mesalazine

Last reviewed 01/2018

MESALAZINE

This is 5-aminosalycyclic acid. It is used as an alternative to sulphasalazine.

Indications include:

• patients who do not tolerate sulphasalazine it has been shown that 5-ASA analogues are as effective as sulphasalazine in preventing relapses of ulcerative colitis
• patient not allergic to sulphonamides
• some recommend the newer preparations such as mesalazine rather than suphasalazine to be used men with inflammatory bowel disease who wish to start a family (sulphalazine causes reversible infertility) (1)

Different preparations:

Mesalazine = 5 -aminosalicylate

• delayed release Salofalk and Asacol - resin which only dissolves when pH exceeds 6 and 7, respectively, so release of 5-ASA only begins when the drug reaches the ileum (the terminal ileum in the case of Asacol), and continues in the colon
• Pentasa - timed release - formulated as microgranules which release 5-ASA gradually during passage along the gut - release begins more proximally than with pH-dependent coatings

The summary of product characteristics should be consulted before prescribing this drug.

Reference:

• Drug and Therapeutics Bulletin (2002), 39 (12), 91-95.