Mesalamine | Side Effects, Dosage, Uses & More

Generic Name:

mesalamine, Oral capsule

Generic Name:
Pentasa,Delzicol

mesalamine, Oral capsule

All Brands

  • Pentasa
  • Delzicol
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Highlights for mesalamine

Oral capsule
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Mesalamine is used treat ulcerative colitis (inflammation and sores that develop in your colon). It’s also used to manage or prevent symptoms of ulcerative colitis symptoms.

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Mesalamine is available as the following brand-name drugs: Asacol, Asacol HD, Lialda, Apriso, Delzicol, Pentasa, Canasa, and Rowasa. It’s also available in its generic form for some formulations.

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More common side effects of taking this drug include headache, nausea, stomach pain, diarrhea, and gas.

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In some cases, mesalamine can cause serious side effects. These can include a reaction that worsens the symptoms of ulcerative colitis. Symptoms of this reaction can include cramping, stomach pain, and bloody diarrhea.

IMPORTANT INFORMATION

Kidney disease

This drug can increase your risk for developing kidney disease. Although it may only result in minimal damage to your kidney, it can lead to kidney failure. Your doctor will monitor how your kidneys are working while you take this drug.

Reaction to the drug

This drug can cause a reaction that worsens the symptoms of ulcerative colitis . Symptoms of this reaction can include cramping, stomach pain, and bloody diarrhea.

Drug features

This drug is a prescription drug. The oral capsule form of this drug is not available as a generic drug.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

This drug is used treat ulcerative colitis (inflammation and sores that develop in your colon). It’s also used to manage or prevent symptoms of ulcerative colitis.

How it works

This drug belongs to a class of drugs called anti-inflammatory agents.

More Details

How it works

This drug belongs to a class of drugs called anti-inflammatory agents. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

The exact way that this drug works in your body is not fully understood. Generally, it blocks or stops your body from making the substances that can cause inflammation in your colon.

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mesalamine Side Effects

Oral capsule

More Common Side Effects

Some of the more common side effects that can occur with use of mesalamine include:

  • headache

  • nausea

  • inflammation of your nose and throat

  • stomach pain

  • diarrhea

  • upset stomach

  • gas

  • worsening symptoms of ulcerative colitis

The suppository may also cause dizziness and rectal pain.

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Acute intolerance syndrome. Symptoms can include:

    • cramping
    • sharp stomach pain
    • bloody diarrhea
    • fever
    • headache
    • rash
  • Hypersensitivity reaction that can lead to heart problems. Symptoms can include:

    • chest pain
    • shortness of breath
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug does not cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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mesalamine May Interact with Other Medications

Oral capsule

Mesalamine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Heartburn drugs

Using antacids with the oral capsule form of mesalamine can decrease the effectiveness of mesalamine. These drugs should not be taken together.

These heartburn drugs include:

  • calcium carbonate
  • magnesium hydroxide
  • aluminum hydroxide

Certain pain drugs

Using mesalamine with certain pain medications can increase your risk for developing kidney problems.

These drugs include:

  • celecoxib
  • diclofenac
  • etodolac
  • fenoprofen
  • flurbiprofen
  • ibuprofen
  • indomethacin
  • ketoprofen
  • ketorolac
  • meclofenamate
  • meloxicam
  • nabumetone
  • naproxen
  • oxaprozin
  • piroxicam
  • sulindac
  • tolmetin

Other ulcerative colitis drugs

Using mesalamine with azathioprine or mercaptopurine can increase your risk for developing side effects caused by azathioprine or mercaptopurine. Your doctor may need to monitor you more closely for side effects.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with liver disease

If you have liver disease, you may be at higher risk for liver failure when using this drug.

People with phenylketonuria

If you have phenylketonuria, you may need to avoid the capsule form of this drug. This form contains phenylalanine, which could worsen your condition. The recommended daily adult dose of this drug in this capsule form also includes 2.24 mg of phenylalanine. None of the other forms of this drug contain phenylalanine.

People with kidney disease

This drug can increase your risk for developing kidney disease. Although it may only result in minimal damage to your kidney, it can lead to kidney failure. If you already have kidney disease, your doctor will monitor your closely while you take this drug or start you on a lower dose.

Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

If you are aged 65 years or older, you may be at higher risk for certain side effects from this drug that affect your blood. Your doctor can monitor you for these side effects during treatment using blood tests.

When to call the doctor

Call your doctor if you have worsening symptoms of ulcerative colitis.

Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

Call 9-1-1 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take mesalamine (Dosage)

Oral capsule

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Ulcerative colitis

Brand: Apriso

Form: Extended-release oral capsule
Strengths: 0.375 g

Brand: Delzicol

Form: Extended-release oral capsule
Strengths: 400 mg

Brand: Pentasa

Form: Extended-release oral capsule
Strengths: 250 mg, 500 mg

Apriso:

Adult dosage (ages 18 years and older)
  • 1.5 g by mouth, once per day for maintenance treatment of ulcerative colitis (symptoms controlled).
  • Apriso is not used to treat active ulcerative colitis.
Child dosage (ages 0–17 years)

It has not been confirmed that Apriso is safe and effective for use in people younger than 18 years.

Delzicol:

Adult dosage (ages 18 years and older)
  • 800 mg by mouth, three times per day for 6 weeks when treating active ulcerative colitis. Once symptoms are controlled, 1.6 g by mouth, two to four times per day, in divided doses.
Child dosage (ages 5–17 years)

The recommended dose is based on weight. The dose should be given twice per day for 6 weeks when treating active ulcerative colitis.

Child dosage (ages 0–4 years)

It has not been confirmed that Delzicol is safe and effective for use in people younger than 11 years.

Pentasa:

Adult dosage (ages 18 years and older)
  • 1 g by mouth, four times per day, for both active treatment and maintenance treatment of ulcerative colitis.
Child dosage (ages 0–17 years)

It has not been confirmed that Pentasa is safe and effective for use in people younger than 18 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all

Your symptoms of ulcerative colitis may come back or may worsen.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. If you think you’ve taken too much of the drug, act right away. Call your doctor or local poison control center, or go to the nearest emergency room.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

When treating active ulcerative colitis, you should experience a reduction in symptoms. These may include frequent, sometimes bloody stools, cramping, or stomach pain. When on maintenance treatment for ulcerative colitis, you may not notice any difference when taking this drug as it is helping to prevent acute flare-ups.

This drug can be used as either a short-term or long-term drug treatment.

Important considerations for taking this drug
take with or without food You can take this drug with or without food
swallow whole The capsules must be swallowed whole
store at room temperature Store this drug at room temperature See Details
refillable A prescription for this medication is refillable See Details
travel Travel See Details
clinical monitoring Clinical monitoring See Details
not ususally stocked Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
prior authorization Insurance See Details

Store this drug at room temperature

Keep it between 59°F and 86°F (15°C and 30°C).

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your kidney function and liver function may be checked. Your healthcare provider may do this to help determine if you are having any adverse kidney or liver effects from using this drug. Your healthcare provider will check this with a blood test.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What does the pill look like?

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How Much Does mesalamine Cost?

Oral capsule

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Lowest price for mesalamine

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These prices represent the lowest priced national pharmacies for mesalamine on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 5, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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