II. Mechanism
III. Indications
IV. General
- Rectal forms are preferred for Proctitis
- Use oral and rectal forms combined for better results where pancolitis is present
V. Dosing: Ulcerative Colitis
- Oral
- Active disease: 2.4 to 4.8 grams/day divided 3 times daily
- Maintenance: 1.2 to 2.4 grams/day divided 3 times daily
- Suppository
- Active disease: 1000 mg once daily
- Maintenance: 500 mg once to twice daily
- Enema
- Active disease: 1 to 4 grams daily
- Maintenance: 2-4 grams daily to every third day
VI. Dosing: General
- Oral
- Asacol 800 mg orally three times daily
- Pentasa 1000 mg orally four times daily
- Mesalamine MMX (e.g. Lialda) 1200 mg orally twice daily (up to 2-4 tabs orally once daily or in divided dosing)
- Apriso 1.5 grams orally every morning
- Balsalazide Disodium (Giazo, Colazal) 750 mg orally three times daily
- Rectal (Provides high distal colon concentrations)
- Rowasa 500 mg suppository per Rectum twice daily
- Rowasa 4g in 60 ml Enema at bedtime
- Canasa 1000 mg rectal suppository at bedtime
VII. Adverse Effects
- Interstitial Nephritis
- Suppositories and enemas may cause rectal irritation
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Related Studies
| mesalamine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| MESALAMINE 1,000 MG SUPP | Generic | $2.21 each |
| MESALAMINE 4 GM/60 ML ENEMA | Generic | $0.13 per ml |
| MESALAMINE 4 GM/60 ML KIT | Generic | $116.13 each |
| MESALAMINE 800 MG DR TABLET | Generic | $5.99 each |
| MESALAMINE DR 1.2 GM TABLET | Generic | $2.19 each |
| MESALAMINE DR 400 MG CAPSULE | Generic | $2.53 each |
| MESALAMINE ER 0.375 GRAM CAP | Generic | $0.89 each |
| MESALAMINE ER 500 MG CAPSULE | Generic | $4.64 each |
| pentasa (on 2/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| PENTASA 250 MG CAPSULE | $2.91 each | |
| PENTASA 500 MG CAPSULE | Generic | $4.64 each |
| lialda (on 6/14/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| LIALDA DR 1.2 GM TABLET | Generic | $2.05 each |
| delzicol (on 7/19/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| DELZICOL DR 400 MG CAPSULE | Generic | $2.11 each |
| balsalazide disodium (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| BALSALAZIDE DISODIUM 750 MG CP | Generic | $0.42 each |
Ontology: mesalamine (C0127615)
| Definition (NCI) | An agent derived from sulfasalazine, an antiinflammatory agent. Mesalamine may reduce inflammation through inhibition of cyclooxygenase and prostaglandin production. Following rectal or oral administration, only a small amount of mesalamine is absorbed; the remainder, acting topically, reduces bowel inflammation, diarrhea, rectal bleeding and stomach pain. (NCI04) |
| Definition (MSH) | An anti-inflammatory agent, structurally related to the SALICYLATES, which is active in INFLAMMATORY BOWEL DISEASE. It is considered to be the active moiety of SULPHASALAZINE. (From Martindale, The Extra Pharmacopoeia, 30th ed) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D019804 |
| SnomedCT | 387501005, 346319009, 317439005, 363629007, 86977007 |
| English | Mesalamine, Mesalazine duplicate deleted, 5 Aminosalicylic Acid, 5-Aminosalicylic Acid, 5-Amino-2-hydroxybenzoic Acid, m Aminosalicylic Acid, m-Aminosalicylic Acid, meta Aminosalicylic Acid, meta-Aminosalicylic Acid, mesalamine (medication), mesalamine (Rowasa), MESALAMINE, Mesalamine [Chemical/Ingredient], 5 asa, m-aminosalicylic acid, 5-asa, asa 5, mesalazine, Mesalazine duplicate deleted (product), Mesalamine product (product), 5-aminosalicylic acid (substance), 5-ASA, 5-Aminosalicylic acid, Fisalamine, m-Aminosalicylic acid, Mesalamine (substance), 5-aminosalicylic acid, 5ASA - Mesalazine, Mesalamine (product), Mesalamine product, Mesalamine product (substance), Mesalazine duplicate deleted (substance), Mesalazine, mesalamine |
| Swedish | Mesalamin |
| Czech | mesalazin, mesalamin |
| Finnish | Mesalatsiini |
| Russian | MEZALAMIN, MEZALAZIN, 5-AMINOSALITSILAT, 5-АМИНОСАЛИЦИЛАТ, МЕЗАЛАЗИН, МЕЗАЛАМИН |
| Spanish | mesalazina, mesalamina, mesalazina (sustancia), 5-ASA, mesalazina (producto), mesalazina (duplicado borrado) (producto), mesalamina, producto (producto), mesalamina, producto, mesalazina (duplicado borrado), mesalamina (producto), mesalamina (sustancia), fisalamina, ácido 5-aminosalicílico, ácido m-aminosalicílico, Mesalacina, Mesalamina |
| Japanese | メサラミン, ペンタサ, 5-アミノサリチル酸, フィサラミン(メサラジン), メサラジン |
| French | Acide 5-amino-salicylique, Acide 5-aminosalicylique, Mésalazine, Fisalamine, Mésalamine |
| Polish | Mesalamina, Mesalazyna, 5-aminosalicylan, Kwas 5-aminosalicylowy, 5-ASA |
| German | Mesalamine |
| Italian | Mesalamina |
| Portuguese | Mesalamina, Mesalazina |
Ontology: Pentasa (C0678171)
| Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
| MSH | D019804 |
| English | pentasa, Pentasa, Allphar Brand of Mesalamine, Ferring Brand of Mesalamine, Yamanouchi Brand of Mesalamine |
Ontology: Asacol (C0678172)
| Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
| MSH | D019804 |
| English | asacol, Asacol, Byk Brand of Mesalamine, Procter & Gamble Brand of Mesalamine |
Ontology: Rowasa (C0699623)
| Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
| MSH | D019804 |
| English | rowasa, Rowasa, Solvay Brand of Mesalamine |
Ontology: Lialda (C1873792)
| Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
| English | Lialda |
