Mesalazine
5-aminosalicylic acid, given by mouth or rectally to treat ulcerative colitis and keep it in remission.
Also called mesalamine (US name) or 5-ASA (abbreviation).
Drug card
- Class
- Aminosalicylate
- How it works
- Delivering 5-ASA to the bowel lining to damp local inflammation
- Used for
- Ulcerative colitis: treating flares and keeping remission
- Crohn's disease
- Known for
- Kidney damage (interstitial nephritis)
- Its name
- -salazine, -salazide means an aminosalicylate (mesalazine type)
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does mesalazine work?
The active part of sulfasalazine, made in delayed-release, rectal and other forms so that it reaches the colon, where little is absorbed and it acts on the lining. It probably damps inflammation by inhibiting cyclooxygenase and lipoxygenase and so cutting prostaglandin and leukotriene production, but the exact mechanism is unclear.
Uses
What is mesalazine used for?
- Ulcerative colitis: treating flares and keeping remission
- Crohn's disease
Side effects
Side effects of mesalazine
- Kidney damage (interstitial nephritis)Known forSerious
- Headache
- Nausea
- Abdominal pain
- Flare-like reaction: cramps, bloody diarrhea, feverSerious
- Agranulocytosis and other blood disordersSerious
- Myocarditis and pericarditisSerious
- PancreatitisSerious
- Liver injurySerious
- Severe skin reactions (such as SJS/TEN, DRESS)Serious
- Photosensitivity
- Lung inflammation (pneumonitis)Serious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Check kidney function before starting and periodically; take extra care with NSAIDs and other nephrotoxic drugs.
- Contraindicated in allergy to salicylates or aminosalicylates.
- With azathioprine or mercaptopurine, monitor blood counts: blood disorders become more likely.
- Ensure good fluid intake: mesalazine kidney stones do not show on X-ray or CT.
Remember it
A way to remember it
5-ASA is aspirin's cousin for the colon.
Mesalazine is 5-aminosalicylic acid, a salicylate like aspirin, but it is made to work on the bowel lining; people allergic to salicylates should not take it.
Written for biofideX
Its name
-salazine, -salazide means aminosalicylate (mesalazine type)
Mesalazine (5-ASA) treats ulcerative colitis; sulfasalazine and balsalazide are prodrugs that gut bacteria split to free it in the colon. Mesalazine's US name, mesalamine, lacks it.
- Every drug name stem
Its class
Aminosalicylates
Aminosalicylates bring 5-aminosalicylic acid (5-ASA) to the inflamed bowel, where it acts topically on the lining. How it works is not fully known; it seems to cut prostaglandin and leukotriene production by inhibiting the cyclooxygenase and lipoxygenase pathways. Sulfasalazine is a prodrug that colonic bacteria split into 5-ASA, the main active part, and sulfapyridine.
Easily mixed up with non-steroidal anti-inflammatory drugs and glucocorticoids.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Mesalamine delayed-release tablets: label (DailyMed)
- Mesalamine (NCI Thesaurus)
- About mesalazine (NHS)
- Side effects of mesalazine (NHS)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Stomach and gut
Mesalazine is one of 15 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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