Mesalazine
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Asacol

Mesalazine, also known as Mesalamine or 5-aminosalicylic acid (5-ASA), is an anti-inflammatory drug used to treat inflammation of the digestive tract (Crohn's disease) and mild to moderate ulcerative colitis. Mesalazine is a bowel-specific drug that is metabolized in the gut and has its predominant actions there, thereby having fewer systemic side effects. Chemically, Mesalazine is 5-amino-2-hydroxybenzoic acid. Mesalazine's empirical formula is C7H7NO3 and its molecular weight is 153.14. more...

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It is sold in the U.S. under the names:

  • CANASA: Rectal suppository with 500 mfg of mesalamine in a base of Hard Fat NF.
  • ROWASA: Rectal suppository and suspension enema.
  • PENTASA: Suspension enema, 250mg, and 500mg tablets.
  • ASACOL: Suspension enema and 400mg tablets

Known side effects

  • Cramping
  • Sudden severe stomach pain
  • Bloody diarrhea
  • Fever
  • Severe headache
  • Rash
  • Nausea
  • Hepatic impairment
  • Agranulocytosis, Aplastic anaemia, Neutropenia, Thrombocytopenia- any sore throats, bruising or excessive bleeding should be reported to the prescribing physician and a Full blood count (rbc and wbc) as well as liver function test be performed
  • Myocarditis
  • Methaeoglobinaemia

Dosing depends on preparation- the UK guidelines from the British National Formulary are: Asacol: 400mg tablets- 6 tablets daily for an acute attack, tablets for prophylaxis. Not recommended for children

NB- preparations that lower stool pH (such as lactulose, a laxative) will affect the binding of Mesalazine in the bowel and will therefore reduce its efficacy.

Pentasa 4g daily for an acute attack, 1.5g daily for prophylaxis

Sources for more information- British National Formulary, Davidsons Practice of Medicine, Oxford Textbook of Medicine, any other text book of medicine-

Read more at Wikipedia.org


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Phthalate exposure from drugs?
From Science News, 4/3/04

A regimen of prescription pills may explain the highest blood concentration of a phthalate ever observed, medical researchers say. Phthalates are used as solvents, in plastics formulations, and for other purposes.

Last year, Russ Hauser of the Harvard School of Public Health in Boston and his colleagues found that men with high exposures to certain phthalates are likely to have sperm abnormalities (SN: 5/31/08, p. 339).

Phthalates are common in people's urine, but how these chemicals get into the body has remained unclear. Contact with phthalate-containing plastics and cosmetics is one likely path of exposure. Oral medications, which are sometimes coated with phthalates to control when the pills dissolve, could be another.

One volunteer in Hauser's study had a concentration of mono-butyl phthalate in his urine several hundred times higher than average in the United States. In a report in an upcoming Environmental Health Perspectives, Hauser and his team suggest that the man's primary exposure to the phthalate was from a drug, Asacol, that he had been taking 12 times daily for ulcerative colitis.

Asacol's coating contains dibutyl phthalate, which the body converts into mono butyl phthalate, but not three other phthalates the researchers studied. These three chemicals showed up in unremarkable concentrations in the patient's urine. Longterm use of phthalate-coated pills may be an underrated route of phthalate exposure, the researchers suggest.--B.H.

COPYRIGHT 2004 Science Service, Inc.
COPYRIGHT 2004 Gale Group

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