Mesalamine, Oral/Rectal

What are other names for this medicine?

Type of medicine: anti-inflammatory

Generic and brand names: mesalamine, oral; mesalamine, rectal; 5-Aminosalicylic Acid; Asacol; Canasa; Lialda; Pentasa; Rowasa

What is this medicine used for?

This medicine is used to treat ulcerative colitis (inflammation of the colon or rectum).

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine, food, wine, preservative, or dye
• asthma
• heart problems, especially pericarditis
• kidney or liver disease
• pancreatitis
• pyloric stenosis (narrowing of the tube leading out of the stomach)

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine comes in several forms: suppositories, an oral form to be taken by mouth, and a liquid form to be used as an enema.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. If your healthcare provider has not given you specific instructions, follow the directions that come in the medicine package. Do not take more or take it longer than prescribed. Ask your healthcare provider or pharmacist about anything you do not understand.

If you have capsules or tablets that you take by mouth, do not break, crush, or chew them. Swallow the capsules or tablets whole with a full glass of water. The tablets should be taken with food.

If you are using the liquid enema:

The liquid enema may darken slightly in color. Throw away any bottles that contain very dark brown liquid.

Shake the bottle well before you use the medicine. Wash your hands before using this medicine. Lie on your left side. Bend your right knee. Remove the protective cover from the tip. Moisten the tube end with a lubricant. Insert the end of the tube gently into your rectum. Gently and steadily squeeze the bag to empty as much as possible into your rectum. A slow flow helps lessen discomfort. Remove the tube when the bag is empty. Use the enema at bedtime and hold it in the rectum for 8 hours if possible.

If you are using a suppository:

Wash your hands before using this medicine. Remove the foil wrapper and moisten the suppository with water or water-based lubricating jelly. If the suppository is too soft to insert easily, run cold water over it or put it in ice water until it is firm. If it is too dry or hard, moisten it with warm water. Lie on your left side and bend your right knee up toward your chest. Gently push the suppository into your rectum so it is deep enough not to come out. Keep the suppository in the rectum for 1 to 3 hours or more if possible.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: slow movements, weakness, nausea, vomiting, diarrhea, decreased urination.

What should I watch out for?

If you notice partial or whole tablets in your bowel movements, contact your healthcare provider.

The liquid enema or suppository forms of this medicine will stain clothing, bedclothes, floors, and countertops. You can protect your clothing by wearing a sanitary napkin or adult undergarment such as Depends.

You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives, itching, rash, tightness in your chest, trouble breathing, swelling of the tongue and throat).

Serious (report these to your healthcare provider right away): Abdominal pain or cramps, bloody diarrhea, rash, fever, headache, chest pain, yellow skin or eyes, decreased urine production, severe or unusual back pain.

Other: Gas, nausea, flu or cold symptoms, tiredness, dizziness, pain in your legs or joints, rectal pain, mild hair loss, constipation.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• azathioprine (Azasan, Imuran)
• cancer medicines such as mercaptopurine (Purinethol) and thioguanine
• digoxin (Lanoxicaps, Lanoxin)
• NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Anaprox, Naprosyn), or indomethacin (Indocin)
• sulfasalazine (Azulfidine)

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.