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Mesalamine Medication: Uses, Dosage, and Side Effects Explained
Summary of Key Points
Mesalamine is a medication commonly prescribed to manage inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. It works by reducing inflammation in the intestines, which helps relieve symptoms like diarrhea, abdominal pain, and rectal bleeding. Mesalamine is available in several forms, including tablets, capsules, and enemas. Always consult your healthcare provider before starting or adjusting this medication. You can also schedule a telemedicine appointment with us for personalized care and guidance.
Names of Mesalamine Medication
US Brand Names: Asacol HD, Lialda, Apriso, Pentasa, Delzicol, Rowasa, Canasa
Mesalamine is the generic name for this medication. The generic name refers to the active ingredient, while brand names are specific to the companies that manufacture the drug. The generic name is listed in parentheses.
Pharmacologic Category of Mesalamine
Aminosalicylates (5-ASA)
Anti-inflammatory agents
Mesalamine Dosage
Mesalamine is used to treat various gastrointestinal conditions. Below are the recommended dosages for adults. Always consult your doctor before making any changes to your dose, and consider scheduling a telemedicine appointment with us for further guidance.
Mesalamine for Ulcerative Colitis (Mild to Moderate)
Oral tablets/capsules: 2.4 to 4.8 grams per day, divided into two or three doses. The duration of treatment varies based on your response but is often long-term.
Rectal suppository: 1 gram once daily at bedtime for 3 to 6 weeks.
Rectal enema: 4 grams once daily at bedtime for 3 to 6 weeks.
Mesalamine for Crohn’s Disease (Mild to Moderate)
Oral tablets/capsules: 3.2 to 4.8 grams per day, divided into two or three doses. Treatment is often long-term to help manage symptoms.
Proctitis and Proctosigmoiditis
Rectal suppository: 1 gram once daily at bedtime for 3 to 6 weeks.
Rectal enema: 4 grams once daily at bedtime for 3 to 6 weeks.
Mesalamine for Diverticulitis, Colitis, and Irritable Bowel Syndrome (IBS)
Oral tablets/capsules: 2.4 to 4.8 grams per day, divided into two or three doses. The length of treatment depends on the severity of symptoms.
Gastrointestinal and Intestinal Inflammation
Oral tablets/capsules: 2.4 to 4.8 grams per day, divided into two or three doses. The duration of treatment depends on the severity of the condition and how well you respond to therapy.
Dosage Forms and Strengths of Mesalamine
Oral tablets: 400 mg, 800 mg, 1.2 grams
Oral capsules: 250 mg, 500 mg
Rectal suppositories: 1 gram
Rectal enema: 4 grams/60 mL
Administration Instructions for Mesalamine
Mesalamine should be taken exactly as prescribed by your healthcare provider. Oral tablets and capsules must be swallowed whole—do not crush or chew them, as this can interfere with the proper release of the medication in the intestines. Rectal forms, such as suppositories and enemas, should be used as directed, typically at bedtime. If you miss a dose, take it as soon as you remember, but avoid doubling up on doses. If you have any questions about how to take your medication, consult your doctor or one of our telemedicine providers.
Contraindications for Mesalamine
A contraindication is a specific condition or situation where a medication should not be used because it may cause harm. If you have any of the following conditions, you should not take Mesalamine, or you should discuss alternative treatments with your healthcare provider.
Allergy to Mesalamine or Salicylates: If you are allergic to Mesalamine or other salicylates (such as aspirin), taking this medication could trigger a severe allergic reaction, including difficulty breathing, rash, or swelling.
Severe Liver Disease: Mesalamine is processed by the liver. If you have severe liver disease, your body may not metabolize the medication properly, which could lead to toxicity.
Severe Kidney Disease: Mesalamine can affect kidney function, and if you already have severe kidney disease, taking this medication could worsen your condition.
Intestinal Blockage: If you have an intestinal obstruction, Mesalamine may not move through your digestive system as it should, potentially leading to complications.
Mesalamine Drug Interactions
Mesalamine can interact with other medications, which may affect its effectiveness or increase the risk of side effects. Be sure to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with Mesalamine:
Azathioprine (Imuran): Taking Mesalamine with Azathioprine may increase the risk of blood disorders, such as a low white blood cell count.
Mercaptopurine (Purinethol): Similar to Azathioprine, combining Mesalamine with Mercaptopurine can increase the risk of bone marrow suppression, which may lead to serious infections.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like Ibuprofen (Advil, Motrin) or Naproxen (Aleve): Using NSAIDs with Mesalamine may increase the risk of kidney damage.
Warfarin (Coumadin): Mesalamine may alter how Warfarin works, increasing the risk of bleeding or clotting issues.
Mesalamine in Pregnancy
Is it Safe to Take Mesalamine When Pregnant?
Mesalamine is generally considered safe during pregnancy, especially for managing conditions like ulcerative colitis or Crohn’s disease, which often require ongoing treatment. However, it’s essential to carefully weigh the benefits and risks with your healthcare provider. Untreated inflammatory bowel disease (IBD) can lead to complications for both the mother and baby, so continuing treatment is often recommended. Always consult your healthcare provider before starting or continuing Mesalamine during pregnancy to ensure the best outcome for you and your baby.
Mesalamine While Breastfeeding
Is it Safe to Take Mesalamine While Breastfeeding?
Mesalamine is considered safe to use while breastfeeding. Only small amounts of the medication pass into breast milk, and studies have shown no harmful effects on nursing infants. However, if your baby shows any unusual symptoms, such as diarrhea, contact your healthcare provider right away. As always, it’s important to discuss any concerns with your healthcare provider before using Mesalamine while breastfeeding.
Estimated Cost of Mesalamine Medication
The cost of a 30-day supply of Mesalamine can vary depending on the dosage and brand. Without insurance, the estimated cost using a GoodRx coupon ranges from $300 to $700. For the most accurate pricing, check with your pharmacy, and consider using a GoodRx coupon to help reduce costs.
Possible Alternatives to Mesalamine
If Mesalamine is not suitable for you, or if you are exploring other treatment options, several alternatives may help manage your condition. Always discuss any changes to your treatment plan with your healthcare provider, or schedule a telemedicine appointment with one of our providers for personalized advice.
Ulcerative Colitis
Alternative treatments include corticosteroids (e.g., prednisone), immunosuppressants (e.g., azathioprine), or biologics (e.g., infliximab). Additionally, dietary adjustments, such as avoiding high-fiber foods during flare-ups, may provide relief.
Crohn’s Disease
Similar to ulcerative colitis, treatment options for Crohn’s disease include corticosteroids, immunosuppressants, and biologics. In some cases, surgery may be necessary to remove damaged sections of the intestine.
Inflammatory Bowel Disease (IBD)
In addition to Mesalamine, biologics, immunosuppressants, and dietary modifications (e.g., a low-residue diet) can help manage IBD symptoms.
Proctitis
Treatment options for proctitis include topical corticosteroids, immunosuppressants, and antibiotics if an infection is present. Sitz baths and anti-inflammatory diets may also offer symptom relief.
Proctosigmoiditis
In addition to Mesalamine, corticosteroid enemas or suppositories may be used to treat proctosigmoiditis. Dietary changes, such as avoiding spicy or fatty foods, may also help manage symptoms.
Diverticulitis
During flare-ups of diverticulitis, antibiotics and a liquid or low-fiber diet may be recommended. In severe cases, surgery may be necessary to remove affected areas of the intestine.
Colitis
Treatment for colitis depends on the underlying cause and may include antibiotics, corticosteroids, or immunosuppressants. Probiotics and a low-fiber diet may also help manage symptoms.
Irritable Bowel Syndrome (IBS)
While Mesalamine is not typically used for IBS, other treatments such as dietary changes (e.g., a low FODMAP diet), fiber supplements, and antispasmodic medications may help manage symptoms.
Gastrointestinal Inflammation
Treatment for gastrointestinal inflammation depends on the underlying cause but may include corticosteroids, immunosuppressants, or dietary changes to reduce symptoms.
Intestinal Inflammation
Similar to gastrointestinal inflammation, treatment for intestinal inflammation may involve corticosteroids, immunosuppressants, or biologics, depending on the cause.
Recent Updates on Mesalamine Research
Recent studies continue to investigate the long-term safety and effectiveness of Mesalamine in treating inflammatory bowel diseases like ulcerative colitis and Crohn’s disease. One area of research focuses on developing new Mesalamine formulations that provide more targeted delivery to specific areas of the gastrointestinal tract, potentially improving effectiveness and reducing side effects. Additionally, researchers are exploring the combination of Mesalamine with other medications, such as biologics, to determine whether combination therapy can offer better symptom control for patients with moderate to severe disease.
It’s important to stay informed about new research and discuss any potential changes to your treatment plan with your healthcare provider. If you have questions about Mesalamine or your current treatment, schedule a telemedicine appointment with one of our providers today.
