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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/09/02 16:25:39」(JST)

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Mesalazine (INN, BAN), also known as mesalamine (USAN) or 5-aminosalicylic acid (5-ASA), is an aminosalicylate anti-inflammatory drug^[2] used to treat inflammatory bowel disease, including ulcerative colitis,^[3]^[4]^[5] or inflamed anus or rectum,^[6] and to maintain remission in Crohn's disease.^[3]^[7]

It is sold in an oral form to maintain remission in Crohn's disease,^[3] and as a rectal suppository^[4]^[6] and an enema for the lower bowel conditions.^[5] It is generic and sold under many brand names worldwide,^[1] and there are many formulations.^[8]

There are no data on use in pregnant women, but the drug does cross the placenta and is excreted in breast milk. The drug should not be used in children under two, people with kidney disease, or people who are allergic to aspirin.^[4]

Side effects are primarily gastrointestinal but may also include headache; GI effects include nausea, diarrhea and abdominal pain. There have been scattered reports of various problems when the oral form is used, including:problems caused by myelosuppression (leukopenia, neutropenia, agranulocytosis, aplastic anaemia, and thrombocytopenia), as well as hair loss, peripheral neuropathy, pancreatitis, liver problems, myocarditis and pericarditis, allergic and fibrotic lung reactions, lupus erythematosus-like reactions and rash (including urticaria), drug fever, interstitial nephritis and nephrotic syndrome, usually reversible on withdrawal. Very rarely, use of mesalazine has been associated with an exacerbation of the symptoms of colitis, Stevens Johnson syndrome and erythema multiforme.^[3]^[4]

Mesalazine is the active moiety of sulfasalazine, which is metabolized to sulfapyridine and mesalazine.^[9] It is also the active component of the prodrug balsalazide along with the inert carrier molecule 4-aminobenzoyl-beta-alanine.^[10]

References

^ ^a ^b Drugs.com International trade names for mesalazine April 20, 2016
^ "mesalazine". PharmGKB.
^ ^a ^b ^c ^d UK Electronic Medicines Compendium UL Oral Label Last revised December 2015
^ ^a ^b ^c ^d UK Electronic Medicines Compendium Suppository Label Last revised February 2016
^ ^a ^b UK Electronic Medicines Compendium UK Enema Label Last revised January 2016
^ ^a ^b FDA. US Suppository Label Last updated Nov 2015
^ 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. PMID 17877506. doi:10.1111/j.1365-2036.2007.03455.x. Retrieved 2009-12-20.
^ Ye B, van Langenberg DR. Mesalazine preparations for the treatment of ulcerative colitis: Are all created equal? World J Gastrointest Pharmacol Ther. 2015 Nov 6;6(4):137-44. PMID 26558148 PMC 4635154
^ Lippencott's Illustrated Reviews: Pharmacology, 4th Ed. Finkel, Cubeddu and Clark
^ Drugs & Therapy Properties 2003 Oct; Vol 19, No. 10

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.

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1. 炎症性腸疾患治療におけるスルファサラジンおよび5-アミノサリチル酸 sulfasalazine and 5 aminosalicylates in the treatment of inflammatory bowel disease
2. Management of severe ulcerative colitis in adults
3. クローン病術後の再発予防のための内科的治療 medical prophylaxis of postoperative crohn disease
4. 成人における軽症～中等症クローン病の内科的マネージメントの概要 overview of the medical management of mild to moderate crohn disease in adults
5. Management of mild to moderate ulcerative colitis in adults

English Journal

Pectin-chitosan physical hydrogels as potential drug delivery vehicles.

Neufeld L1, Bianco-Peled H2.
International journal of biological macromolecules.Int J Biol Macromol.2017 Aug;101:852-861. doi: 10.1016/j.ijbiomac.2017.03.167. Epub 2017 Mar 30.
PMID 28366853

Neuroimaging of Takayasu Arteritis in a Patient with Ulcerative Rectocolitis.

Monti L1, Servillo R2, Grazzini I2, Khader L2, Acampa M2, Cerase A2.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.J Stroke Cerebrovasc Dis.2017 Jul;26(7):e129-e132. doi: 10.1016/j.jstrokecerebrovasdis.2017.04.007. Epub 2017 May 4.
PMID 28479185

5-aminosalicylic acid agents for prevention of recurrent diverticulitis: a systematic review and meta-analysis.

Urushidani S1,2, Kuriyama A3, Matsumura M1.
Journal of gastroenterology and hepatology.J Gastroenterol Hepatol.2017 Jun 17. doi: 10.1111/jgh.13846. [Epub ahead of print]
PMID 28623877

Japanese Journal

症例報告 Mesalazineの中止により軽快した薬剤性好酸球性肺炎の1例

広島医学 70(6), 304-308, 2017-06
NAID 40021256609

症例報告メサラジンにより粘膜炎症の改善が認められたIgA血管炎の1例

福島医学雑誌 = Fukushima medical journal 67(1), 27-32, 2017-04
NAID 40021239363

臨床研究・症例報告メサラジン製剤に対するアレルギー反応を認めたCrohn病の幼児例 (内分泌代謝)

小児科臨床 70(4), 492-497, 2017-04
NAID 40021134725

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★リンクテーブル★

リンク元	「急性尿細管間質性腎炎」「メサラジン」「mesalamine」

「急性尿細管間質性腎炎」

Mesalazine
Clinical data
Trade names	Many names worldwide, including Azacol, Lialda, Pentasa, and Apriso
AHFS/Drugs.com	Monograph
MedlinePlus	a688021
License data	US DailyMed: 47586; US FDA: Mesalazine;
Pregnancy; category	US: B (No risk in non-human studies); ;
Routes of; administration	oral, rectal
ATC code	A07EC02 (WHO);
Legal status
Legal status	US: ℞-only;
Pharmacokinetic data
Bioavailability	orally: 20–30% absorbed; rectally: 10–35%
Metabolism	Rapidly & extensively metabolised intestinal mucosal wall and the liver
Biological half-life	5 hours after initial dose.; At steady state 7 hours
Identifiers
	IUPAC name 5-Amino-2-hydroxybenzoic acid;
CAS Number	89-57-6 ;
PubChem CID	4075;
IUPHAR/BPS	2700;
DrugBank	DB00244 ;
ChemSpider	3933 ;
UNII	4Q81I59GXC;
KEGG	D00377 ;
ChEBI	CHEBI:6775 ;
ChEMBL	CHEMBL704 ;
ECHA InfoCard	100.001.745
Chemical and physical data
Formula	C7H7NO3
Molar mass	153.135 g/mol
3D model (JSmol)	Interactive image;
	SMILES O=C(O)c1cc(ccc1O)N ;
	InChI InChI=1S/C7H7NO3/c8-4-1-2-6(9)5(3-4)7(10)11/h1-3,9H,8H2,(H,10,11) ; Key:KBOPZPXVLCULAV-UHFFFAOYSA-N ;
(verify)

　　[★]

英: acute tubulointerstitial nephritis
同: 急性間質性腎炎 acute interstitial nephritis, AIN
関: 尿細管間質性腎炎

原因

薬剤性

antibiotics (lactams, sulfonamides, quinolones, vancomycin, erythromycin, minocycline, rifampin, ethambutol, acyclovir)
NSAIDs,COX-2阻害薬
利尿薬(thiazides, furosemide, triamterene)
抗てんかん薬(フェニトイン、フェノバルビタール、カルバマゼピン、バルプロ酸)
その他(カプトプリル、H2受容体阻害薬、プロトンポンプ阻害薬、mesalazine、indinavir、アロプリノール)

感染症

細菌(Streptococcus、Staphylococcus、Legionella、Salmonella、Brucella、Yersinia、Corynebacterium diphtheriae)
ウイルス(Epstein-Barr virus、cytomegalovirus、Hantavirus、polyomavirus、HIV)
その他(レプトスピラ、リケッチア、マイコプラズマ)

特発性

「メサラジン」

　　[★]

英: mesalazine
商: アサコール、ペンタサ
関: メサラミン, 5-アミノサリチル酸、その他の消化器官用薬

化学名：5-aminosalicylic acid
分子式：C7H7NO3
分子量：153.14

「mesalamine」

　　[★]

メサラミン

関: 5-aminosalicylate、5-aminosalicylic acid、mesalazine

[generics-1] Drugs.com International trade names for mesalazine April 20, 2016

[PharmGKB-2] "mesalazine". PharmGKB.

[UKOralLabel-3] UK Electronic Medicines Compendium UL Oral Label Last revised December 2015

[UKSuppLabel-4] UK Electronic Medicines Compendium Suppository Label Last revised February 2016

[UKEnemaLabel-5] UK Electronic Medicines Compendium UK Enema Label Last revised January 2016

[USSuppLabel-6] FDA. US Suppository Label Last updated Nov 2015

[7] 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. PMID 17877506. doi:10.1111/j.1365-2036.2007.03455.x. Retrieved 2009-12-20.

[8] Ye B, van Langenberg DR. Mesalazine preparations for the treatment of ulcerative colitis: Are all created equal? World J Gastrointest Pharmacol Ther. 2015 Nov 6;6(4):137-44. PMID 26558148 PMC 4635154

[9] Lippencott's Illustrated Reviews: Pharmacology, 4th Ed. Finkel, Cubeddu and Clark

[10] Drugs & Therapy Properties 2003 Oct; Vol 19, No. 10

v t e Antidiarrheals, intestinal anti-inflammatory and anti-infective agents (A07)
Rehydration	Oral rehydration therapy
Intestinal anti-infectives	Antibiotics Amphotericin B Colistin Fidaxomicin Kanamycin Natamycin Neomycin Nystatin Paromomycin Polymyxin B Rifaximin Streptomycin Vancomycin Sulfonamides Phthalylsulfathiazole Succinylsulfathiazole Sulfaguanidine Nitrofuran Nifuroxazide Nifurzide Imidazole Miconazole Arsenical Acetarsol Oxyquinoline Broxyquinoline
Intestinal adsorbents	Charcoal Bismuth Pectin Kaolin Crospovidone Attapulgite Diosmectite
Antipropulsives (opioids)	Opium tincture (laudanum) Codeine Morphine Camphorated opium tincture (paregoric) crosses BBB: Diphenoxylate (Diphenoxylate/atropine) Difenoxin does not cross BBB: Eluxadoline Loperamide
Intestinal anti-inflammatory agents	corticosteroids acting locally Prednisolone Hydrocortisone Prednisone Betamethasone Tixocortol Budesonide Beclometasone antiallergic agents, excluding corticosteroids Cromoglicic acid aminosalicylic acid and similar agents Sulfasalazine Mesalazine Olsalazine Balsalazide
Antidiarrheal micro-organisms	Saccharomyces boulardii
Other antidiarrheals	Albumin tannate Ceratonia Crofelemer Octreotide Racecadotril

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案内

案内

mesalazine