowel Disease (Intestinal Problems of IBD)
The inflammatory bowel diseases (IBD) are Crohn's disease (CD) and ulcerative colitis (UC). The intestinal complications of...
Crohn's Disease vs. Ulcerative Colitis (UC)
Crohn's disease and ulcerative colitis are diseases that cause inflammation of part of or the entire digestive tract (GI)....
Is Colitis Contagious?
Colitis is a term that us used to describe inflammation of the colon. The terms enteritis, proctitis, and inflammatory bowel...
Is Crohn's Disease Contagious?
Crohn's disease, a form of inflammatory bowel disease (IBD), and is characterized by symptoms and signs that...
Treatment & Diagnosis
- Ulcerative Colitis FAQs
- Crohn's Disease FAQs
- Medication Disposal
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Dangers of Mixing Medications
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
Health Solutions From Our Sponsors
- Surgery Second Opinion
- Caregivers: Don't Forget Your Needs
- Drug Abuse Recovery
- Dupuytren’s Treatment
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
FDA Prescribing Information