Mesalamine (Asacol, Lialda, Pentasa, Apriso): A Comprehensive Medication Profile

Names of Medication

US Brand Names: Asacol, Lialda, Pentasa, Apriso (Mesalamine)

Pharmacologic category

Mesalamine belongs to a class of drugs known as aminosalicylates, which are anti-inflammatory drugs used to treat inflammatory bowel diseases. Other medications in this category include Sulfasalazine (Azulfidine) and Balsalazide (Colazal).

Dosing

Mesalamine is primarily used in the management of inflammatory bowel diseases. The dose varies depending on the specific disease and the individual patient.

Ulcerative Colitis

The typical dose ranges from 1.2 to 4.8g per day, depending on the severity of the condition and the specific product being used.

Crohn’s Disease

The standard dose is up to 4g per day, again depending on the severity and the specific Mesalamine product.

Proctitis

Mesalamine is also used to treat proctitis with a typical dose of 1g administered rectally once daily at bedtime.

Proctosigmoiditis

For Proctosigmoiditis, a typical dose would be 1g administered rectally once daily at bedtime.

Remember

You should never adjust the dose of your medication without speaking to your doctor first.

Dosage Forms and strengths

Mesalamine is available in several dosage forms and strengths:
Oral tablets: 400 mg (Asacol), 1.2g (Lialda), 500mg (Pentasa), 0.375g (Apriso)
Rectal suspension: 4g/60mL
Rectal suppository: 500mg, 1000mg

Administration Instructions

Mesalamine should be taken exactly as prescribed by your healthcare provider. The oral forms should be swallowed whole, not crushed or chewed. Rectal forms should be used as directed by your healthcare provider.

Adverse Reactions and Side Effects

Like all medications, Mesalamine can cause side effects. Most people do not experience side effects or only have minor side effects. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Headache (common)

Headaches are a common side effect of Mesalamine, occurring in up to 15% of patients. This is likely due to the medication’s impact on various bodily systems, as it works to reduce inflammation in the body.

Abdominal Pain (common)

Abdominal pain is another common side effect, occurring in approximately 10% of patients. It arises as the medication interacts with the gastrointestinal tract to reduce inflammation.

Diarrhea (less common)

Although Mesalamine is used to manage conditions that cause diarrhea, in some cases, it can itself lead to diarrhea, occurring in about 3-6% of patients. This is likely due to the medication’s effects on the digestive system.

Rash (rare)

Rashes are a less common side effect of Mesalamine, occurring in less than 1% of patients. This is likely an immune response, as the body reacts to the medication.

Contraindications to taking Mesalamine

Contraindications refer to conditions or factors that serve as a reason to withhold a certain medical treatment due to the harm that it would cause the patient. Here are some contraindications to taking Mesalamine:

Hypersensitivity to Mesalamine or salicylates

If you have a known hypersensitivity or allergy to Mesalamine or other salicylates, you should not take Mesalamine. This is because the drug could cause a severe allergic reaction, leading to symptoms such as difficulty breathing, hives, or swelling of the face, lips, tongue, or throat.

Severe kidney disease

Patients with severe kidney disease should not take Mesalamine. The drug is partially excreted by the kidneys, and reduced kidney function could lead to increased levels of the drug in the body, potentially leading to toxicity.

Drug to Drug Interactions

Certain medications may interact with Mesalamine, altering its effectiveness or increasing the risk of side effects. These include:
Azathioprine (Imuran)
Mercaptopurine (Purinethol)
Anticoagulants like warfarin (Coumadin)
Probenecid (Probalan)
Spironolactone (Aldactone)
Always inform your healthcare provider about all the medications you’re currently taking, including over-the-counter drugs, prescription medications, and herbal supplements.

Mesalamine in Pregnancy

Mesalamine should only be used during pregnancy if clearly needed and if the benefits outweigh the risks. Animal studies have shown an increased risk of fetal harm, but there are no well-controlled studies in pregnant women. Always consult with your healthcare provider if you are pregnant or planning to become pregnant while on Mesalamine.

Mesalamine while Breastfeeding

Mesalamine and its metabolites are known to be excreted in breast milk. While there are no reports of harm to nursing infants, consult your healthcare provider before breastfeeding while on Mesalamine.

Estimated Cost of Medication

The cost of Mesalamine can vary depending on the pharmacy and location. As of May 2023, the estimated cost for a 30-day supply of Mesalamine 1.2g (Lialda) is about $1000-$1200 without insurance, but with a GoodRx coupon, it could be reduced to around $850. Remember, these prices are only estimates and actual prices may vary.

Brief Legal Disclaimer

This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.

Please remember that the information contained in this article is for informational purposes only and should not replace the advice of a medical professional. Always consult with your doctor or a qualified healthcare professional if you have any questions or concerns about your health or medications.
Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.