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...

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-

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