Mesalazine
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| Systematic (IUPAC) name |
| 5-amino-2-hydroxybenzoic acid |
| Clinical data |
| Trade names |
Pentasa, Delzicol, Canasa, Rowasa, Lialda, Apriso, Salofalk |
| AHFS/Drugs.com |
monograph |
| MedlinePlus |
a688021 |
| Licence data |
US Daily Med:link |
| Pregnancy cat. |
B (US) |
| Legal status |
℞-only (US) |
| Routes |
oral, rectal |
| Pharmacokinetic data |
| Bioavailability |
orally: 20-30% absorbed
rectally: 10-35% |
| Metabolism |
Rapidly & extensively metabolised intestinal mucosal wall and the liver |
| Half-life |
5 hours after initial dose.
At steady state 7 hours |
| Identifiers |
| CAS number |
89-57-6 Y |
| ATC code |
A07EC02 |
| PubChem |
CID 4075 |
| IUPHAR ligand |
2700 |
| DrugBank |
DB00244 |
| ChemSpider |
3933 Y |
| UNII |
4Q81I59GXC Y |
| KEGG |
D00377 Y |
| ChEBI |
CHEBI:6775 Y |
| ChEMBL |
CHEMBL704 Y |
| Chemical data |
| Formula |
C7H7NO3 |
| Mol. mass |
153.135 g/mol |
|
|
InChI
-
InChI=1S/C7H7NO3/c8-4-1-2-6(9)5(3-4)7(10)11/h1-3,9H,8H2,(H,10,11) Y
Key:KBOPZPXVLCULAV-UHFFFAOYSA-N Y
|
| Y (what is this?) (verify) |
Mesalazine (INN, BAN), also known as mesalamine (USAN) or 5-aminosalicylic acid (5-ASA), is an anti-inflammatory drug used to treat inflammatory bowel disease, such as ulcerative colitis[1] and mild-to-moderate Crohn's disease.[2] Mesalazine is a bowel-specific aminosalicylate drug that acts locally in the gut and has its predominant actions there, thereby having few systemic side effects.[3]
As a derivative of salicylic acid, mesalazine is also thought to be an antioxidant that traps free radicals, which are potentially damaging byproducts of metabolism.[3]
Mesalazine is the active moiety of sulfasalazine, which is metabolized to sulfapyridine and mesalazine.[4]
Mesalazine is the active component of the prodrug balsalazide along with the inert carrier molecule 4-aminobenzoyl-beta-alanine.[5]
Contents
- 1 Side effects
- 2 Monitoring
- 3 Formulations
- 4 References
- 5 External links
Side effects[edit]
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This section needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (May 2012) |
Commonly:
- Diarrhea
- Nausea
- Cramping
- Flatulence[6]
Uncommonly:
- Headache
- Exacerbation of the colitis
- Hypersensitivity reactions (including rash, urticaria aka hives, interstitial nephritis and lupus erythematosus-like syndrome)
- Hair loss
Rarely:
- Acute pancreatitis
- Hepatitis
- Nephrotic syndrome
- Blood disorders (including agranulocytosis, aplastic anaemia, leukopenia, neutropenia, thrombocytopenia)
- Fever [7]
Mesalazine avoids the sulfonamide side effects of sulfasalazine (which contains additional sulfapyridine), but carries additional rare risks of:
- Allergic lung reactions
- Allergic myocarditis
- Methaemoglobinaemia
Monitoring[edit]
|
|
This section does not cite any references or sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (November 2009) |
As a result of the small risks of kidney, liver and blood disorders, blood tests should be taken before and after starting treatment. Patients are advised to report any unexplained bleeding, bruising, purpura, sore throat, fever or malaise that occurs during treatment so that a full blood count can be urgently taken.
Formulations[edit]
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This section does not cite any references or sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (November 2009) |
Pentasa 250 MG Extended Release Capsule
Mesalazine is formulated for oral ingestion as tablets or granules, and for rectal administration as a rectal suppository, suspension or enemas.[citation needed] It is marketed under a variety of brand names:[citation needed]
- UK: Asacol, Ipocal, Pentasa, Salofalk, Mezavant XL
- Ireland: Asacolon, Pentasa, Salofalk, Mezavant XL
- France: Asacol, Pentasa, Mezavant
- US: Canasa, Rowasa, Pentasa, Delzicol, Lialda, Apriso, Salofalk
- Spain / España: Pentasa, Claversal, Lixacol, Mezavant, Salofalk
- Canada: Asacol, Pentasa, Salofalk, Mezavant
- India: Mesacol (available as tablets, suppositories, enema), VEGAZ-OD.
- Mexico: Salofalk
- Serbia: Salofalk
- Uruguay: Mesacron, Mesalazina
- Brazil: Mesalazina, Mesalazina Enema, Mesacol, Mesacol MNX, Asalit,
- Australia: Mesasal
- Egypt: Pentasa, Salofalk
- Belgium: Dipentum (olsalazine)
Chron-asa 5, Pentasa, Pentasa Enema, Mesaneo
Dosing depends on the preparation used; in particular, slow-release tablets may have quite different drug delivery characteristics and are not interchangeable.[citation needed]
Preparations that lower stool pH (such as lactulose, a laxative) will possibly affect the binding of mesalazine in the bowel and will therefore reduce its efficacy.[citation needed]
References[edit]
- ^ Kruis, W.; Schreiber, I.; Theuer, D.; Brandes, J. W.; Schütz, E.; Howaldt, S.; Krakamp, B.; Hämling, J.; Mönnikes, H.; Koop, I.; Stolte, M.; Pallant, D.; Ewald, U. (2001). "Low dose balsalazide (1.5 g twice daily) and mesalazine (0.5 g three times daily) maintained remission of ulcerative colitis but high dose balsalazide (3.0 g twice daily) was superior in preventing relapses". Gut 49 (6): 783–789. doi:10.1136/gut.49.6.783. PMC 1728533. PMID 11709512. edit
- ^ Sandborn WJ, Feagan BG, Lichtenstein GR (October 2007). "Medical management of mild to moderate Crohn's disease: evidence-based treatment algorithms for induction and maintenance of remission". Alimentary Pharmacology & Therapeutics 26 (7): 987–1003. doi:10.1111/j.1365-2036.2007.03455.x. PMID 17877506. Retrieved 2009-12-20.
- ^ a b "mesalazine". PharmGKB.
- ^ Lippencott's Illustrated Reviews: Pharmacology, 4th Ed. Finkel, Cubeddu and Clark
- ^ Drugs & Therapy Properties 2003 Oct; Vol 19, No. 10
- ^ "Lialda Side Effects & Safety Information". Shire US. October 2007. Retrieved 2008-01-07.
- ^ "Desensitization after fever induced by mesalazine". December 2001. Retrieved 2001-12-24.
- Mehta, Dinesh K, ed. (March 2003). British National Formulary 45. London: Pharmaceutical Press. ISBN 0-85369-555-5.
- Sweetman, Sean C, ed. (November 2004). Martindale: The complete drug reference (34th ed.). London: Pharmaceutical Press. ISBN 0-85369-550-4.
External links[edit]
- Bickston, S. J.; Cominelli, F. (January 2003). "Optimal dosing of 5-aminosalicylic acid: 5 Decades of choosing between politicians". Clinical Gastroenterology and Hepatology 1 (1): 3–4. doi:10.1053/jcgh.2003.50001. PMID 15017510. edit
- "Novel formulation increases efficacy of mesalamine for treating ulcerative colitis". Reuters. February 16, 2007.
- "Once daily mesalazine effective in active ulcerative colitis: study". Reuters. January 30, 2009.
- Pentasa Official Site
- Asacol Official Site
- Lialda Official Site
- Apriso Official Site
- Pentasa Full Prescribing Information Shire
- Asacol Full Prescribing Information Warner Chilcott
- Lialda Full Prescribing Information Shire
- Apriso Full Prescribing Information Salix Pharmaceuticals
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Antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07)
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| Rehydration |
|
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| Intestinal anti-infectives |
- Antibiotics
- Amphotericin B
- Colistin
- Fidaxomicin
- Kanamycin
- Natamycin
- Neomycin
- Nystatin
- Paromomycin
- Polymyxin B
- Rifaximin
- Streptomycin
- Vancomycin
- Sulfonamides
- Phthalylsulfathiazole
- Succinylsulfathiazole
- Sulfaguanidine
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| Intestinal adsorbents |
- Charcoal
- Bismuth
- Pectin
- Kaolin
- Crospovidone
- Attapulgite
- Diosmectite
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| Antipropulsives (opioids) |
- Opium tincture (laudanum)
- Codeine
- Morphine
- Camphorated opium tincture (paregoric)
- crosses BBB: Diphenoxylate (Diphenoxylate/atropine)
- Difenoxin
- does not cross BBB: Loperamide
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| Intestinal anti-inflammatory agents |
- corticosteroids acting locally
- Prednisolone
- Hydrocortisone
- Prednisone
- Betamethasone
- Tixocortol
- Budesonide
- Beclometasone
- antiallergic agents, excluding corticosteroids
- aminosalicylic acid and similar agents
- Sulfasalazine
- Mesalazine
- Olsalazine
- Balsalazide
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| Antidiarrheal micro-organisms |
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| Other antidiarrheals |
- Albumin tannate
- Ceratonia
- Octreotide
- Racecadotril
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noco/cong/tumr, sysi/epon
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proc, drug (A2A/2B/3/4/5/6/7/14/16), blte
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