section name header

Pronunciation

me-SAL-a-meen

Classifications

Therapeutic Classification: gastrointestinal anti-inflammatories

Indications

REMS


Delzicol, Lialda, and Pentasa

Apriso

Canasa

Rowasa

Action

  • Locally acting anti-inflammatory action in the colon, where activity is probably due to inhibition of prostaglandin synthesis.
Therapeutic effects:
  • Reduction in the symptoms of ulcerative colitis, proctosigmoiditis, and proctitis.

Pharmacokinetics

Absorption: 28% absorbed following oral administration; 10–30% absorbed from the colon, depending on retention time, following rectal administration.

Distribution: Unknown.

Metabolism/Excretion: Some metabolism occurs, site unknown; mostly eliminated unchanged in the feces.

Half-Life: Oral: 12 hr (range 2–15 hr); Rectal: 0.5–1.5 hr.

Time/Action Profile

(clinical improvement)

ROUTEONSETPEAKDURATION
POunknownunknown6–8 hr
ER2 hr9–12 hr24 hr
Rectal3–21 daysunknown24 hr





Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: pericarditis

Derm: ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS, DRUG REACTION WITH EOSINOPHILIA AND SYSTEMATIC SYMPTOMS (DRESS), hair loss, photosensitivity, rash, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS

EENT: pharyngitis, rhinitis

GI: diarrhea, eructation (PO), flatulence, HEPATOTOXICITY, nausea, pancreatitis, vomiting

GU: interstitial nephritis, nephrolithiasis, renal impairment

Local: anal irritation (enema, suppository)

MS: back pain, myalgia

Neuro: headache, dizziness, malaise, weakness

Misc: acute intolerance syndrome, fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)

Interactions

Drug-drug:

Route/Dosage

Treatment of Ulcerative Colitis

Maintenance of Remission of Ulcerative Colitis

Treatment of Ulcerative Proctosigmoiditis

Treatment of Ulcerative Proctitis

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Apriso, Asacol, Asacol HD, Canasa, Delzicol, Lialda, Pentasa, Rowasa

Canadian Brand Names

Mezavant, Mezera, Octasa, Salofalk, Teva 5-ASA