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mesalamine (me SAL a meen)
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Asacol
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400 mg
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Pentasa
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250 mg
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Rowasa
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500 mg
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Suppository and Rectal Suspension
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This drug is not available in a generic form.
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What is mesalamine?
Mesalamine is an anti-inflammatory drug which acts on the
lining of the gut to reduce inflammation. There are three
different forms available. Asacol becomes active in the
small bowel just before the colon is reached. Pentasa, on
the other hand, is released in the small intestine just
beyond the stomach. Therefore, this drug may be particularly
helpful in Crohn's disease patients with small bowel
involvement. Rowasa is the same medication given either by
suppository or by enema. Its primary use is for inflammation
of the rectum and lower or left side of the colon.
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What is it used for?
These drugs are used to treat ulcerative colitis,
ulcerative proctitis, Crohn's disease and collagenous or
lymphocytic colitis. They are much more helpful in the
chronic phase of these diseases than when there is severe
inflammation. At those times, steroid drugs such as
prednisone are usually more effective.
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How do I take it?
Follow your physician's instructions carefully. For
rectal suspension, use as a retention enema at bedtime. If
possible, empty the rectum prior to instilling the
suspension. The enema should be retained at least eight
hours for best results. Suppositories should be used one or
two times a day and retained for 1 to 3 hours or longer for
best results. For oral dosage, swallow the pill or capsule
whole and do not break, crush or chew. Keep all medications
away from children. Never share your medications with anyone
else.
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What do I do for a missed dose?
If you miss a dose of this medicine, take it as soon as
possible. If it is almost time for the next dose, skip the
missed dose and return to the regular schedule. Do not
double up the medication.
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Are there interactions with food or beverages?
The drug may be taken with food or milk. There are
no known interactions with food.
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Are there interactions with other drugs?
An interaction generally means that one drug
may increase or decrease the effect of another drug. Also,
the more medications a person takes, the more likely there
will be a drug interaction. Interactions with this drug may
occur with sulfasalazine (Azulfidine).
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Is there a problem if I have another disorder or
disease?
At times, a drug may have a different or enhanced effect
when other diseases are present. At other times, the drug
may worsen or effect another disease. With this drug, severe
kidney disease may be a problem.
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What about allergies?
People who have known allergies or asthma may be at an
increased risk for a reaction from any new medication. The
physician should always know a patient's allergy history.
Signs of an allergic reaction are skin rash, hives or fever.
Of course, a person should not take mesalamine if there has
been a previous reaction to this or salicylates (aspirin).
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What if I'm pregnant, considering pregnancy or
breast-feeding?
Most females now know that, if possible, no drug,
including alcohol, should be taken during pregnancy or
lactation. The potential danger, of course, is an injury to
the baby. However, some drugs are much safer than others in
this regard. So, the FDA has a grading system for each drug
which reflects what is known medically. It ranks drugs from
A, where medical studies show no evidence for danger to the
fetus or mother, to B, C, D and X, where the medical
evidence indicates that the risk to the fetus outweighs any
benefit to the mother. Mesalamine is ranked B. Always
consult your physician before taking any drug during or when
planning pregnancy.
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What are the effects on sexual function?
There are no known adverse effects of mesalamine on
sexual function.
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Are there other precautions?
- Intact or partially intact tablets (small beads) may
appear in the stool. These are empty shells from the
medication. If this is a frequent occurrence, check with
your physician.
- Enemas may stain clothing.
- Avoid taking the drug for six weeks after chicken pox
vaccination (Varivax) as it may result in Reyes
Syndrome.
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How long is it safe to take mesalamine?
Regular use of 1 to 3 weeks is usually necessary to
determine the drug's effectiveness. Long-term use of months
to years is generally necessary and safe but does require a
physician's supervision and periodic evaluation.
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How about side effects?
Adverse reactions can occur with any drug, even
over-the-counter medications. Some of these are mild such as
a stomach upset, which may be avoided by taking the
medication with food. Minor reactions may go away on their
own but if they persist, contact the physician. For major
reactions, the patient should contact the physician
immediately.
For mesalamine, the following are the observed side
effects:
Minor:
- abdominal cramps
- indigestion
- nausea
- bloating
- diarrhea
- headache
- dizziness
- rash
Major:
- fever
- severe headache
- increased blood in stool
- sudden severe stomach pain
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A physician's comment...
These drugs are a major advance in treating chronic
inflammatory bowel disease. They generally can be used in
high doses with minimal side effects compared to the
previous product, sulfasalazine. It is generally
well-tolerated and safe to use long-term. Since it rarely
may have an effect on the bone marrow, periodic testing of
the blood is necessary.
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Posted: July 1998
Crohn's
Disease | Ulcerative
Colitis
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