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Mesalamine

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About Mesalamine / Mesalazine

Also known as mesalazine, mesalamine, mesalasine, 5-amino-2-hydroxybenzoic acid, 5-Aminosalicylic Acid, 5-ASA, to name a few.

Mesalazine / Mesalamine is a pro-drug form of 5-ASA. These drugs are related to aspirin. Mesalazine comes in various time-released forms, to allow the drug to travel to the appropriate part of the digestive system and be applied directly to the inflamed part. The time release coating also avoids the drug irritating the stomach, as aspirin can.

Mesalamine Routes of Administration

Mesalamine therapy offers 3 different routes of administration: Oral and Rectal Enema or Rectal Suppository. For treatment of the Colon or Rectum, a Suppository or Enema treatment is generally preferred due to direct treatment of the affected area. However, rectally based treatments have a lower rate of treatment compliance and are less preferred by patients versus oral treatments (pills).

Oral Mesalamine treatments are a challenge because the "active state" of Mesalamine, 5-ASA, breaks down very quickly in the body and is not likely to survive the time it takes to reach the part of the digestive tract requiring treatment. Also, absorption throughout the body is not generally desired because this can increase the risk of side effects.

A solution comes in the form of Mesalamine with an Enteric Coating which will not disintigrate until it reaches pH 7 of the intestinal tract. Some companies offer an Enteric Coating that requires bacteria found in the Colon to break it down resulting in release of the Mesalamine drug.
Oral Mesalamine (by Mouth)
Apriso
Asacol
Asacol HD (High Dose)
Lialda
Mesasal
Pentasa
Rowasa Sachets
Salofalk Tablets [13] or Granules[14]
Mesalamine Suppositories
Canasa
Claversal
Salofalk Suppository[15
Mesalamine Enema
Rowasa Enema
SFRowasa Enema
Salofalk Enema[16] and Salofalk Foam Enema[17]

Mesalamine-Induced Acute Intolerance Syndrome

Mesalamine can cause acute intolerance syndrome and the symptoms can be hard to differentiate from the IBD. About 3% of patients are thought to get acute intolerance syndrome. The symptoms may include bloody diarrhea, abdominal pain, cramping, fever, rash, and/or headache. As such, anyone taking Lialda should be closely observed for worsening of these symptoms if they are already present from IBD.

References

1. Apriso Prescribing Information. Accessed July 2012. http://www.aprisorx.com/assets/pdf/apriso-pi.pdf

2. Asacol. Accessed July 2012. http://www.asacol.com/pdf/asacol-info.pdf

3. Asacol HD. Accessed July 2012. http://www.asacolhd.com/pdfs/AsacolH...ribingInfo.pdf

4. Canasa Prescribing Information. Accessed July 2012. http://www.canasa.com/pdf/prescribing-info.pdf

5. Claversal. Accessed July 2012. http://www.vademecum.es/medicamento-claversal_ficha_789

6. Dipentum Prescribing Information. Accessed July 2012. http://www.accessdata.fda.gov/drugsa...715s027lbl.pdf

7. Lialda Prescribing Information. Accessed July 2012. http://pi.shirecontent.com/?product=...A&language=ENG

8. http://en.wikipedia.org/wiki/Mesalazine

9. Mesalazine. Wikipedia. Mesalazine at Wikipedia

10. Mesasal Prescribing Information. Accessed July 2012. http://www.gsk.com.au/resources.ashx..._Mesasal_2.pdf

11. Prantera C and Rizzi M. 5-ASA in ulcerative colitis: Improving treatment compliance. World J. Gastroenterol. 2009; 15(35)L 4353-4355. http://www.wjgnet.com/1007-9327/pdf/v15/i35/4353.pdf

12. Punchard NA, Greenfield SM, Thompson RPH. Mechanism of action of 5-aminosalicyclic acid. Mediators of Inflammation. 1992; 1(3): 151-165. http://downloads.hindawi.com/journal...992/480976.pdf

13. http://www.orphan.com.au/file_upload...PI_06May10.pdf

14. http://www.orphan.com.au/file_upload...PI_06May10.pdf

15. Salofalk Suppository. http://www.orphan.com.au/file_upload...itory%20PI.pdf

16. http://www.orphan.com.au/file_upload...%20(clean).pdf

17. http://www.orphan.com.au/file_upload...%20(clean).pdf

18. SFRowasa Prescribing Information. Accessed July 2012. http://www.medapharma.us/products/pi/sfRowasa_PI.pdf

19. Rowasa Rectal Suspension Enema. Accessed July 2012. www.medapharma.us/products/pi/Rowasa_PI.pdf

20. http://www.ncbi.nlm.nih.gov/pmc/arti...m-0305-919.pdf

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