DRUG ! Aminosalicylates - Mesalazine

Question 1

What is mesalazine (aminosalicylate) used for?

Answer 1

1) 1st line for mild to moderate Ulcerative Colitis

2) sulfasalazine for rheumatoid arthritis

Question 2

How does mesalazine work?

Answer 2

Mesalazine releases 5-aminosalicylic acid (5-ASA)

which has anti-inflammatory and immunosuppressive effects.

Question 3

What are the side effects of mesalazine?

Answer 3

• mesalazine has fewer side effects than sulfasalazine
• GI upset (nausea, dyspepsia)
• headache

Rare:

• leucopenia
• thrombocytopenia
• renal impairment

Question 4

What are the contraindications of mesalazine?

Answer 4

Mesalazine is a salicylate like aspirin. So do not give to pts with aspirin allergy.

Question 5

What are the drug interactions of mesalazine?

Answer 5

• PPIs
• Lactulose

Mesalazine tablets with a pH sensitive are meant to target the colon.
However alongside PPIs they may be released earlier due to the higher pH of the stomach.

Lactulose lowers the stool pH so may prevent 5-ASA release in the colon

Question 6

How is mesalazine prescribed?

Answer 6

For rectal UC - mesalazine suppositary.

Or as a tablet to be swallowed whole.