Mesalamine

Administration

• Type: Anti-inflammatory
• Dosage Forms: TAB 800mg, 1.2g
• Routes of Administration: Oral
• Common Trade Names: Apriso, Asacol, Asacol HD, Delzicol, Lialda, Pentasa

Adult Dosing

Ulcerative Colitis

• Mild-Moderate Active
  • 2.4-4.8g PO qd x 8 weeks
• Moderate Active
  • 1600 mg PO tid x 6 weeks
• Maintenance tx
  • 2.4 g PO qd

Pediatric Dosing

• Chron Disease
  • 50-100mg/kg/day PO divided every 6-12hrs; max dose 1000mg/dose
• Ulcerative Colitis (mild to moderate)
  • Children >5 years old:
    • 17 to <33 kg: Oral: 800 mg in the morning and 400 mg in the evening for 6 weeks; maximum daily dose: 1,200 mg/day
    • 33 to <54 kg: Oral: 1,200 mg in the morning and 800 mg in the evening for 6 weeks; maximum daily dose: 2,000 mg/day
    • 54 to 90 kg: Oral: 1,200 mg in the morning and 1,200 mg in the evening for 6 weeks; maximum daily dose: 2,400 mg/day

Special Populations

• Pregnancy Rating: C
• Lactation risk: Caution advised.

Renal Dosing

• Adult: Not defined
• Pediatric: Not defined

Hepatic Dosing

• Adult: Not defined
• Pediatric: Not defined

Contraindications

• Allergy to class/drug
• Influenza, varicella, or febrile infection in pts <20 yo

Adverse Reactions

Serious

• Acute intolerance syndrome
• Hypersensitivity reaction
• Anaphylaxis
• Angioedema
• Stevens-Johnson syndrome
• Nephropathy, interstitial nephritis, renal failure
• Hepatotoxicity, hepatic failure
• Pericarditis, myocarditis, pneumonitis
• Agranulocytosis, aplastic anemia
• Pancreatitis

Common

• Headache
• Flatulence
• Nausea
• AST, ALT elevation
• Abdominal pain

Pharmacology

• Half-life: 2-15h (tid dosing) and 7-12h (qd dosing)
• Metabolism: GI tract, liver
• Excretion: Urine, feces

Mechanism of Action

• Blocks cyclooxygenase and inhibits prostaglandin production in the colon, exerting local anti-inflammatory effects