Mesalazine (Asacol®)

Indication:
Treatment of mild to moderate Ulcerative colitis and Crohns disease

Site of action:
Terminal ileum and proximal colon

Formulations:
– Tablets 400mg
– Suppositories 250mg, 500mg

Dose:
– Acute 15mg/kg BD
– or 10mg/kg TDS ( max 2.4g as a total daily dose )

Doses will or should be adjusted to ensure ease of administration with the above formulations

Side-effects:
Nausea, vomiting, diarrhoea, abdominal pain, headache, exacerbation of colitis symptoms, rarely reversible pancreatitis, hepatitis and interstitial nephritis, bone marrow suppression, fibrosing alveolitis.
Caution if salicylate hypersensitive

Interactions:
Lactulose may lower stool pH (? affecting release profile of Asacol) but this is not thought to be clinically significant.

Notes:
Indigestion remedies should not be taken at the same time.
Tablets should be swallowed whole, never crushed.
Tablets coated with a pH sensitive acrylic based resin.
Patients should be advised to report any unexplained bleeding, bruising, purpura, sore throat, fever or malaise that occurs during therapy.
Blood count should be performed and therapy stopped immediately if there is a suspicion of a blood dyscrasia.

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