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mesalamine
Asacol, Pentasa, Rowasa

Pregnancy Risk Category B

How supplied
Tablets (delayed-release):
400 mg
Capsules (controlled-release):
250 mg
Rectal suspension:
4 g/60 ml
Suppositories:
500 mg

Action
Unknown. An active metabolite of sulfasalazine; probably acts topically by inhibiting prostaglandin production in the colon.

Indications & dosage
Active mild to moderate distal ulcerative colitis, proctitis, or proctosigmoiditis--

Adults:
800 mg P.O. (tablets) t.i.d. for total dose of 2.4 g/day for 6 weeks; or 1 g P.O. (capsules) q.i.d. for total dose of 4 g up to 8 weeks; or 500 mg P.R. (suppository) b.i.d.; or 4 g as retention enema once daily (preferably h.s.). Rectal dosage form should be retained overnight (for about 8 hours). Usual course of therapy for rectal form is 3 to 6 weeks.

Adverse reactions
CNS:
headache, dizziness, fatigue, malaise, asthenia, chills.
CV:
chest pain.
GI:
abdominal pain, cramps, discomfort, flatulence, diarrhea, rectal pain, bloating, nausea, pancolitis, vomiting, constipation, eructation.
Musculoskeletal:
arthralgia, myalgia, back pain, hypertonia.
Respiratory:
wheezing.
Skin:
itching, rash, urticaria, hair loss.
Other:
fever.

Interactions
Drug-drug.
Lactulose: may impair release of delayed or extended-release products. Monitor closely.
Omeprazole:
increased absorption of mesalamine. Monitor closely.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug, its components, or salicylates.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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