Mesalazine

Mesalazine
Systematic (IUPAC) name
5-amino-2-hydroxybenzoic acid
Clinical data
Trade names Pentasa, Delzicol, Canasa, Rowasa, Lialda, Apriso, Salofalk
AHFS/Drugs.com monograph
MedlinePlus a688021
Licence data US Daily Med:link
  • US: B (No risk in non-human studies)
oral, rectal
Pharmacokinetic data
Bioavailability orally: 20-30% absorbed
rectally: 10-35%
Metabolism Rapidly & extensively metabolised intestinal mucosal wall and the liver
Half-life 5 hours after initial dose.
At steady state 7 hours
Identifiers
89-57-6 Yes
A07EC02
PubChem CID 4075
IUPHAR ligand 2700
DrugBank DB00244 Yes
ChemSpider 3933 Yes
UNII 4Q81I59GXC Yes
KEGG D00377 Yes
ChEBI CHEBI:6775 Yes
ChEMBL CHEMBL704 Yes
Chemical data
Formula C7H7NO3
153.135 g/mol
 Yes (what is this?)  (verify)

Mesalazine (INN, BAN), also known as mesalamine (USAN) or 5-aminosalicylic acid (5-ASA), is an anti-inflammatory drug used to treat inflammatory bowel disease, such as ulcerative colitis[1] and mild-to-moderate Crohn's disease.[2] Mesalazine is a bowel-specific aminosalicylate drug that acts locally in the gut and has its predominant actions there, thereby having few systemic side effects.[3]

As a derivative of salicylic acid, mesalazine is also thought to be an antioxidant that traps free radicals, which are potentially damaging byproducts of metabolism.[3]

Mesalazine is the active moiety of sulfasalazine, which is metabolized to sulfapyridine and mesalazine.[4]

Mesalazine is the active component of the prodrug balsalazide along with the inert carrier molecule 4-aminobenzoyl-beta-alanine.[5]

Side effects

Commonly:

Uncommonly:

Rarely:

Mesalazine avoids the sulfonamide side effects of sulfasalazine (which contains additional sulfapyridine), but carries additional rare risks of:

Monitoring

As a result of the small risks of kidney, liver and blood disorders, blood tests should be taken before and after starting treatment. Patients are advised to report any unexplained bleeding, bruising, purpura, sore throat, fever or malaise that occurs during treatment so that a full blood count can be urgently taken.

Formulations

Pentasa 250 MG Extended Release Capsule

Mesalazine is formulated for oral ingestion as tablets or granules, and for rectal administration as a rectal suppository, suspension or enemas.[8] It is marketed under a variety of brand names:

Chron-asa 5, Pentasa, Pentasa Enema, Mesaneo

Dosing depends on the preparation used; in particular, slow-release tablets may have quite different drug delivery characteristics and are not interchangeable.

Preparations that lower stool pH (such as lactulose, a laxative) will possibly affect the binding of mesalazine in the bowel and will therefore reduce its efficacy.

References

  1. ↑ Kruis, W.; Schreiber, I.; Theuer, D.; Brandes, J. W.; Schütz, E.; Howaldt, S.; Krakamp, B.; Hämling, J.; Mönnikes, H.; Koop, I.; Stolte, M.; Pallant, D.; Ewald, U. (2001). "Low dose balsalazide (1.5 g twice daily) and mesalazine (0.5 g three times daily) maintained remission of ulcerative colitis but high dose balsalazide (3.0 g twice daily) was superior in preventing relapses". Gut 49 (6): 783–789. doi:10.1136/gut.49.6.783. PMC 1728533. PMID 11709512.
  2. ↑ Sandborn WJ, Feagan BG, Lichtenstein GR (October 2007). "Medical management of mild to moderate Crohn's disease: evidence-based treatment algorithms for induction and maintenance of remission". Alimentary Pharmacology & Therapeutics 26 (7): 987–1003. doi:10.1111/j.1365-2036.2007.03455.x. PMID 17877506. Retrieved 2009-12-20.
  3. ↑ 3.0 3.1 "mesalazine". PharmGKB.
  4. ↑ Lippencott's Illustrated Reviews: Pharmacology, 4th Ed. Finkel, Cubeddu and Clark
  5. ↑ Drugs & Therapy Properties 2003 Oct; Vol 19, No. 10
  6. ↑ "Lialda Side Effects & Safety Information". Shire US. October 2007. Retrieved 2008-01-07.
  7. ↑ "Desensitization after fever induced by mesalazine". December 2001. Retrieved 2001-12-24.
  8. ↑ "MedlinePlus: Mesalamine". April 2014. Retrieved 2014-05-12.

External links