Gastroenterology Book

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Sulfa-free 5-Aminosalacylic acid

Aka: Sulfa-free 5-Aminosalacylic acid, Sulfa-free 5-ASA, Mesalamine, Asacol, Pentasa, Rowasa, Mesalamine MMX, Lialda, Delzicol, Balsalazide Disodium, Giazo, Colazal
  1. Mechanism
    1. 5-Aminosalicylic Acid Derivative
  2. Indications
    1. Inflammatory Bowel Disease
      1. Ulcerative Colitis
      2. Crohns Disease
  3. General
    1. Rectal forms are preferred for Proctitis
    2. Use oral and rectal forms combined for better results where pancolitis is present
  4. Dosing: Ulcerative Colitis
    1. Oral
      1. Active disease: 2.4 to 4.8 grams/day divided 3 times daily
      2. Maintenance: 1.2 to 2.4 grams/day divided 3 times daily
    2. Suppository
      1. Active disease: 1000 mg once daily
      2. Maintenance: 500 mg once to twice daily
    3. Enema
      1. Active disease: 1 to 4 grams daily
      2. Maintenance: 2-4 grams daily to every third day
  5. Dosing: General
    1. Oral
      1. Asacol 800 mg orally three times daily
      2. Pentasa 1000 mg orally four times daily
      3. Mesalamine MMX (e.g. Lialda) 1200 mg orally twice daily (up to 2-4 tabs orally once daily or in divided dosing)
      4. Apriso 1.5 grams orally every morning
      5. Balsalazide Disodium (Giazo, Colazal) 750 mg orally three times daily
    2. Rectal (Provides high distal colon concentrations)
      1. Rowasa 500 mg suppository per Rectum twice daily
      2. Rowasa 4g in 60 ml Enema at bedtime
      3. Canasa 1000 mg rectal suppository at bedtime
  6. Adverse Effects
    1. Interstitial Nephritis
    2. Suppositories and enemas may cause rectal irritation
  7. References
    1. Adams (2013) Am Fam Physician 87(10): 699-705 [PubMed]
    2. Adams (2022) Am Fam Physician 105(4): 406-11 [PubMed]
    3. Kornbluth (2010) Am J Gastroenterol 105(3): 501-23 [PubMed]
Medication Costs
mesalamine (on 11/23/2016 at Medicaid.Gov Pharmacy Drug pricing)
MESALAMINE 4 GM/60 ML ENEMA Generic $0.19 per ml
MESALAMINE 4 GM/60 ML KIT Generic $133.96 each
MESALAMINE 800 MG DR TABLET Generic $5.46 each
asacol (on 5/31/2017 at Medicaid.Gov Pharmacy Drug pricing)
ASACOL HD DR 800 MG TABLET Generic $5.46 each
pentasa (on 6/2/2017 at Medicaid.Gov Pharmacy Drug pricing)
PENTASA 250 MG CAPSULE $2.67 each
PENTASA 500 MG CAPSULE $5.37 each
lialda (on 6/2/2017 at Medicaid.Gov Pharmacy Drug pricing)
LIALDA DR 1.2 GM TABLET $9.00 each
delzicol (on 2/22/2017 at Medicaid.Gov Pharmacy Drug pricing)
DELZICOL DR 400 MG CAPSULE $3.11 each
balsalazide disodium (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
BALSALAZIDE DISODIUM 750 MG CP Generic $0.41 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

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
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Rowasa (C0699623)

Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116)
MSH D019804
English rowasa, Rowasa, Solvay Brand of Mesalamine
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Lialda (C1873792)

Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116)
English Lialda
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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