Mesalamine

About mesalamine

Ulcerative colitis causes inflammation of the intestine, which leads to problems such as ulceration and bleeding. This causes symptoms such as abdominal pain and diarrhea. Crohn's disease is a condition which causes inflammation of any part of the gastrointestinal system. When the inflammation is in the area where the small intestine joins the large intestine then it is called Crohn's ileo-colitis. Aminosalicylates are a group of medicines commonly used to treat inflammatory bowel diseases such as these.

Mesalamine is one of the most commonly used aminosalicylates. Although it is not clear exactly how mesalamine works, it is thought to act on cells lining the intestine to change the way these cells make and release certain chemicals. These chemicals are thought to be a factor in causing the symptoms of ulcerative colitis. Mesalamine allows the damaged intestine to recover and helps to prevent symptoms from flaring up again.

There are a number of different mesalamine preparations, strengths and brands. The way the manufacturers make each of these brands differs slightly; this allows the different brands to release mesalamine in specific areas of the intestine. You will be prescribed the brand that allows mesalamine to be released in the part of your intestine which requires it most.

Mesalamine can be taken by mouth as capsules or tablets, or it can be given into the back passage (rectum) as a suppository or enema.

Before taking mesalamine

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking mesalamine it is important that your physician knows:

• If you are pregnant or breastfeeding. (Although mesalamine is unlikely to be harmful to babies, it is still important that you tell your physician if you are expecting or breastfeeding a baby.)

• If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work.

• If you have ever had kidney stones (renal calculi) before.

• If you have any problems with your breathing.

• If you have ever had an allergic reaction to a medicine. It is particularly important that you tell your physician if you have had an unusual reaction to aspirin or a salicylate.

• If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
  

How to take/use mesalamine

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about mesalamine, and it will also provide you with a full list of the side-effects which you could experience.

• Your dose will depend upon which brand of mesalamine has been prescribed for you. Your physician will tell you how much to take and when to take it, and these directions will also be printed on the label of the pack to remind you about what the physician said to you. Take mesalamine exactly as your physician tells you to.

• Some mesalamine tablets are specially coated to pass through your stomach before they are absorbed. These must be swallowed whole and not broken, chewed or crushed. Check the label on your pack carefully and follow any advice it gives. Also, do not take any indigestion remedies within two hours of taking your doses (either before or after), as this will interfere with the special coating.

• Some mesalamine capsules can be opened and the contents sprinkled on to soft food such as applesauce or yogurt. Pour the contents on to a spoonful of food and swallow without chewing the granules. Check the label on your pack carefully and follow any advice it gives.

• If you forget to take a dose, take it as soon as you remember, unless it is nearly time for your next dose, in which case leave out the missed dose and take the next dose as normal. Do not take two doses together to make up for a forgotten dose.

How to use mesalamine enema

1. Mesalamine works best when your bowel is empty.

2. The enema should be inserted at bedtime so it can work overnight.

3. Shake the enema and release the seal on the nozzle.

4. Lie down on one side and draw your top knee up towards your chest. Insert the enema nozzle into your back passage (rectum).

5. Squeeze the bottle gently to completely empty the contents. This will take around 30-40 seconds.

6. Remove the nozzle from your back passage whilst still squeezing the bottle. Remain where you are for about 5-10 minutes until the urge to pass the enema has eased.

7. Throw away the empty enema bottle in a plastic bag (these are provided with some brands of enema).

8. Wash your hands.

How to use mesalamine suppositories

1. Mesalamine works best when your bowel is empty.

2. The suppository should be inserted at bedtime so it can work overnight.

3. Remove the suppository from the packaging.

4. Using your finger, gently push the suppository into your back passage (rectum). Some people find it helps to squat, or to lie down on one side and draw their knees up towards their chest to do this.

5. Push the suppository in as far as possible. You may have the urge to pass the suppository out again but this should ease after a few minutes.

6. Wash your hands.

Getting the most from your treatment

• Each time you collect a new supply from your pharmacy, check to see if it is the same brand as before. If it is different, discuss this with your pharmacist who will advise you.

• Try to keep your regular appointments with your physician and clinic. This is so your physician can check on your progress. Your physician will want you to have regular blood tests during the treatment.

• Treatment with mesalamine may be long-term to prevent symptom flare-ups. Continue to take/use it unless you are advised otherwise.

• Your physician may advise you make some changes to your diet as part of your treatment. This can include a special diet or a nutritional supplement.

• It is important to maintain a good fluid intake whilst being treated with mesalamine.

Can mesalamine cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with mesalamine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your physician or pharmacist if any of the following continue or become troublesome.

Important: rarely, mesalamine can cause problems with your blood. You should contact your physician immediately if you have any unexplained bleeding, bruising, red or purple discolorations of your skin, an unexplained sore throat or high temperature (fever), or if you feel generally unwell during the treatment.

If you experience any other symptoms which you think may be due to this medicine, speak with your physician or pharmacist.

How to store mesalamine

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines