Adult Dosing
Active ulcerative proctitis (suppositories)
- 1000 mg rectal suppository qhs for 3-6 wks; retain in rectum for 1-3 hrs or longer for maximum benefit
Distal ulcerative colitis, proctosigmoiditis, proctitis (enema)
- 4 g (in 60 mL) enema qhs for 3-6 wks; retain in rectum for about 8 hrs
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Mesalamine enema contains potassium metabisulfite, that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in susceptible people
- Promptly discontinue therapy if an acute intolerance syndrome characterized by cramping, acute abdominal pain and bloody diarrhea, fever, headache and a rash has occurred with mesalamine
- Mesalamine is an active component of sulfasalazine. Consider re-evaluation if there exists a patient's history of sulfasalazine intolerance. Patients who were hypersensitive to sulfasalazine when re-challenged with mesalamine experienced similar adverse events to mesalamine; caution should be exercised
- Monitor renal function with urinanalysis, BUN, and creatinine prior to starting therapy and periodically in patients with preexisting renal disease. Worsening of renal function may occur in patients with preexisting renal disease
- Pancolitis may result in patients using mesalamine
- Worsening of colitis or symptoms of inflammatory bowel disease, including melena and hematochezia, may occur after initiating mesalamine
- Pericarditis may occur with mesalamine containing products including sulfasalazine, which has been reported as manifestations of inflammatory bowel disease. Discontinuation of mesalamine may be warranted in some cases, but re-challenge with mesalamine can be performed under careful clinical observation should the continued therapeutic need for mesalamine be present
Cautions: Use cautiously in
- Renal impairment
- Pregnancy
Pregnancy Category:B
Breastfeeding: Poorly excreted in breastmilk; however, its metabolite, N-acetyl-5-ASA, is excreted in high levels. Monitor the breastfed infants for diarrhea during maternal use. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 18 January 2011). Manufacturer advises caution.
Pricing data from www.DrugStore.com in U.S.A.
- Canasa 1000 MG SUPP [Box] (AXCAN PHARMA US)
30 mg = $573.68
90 mg = $1677.1 - Mesalamine 4 GM ENEM [Bottle] (PERRIGO PHARMACEUTICALS)
60 gm = $35.99
120 gm = $59.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
