Mesalamine, also known as 5-aminosalicylic acid (5-ASA), is a treatment for inflammatory bowel diseases (IBD) like ulcerative colitis and Crohn’s disease. This compound offers relief from symptoms and aids in remission maintenance. Mesalamine is typically prescribed to patients to induce and maintain IBS remission.

Mesalamine’s precise mechanism of mesalamine is not entirely clear. However, its efficacy is attributed to its anti-inflammatory properties within the gastrointestinal tract. Mesalamine is thought to modulate various pathways involved in inflammation by inhibiting prostaglandin and leukotriene synthesis. It also suppresses cytokine production and reduces the scavenging of free radicals. By targeting these pathways, mesalamine affects inflamed intestinal mucosa. This effect reduces digestive symptoms like diarrhea, bloody stool, and pain.

Mesalamine Precautions and Warnings

You shouldn’t use mesalamine if you’re allergic to 5-aminosalicylic acid, other salicylates, or the medication’s inactive ingredients.

Mesalamine can make certain pre-existing conditions work. These conditions include liver and kidney problems. It can also exacerbate chicken pox and flu symptoms in children.

Mesalamine may pass to children in utero or during breastfeeding. Patients should not use mesalamine during pregnancy or while breastfeeding unless the benefits clearly outweigh the risks.

Side Effects of Mesalamine

Mesalamine can cause many side effects, including:

  • Abdominal pain and discomfort
  • Headaches
  • Gas
  • Fatigue
  • Weakness
  • Fever
  • Dizziness
  • Rash or itching
  • Acne
  • Sore throat
  • Flu-like symptoms
  • Changes in urine color
  • Kidney impairment
  • High blood pressure
  • Joint pain
  • Gas
  • Diarrhea
  • Abdominal distension or pain
  • Rectal polyps
  • Nausea

Drug Interactions with Mesalamine

Mesalamine can interfere with other medications. It can change how other drugs work, and other medicines can keep Mesalamine from working normally. Tell your doctor about all the medicines you take to ensure Mesalamine is a safe treatment for your IBS. This includes over-the-counter medications, other prescriptions, herbs, vitamins, supplements, street drugs, and alcohol.

The following medicines are especially likely to interact with Mesalamine:

  • Azathioprine/6-mercaptopurine
  • Anticoagulants (warfarin, coumadin)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Probenecid
  • Sulfasalazine
  • Nephrotoxic agents

Strengths and Dosages of Mesalamine

Mesalamine comes in several different formulations and strengths including tablets, capsules, rectal suppositories, enemas, and rectal foam. Treatment courses vary based on a patient’s symptoms, reactions, and medication tolerance.

FormulationStrengthBrand-name
Extended-release capsule250mgPentasa
Extended-release capsule375mgApriso
Extended-release capsule500mgPentasa
Delayed-release tablet400mgAsacol
Delayed-release tablet800mgAsacol HD
Delayed-release tablet1.2gLialda
Delayed-release capsule400mgDelizicol
Rectal suppositories1000mgCanasa
Rectal enema4g/60mlRowasa

Alternatives to Mesalamine

Yes, there are other aminosalicylic treatments for IBS, Crohn’s disease, and colitis. These include medications like:

Mesalamine FAQs

What is the maximum dose of Mesalamine?

The maximum dose of Mesalamine depends on the formulation. Typically, 4.8g is the maximum daily mesalamine dose for oral treatment. Rectal treatments usually have a maximum dose of 4mg every day.

What is Mesalamine used for?

Mesalamine is used to treat irritable bowel syndrome (IBS) and related conditions like ulcerative colitis and Crohn’s disease.

What is the best time to take Mesalamine?

You should take your Mesalamine according to your doctor’s instructions. The best times to take Mesalamine can depend on the formulation. Many patients take oral tablets or capsules in the morning. Their doctor may also split their doses up throughout the day. Rectal treatments can be most successfully applied before bed to reduce the risk of leaking.

How long can you take Mesalamine?

Mesalamine is usually a long-term maintenance medication. If a patient responds to treatment and their IBS goes into remission, the patient will likely continue to take Mesalamine indefinitely.

Are there foods to avoid when taking Mesalamine?

Food typically does not interact with Mesalamine. However, dietary changes can help reduce IBS symptoms. Your doctor may recommend reducing the following foods to help you stay in remission:

  • High-fiber foods
  • Spicy foods
  • Dairy
  • High-fat foods
  • Artificial additives and sweeteners

How long does it take Mesalamine to work?

Most patients notice results after taking Mesalamine for a few weeks. People with more severe symptoms may take longer to see results. Most patients respond within several months of beginning treatment.

How does Mesalamine work?

Mesalamine reduces digestive tract inflammation by reducing prostaglandin, leukotriene, and cytokine production; and by limiting free radical scavenging. Reducing inflammation reduces the frequency and severity of IBS, eventually helping patients reach remission.

How do you taper off Mesalamine?

Most patients stay on Mesalamine long-term to maintain remission. However, it may be necessary to stop the medication due to poor response, serious side effects, or interactions with other medicines. Talk to your doctor if you want to stop taking Mesalamine. Typically your doctor will assess your current condition before gradually lowering your Mesalamine dosage until you stop taking the medication. Your medical team should closely monitor your condition after you stop taking Mesalamine to respond to any IBS flares.

What is the most common side effect of Mesalamine?

Mesalamine’s most common side effect is digestive distress including nausea, vomiting, diarrhea, gas or flatulence, and abdominal pain. This reaction can be distressing as Mesalamine is prescribed to people already dealing with similar symptoms caused by IBS. Luckily, this side effect is usually temporary and fades after a few weeks.

What tier drug is Mesalamine?

Mesalamine is often listed as a tier 2 or 3 drug. However, this isn’t universal. Contact your insurance company for details about its tier system and how Mesalamine is ranked.

What is the cost of Mesalamine in America?

Generic mesalamine suppositories are available at around $800 for a 30-suppository prescription of 1000mg. Brand-name treatments like Canasa cost around $1400 for the same prescription. Both the brand name and the generic version may cost less with insurance coverage, coupons, discount cards, or patient assistance programs.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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