Mesalazine
This is a 5-aminosalycyclic acid, 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)
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.
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