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Mesalazine safety — GPhC CRA MCQ

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HardGastro-intestinal TherapeuticsMesalazine safetyGPhC CRA

A woman starting mesalazine for ulcerative-colitis maintenance has eGFR 48 mL/min/1.73 m². Baseline FBC and liver tests are satisfactory, but no repeat renal plan is documented. Which recommendation is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Repeat renal tests at 3 months, then at least annually with closer follow-up

SPS advises renal assessment at baseline, after about 3 months and at least annually once stable, with more frequent monitoring when renal function is impaired. Mesalazine can cause renal impairment including interstitial nephritis, which may be clinically silent. Routine serum mesalazine concentrations do not replace renal monitoring.

Reference: NHS SPS, Mesalazine monitoring: https://www.sps.nhs.uk/monitorings/mesalazine-monitoring/