Drug Index


Synonyms :

5-aminosalicylic acid, 5-ASA, Mesalazine

Mechanism :

The mechanism of action of mesalamine is not fully understood but appears to be topical. Mucosal production of arachidonic acid metabolites, both through the cyclooxygenase and lipoxygenase pathways, is increased in patients with chronic inflammatory bowel disease, and it is possible that mesalamine diminishes inflammation by blocking cyclooxygenase and inhibiting prostaglandin production in the colon.

Indication :

• Ulcerative colitis (inflammatory bowel disease). Use suppositories and enemas particularly for distal disease.

• Maintenance of remission in Crohn’s disease

Contraindications :

Contraindicated in patients with hypersensitivity to salicylates or to any of the components, and in severe renal impairment. Serious blood dyscrasias have been reported very rarely with mesalazine. Contraindicated in severe hepatic impairment. Renal function should be regularly assessed, especially in children receiving large oral doses. In addition to routine blood counts and liver function tests, blood urea nitrogen and serum creatinine determinations and a urinalysis should be performed at least monthly for 3 months, then every 3-6 months.

Dosing :

>5 years of age:

17 to <33 kg: 36-71 mg/kg/day, orally in 2 divided doses. Max dose: 1.2 g/day.

33 to <54 kg: 37-61 mg/kg/day, orally in 2 divided doses. Max dose: 2 g/day.

54 to 90 kg: 27-44 mg/kg/day, orally in 2 divided doses. Max dose: 2.4 g/day.

Rectal doses only for children >12 years.

Adverse Effect :

Gastrointestinal: Abdominal pain, discomfort, flatulence, nausea, exacerbation of colitis.

Miscellaneous: Headache, fatigue, asthenia, malaise, weakness, fever, dizziness, rash, pruritus, acne.

Interaction :

Nephrotoxic agents, including non-steroidal anti-inflammatory drugs (NSAIDs): May increase the risk of renal reactions.
Azathioprine or 6-mercaptopurine: Concurrent use of mesalamine can increase the potential for blood disorders.

03/11/2020 23:17:56 Mesalamine
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