Mesalamine

Brand names

• Asacol
• Mesasal
• Novo-5 ASA
• Pentasa
• Quintasa
• Rowasa
• Salofalk

Usage

To treat inflammatory bowel diseases such as ulcerative colitis.

How it works

The exact mechanism of action is uncertain, although it appears that mesalamine inhibits the production of substances known as metabolites of arachidonic acid (specifically, leukotrienes and prostaglandins), which produce inflammation in the digestive tract.

Side effects

Serious

Severe abdominal pains or cramps; bloody diarrhea; fever; severe headache; skin rash and itching; blue or pale skin; severe back or stomach pain, possibly moving to the left arm, neck, or shoulder; chills; rapid heartbeat; nausea or vomiting; shortness of breath; swollen stomach; unusual fatigue; yellow eyes or skin; rectal irritation (with enema).

Common

Mild abdominal cramping, mild diarrhea, dizziness, headache, runny or stuffy nose, sneezing.

Less common

Acne, back or joint pain, gas or flatulence, loss of appetite, loss of hair.

Possible interactions

Other medicaments:

Mesalamine taken concurrently with:

• alendronate (Fosamax) may increase stomach or intestinal upset risks (because of salicylate).
• ardeparin (Normiflo), dalteparin (Fragmin) or enoxaparin (Lovenox) may increase risk of hemorrhage.
• aspirin or other salicylates may increase risk of salicylate toxicity.
• varicella vaccine (Varivax) may result in Reye's syndrome; avoid taking this medicine for 6 weeks following varicella vaccine.
• warfarin (Coumadin) may blunt warfarin effectiveness. More frequent INRs are prudent.

Foods:

Decreased mesalamine levels. Follow prescribed diet.

Herbal medicines or minerals:

Flaxseed, peppermint oil and psyllium husk have commission E monograph indications for irritable bowel syndrome. This is not the same as ulcerative colitis, and those products have not been studied in ulcerative colitis. Aloe, buckthorn berry or bark, cascara sagrada bark, rhubarb root and senna should not be taken by people living with ulcerative colitis.

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