Mesalamine (5-Aminosalicylic Acid, 5-ASA)(me sal’ a meen)
Apriso, AsacolDNC, Asacol HD, CANASA, DelzicolDNC, LialdaDNC, Mesasal (CAN), Novo-5 ASA (CAN), PentasaDNC, Rowasa, Salofalk (CAN)
PREGNANCY CATEGORY B
(RECTAL)
PREGNANCY CATEGORY C (ORAL)
Drug class
Anti-inflammatory
Therapeutic Actions
Mechanism of action is unknown; thought to be a direct, local anti-inflammatory effect in the colon where mesalamine blocks cyclooxygenase and inhibits prostaglandin production in the colon.
Indications
Oral: Remission, treatment and maintenance treatment, and induction of remission with one daily dose, of active mild to moderate ulcerative colitis
Suppository: Treatment of active, distal, mild to moderate ulcerative colitis, ulcerative proctitis, or proctosigmoiditis
Contraindications and Cautions
Contraindicated with hypersensitivity to mesalamine, salicylates, any component of the formulation.
Use cautiously with renal impairment, pregnancy, lactation.
Available Forms
DR tabletsDNC—400, 800 (Asacol HD) mg, 1.2 g; CR capsulesDNC—250, 500 mg; ER capsulesDNC—375 mg; DR capsulesDNC—400 mg; suppositories—1 g; rectal suspension—4 g/60 mL
Dosages
Adults
Rectal
Suspension enema: 60 mL units in one rectal instillation (4 g) once a day, preferably at bedtime, and retained for approximately 8 hr. Usual course of therapy is 3–6 wk. Effects may be seen within 3–21 days.
Rectal suppository: 1 g (1 suppository) bid. Retain suppository for 1–3 hr or longer. Usual course is 3–6 wk.
Oral
DR tablets: 2–4 1.2 g tablets PO once daily with food for total dose of 2.4–4.8 g. Treatment beyond 8 wk has not been studied (Lialda).
ER capsules: 1.5 g/day PO (4 capsules) in the morning (Apriso). Treatment for up to 6 mo.
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