mesalazine at a glance
Medicine class
Aminosalicylate, also called 5-ASA.
Main licensed role
Treatment of active ulcerative colitis and maintenance of remission; this varies by product and formulation.
What is mesalazine used for?
Selected products have the following licensed uses:
Treatment of mild to moderate active ulcerative colitis with oral preparations.
Maintenance of remission of ulcerative colitis with selected oral preparations.
Treatment and maintenance of remission of ulcerative proctitis with the selected suppository.
Treatment and prevention of attacks of mild distal ulcerative colitis with the selected enema.
Maintenance of remission of Crohn’s ileo-colitis with the selected modified-release tablet; this licence is product-specific.
How does mesalazine work?
Mesalazine acts mainly where it contacts the bowel lining. Its mechanism is not fully established, but it reduces local inflammatory signalling and can neutralise reactive oxygen compounds.
mesalazine preparations and strengths
Gastro-resistant tablet
Route: Oral
Strengths: 500 mg, 1000 mg, 1 g
Granules
Route: Oral
Strengths: 500 mg, 1000 mg, 1500 mg, 3 g
How to take mesalazine
Follow the instructions for the prescribed brand, as release characteristics and administration differ.
Swallow modified-release or gastro-resistant tablets as directed. Do not crush or chew them unless the specific leaflet permits breaking or dispersing them.
Pentasa slow-release tablets may be broken or dispersed in cold water and consumed immediately.
Swallow prolonged-release granules without chewing. Selected Pentasa granules can be taken with water or orange juice, or mixed with yoghurt and consumed immediately.
Food instructions vary between products.
Before using a rectal form, empty the bowel if possible. Insert it gently and retain it for as long as practical.
Drink adequate fluids unless a clinician has advised otherwise.
mesalazine side effects
Common or expected effects
- Indigestion or wind
- Abdominal pain
- Nausea or vomiting
- Diarrhoea
- Headache
Get urgent medical advice
- Severe rash, blistering, peeling skin or mouth ulcers
- Chest pain, which can indicate inflammation around the heart
- Unexplained bleeding, bruising, fever or sore throat
- Reduced or changed urine, flank pain or other signs of kidney problems
- Jaundice, dark urine or other signs of liver injury
- Severe or recurrent headache with visual disturbance or tinnitus
- Severe allergic reaction
mesalazine in pregnancy
Mesalazine can generally be continued during pregnancy when clinically needed, because controlling inflammatory bowel disease is important. Tell the specialist or prescriber about a pregnancy and do not stop treatment without their advice; product information recommends an individual benefit–risk assessment.
mesalazine while breastfeeding
Mesalazine is usually compatible with breastfeeding when the infant is healthy, after discussion with the prescriber. Small amounts enter milk; seek advice if the infant develops diarrhoea, vomiting, feeding difficulty, rash or unusual irritability.
mesalazine interactions
Tell the prescriber or pharmacist about all medicines, supplements and non-prescription products. Important examples include:
Azathioprine, mercaptopurine or thioguanine
Mesalazine may increase bone-marrow suppression, so closer blood-count monitoring may be needed.
Common questions about mesalazine
Answers are fully visible for fast scanning and source review.
How quickly does mesalazine start working?
It begins acting on inflammation promptly, but noticeable symptom improvement may take about a week and fuller benefit can take longer.
Why should I stay on the same brand of mesalazine?
Brands use different release systems and may deliver mesalazine to different bowel regions. Use the prescribed product and report symptom changes after any switch.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.