Mesalamine

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Apriso; Asacol HD [DSC]; Canasa; Delzicol; Lialda; Pentasa; Rowasa; SfRowasa

Brand Names: Canada

Asacol 800 [DSC]; Asacol [DSC]; Mezavant; Mezera; Octasa; Pentasa; Salofalk; TEVA-5 ASA

What is this drug used for?

  • It is used to treat ulcerative colitis.
  • It is used to help keep ulcerative colitis flares from coming back.
  • It is used to treat mild to moderate disease at the far end of the colon.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have any of these health problems: Kidney disease or liver disease.
  • If you have a stomach or bowel ulcer.
  • If you have a narrowing of your stomach valve or other type of stomach block.
  • If you have a blockage in your urinary tract, talk with your health care provider.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
  • Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.
  • If you are allergic to sulfites, talk with your doctor. Some products have sulfites.
  • If you have phenylketonuria (PKU), talk with your doctor. Some products have phenylalanine.
  • While taking this drug, your urine may turn reddish-brown when it comes in contact with surfaces or water that have been treated with bleach (like in the toilet). If you notice that your urine is reddish-brown, watch your urine flow. Call the doctor only if your urine is reddish-brown when it leaves the body, before it comes into contact with any surfaces or water that may have been treated with bleach.
  • You may get sunburned more easily. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • Not all products are meant for use in all children. Talk with the doctor before giving this drug to a child.
  • Do not give to children and teenagers who have or are getting better from flu signs, chickenpox, or other viral infections due to the chance of Reye’s syndrome. Reye’s syndrome causes very bad problems to the brain and liver.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

Tablets:

  • You may see parts of this drug in your stool. If this happens a lot, talk with your doctor.

Long-acting capsules (Delzicol):

  • You may see parts of this drug in your stool. If this happens a lot, talk with your doctor.
  • This drug has iron in the capsule coating. If you have high blood iron levels or you take vitamins or other supplements with iron, talk with your doctor.

All rectal products:

  • This drug may stain fabric, flooring, painted surfaces, marble, granite, vinyl, and enamel.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

All products:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
  • Back pain, belly pain, or blood in the urine. May be signs of a kidney stone.
  • Chest pain or pressure, a fast heartbeat, or an abnormal heartbeat.
  • Fever, chills, or sore throat; any unexplained bruising or bleeding; or feeling very tired or weak.
  • Some people may have a reaction to this drug that looks like the signs of ulcerative colitis. Call your doctor right away if you have new or worsening stomach pain or cramps, bloody stools, fever, headache, itching, rash, red or pink eyes, or are not feeling well.
  • Liver problems have rarely happened with this drug. Sometimes, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Some heart problems have rarely happened with this drug. Sometimes, this has been deadly. Call your doctor right away if you have shortness of breath, a big weight gain, or swelling in the arms or legs.
  • Severe skin reactions may happen with this drug. These include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions. Sometimes, body organs may also be affected. These reactions can be deadly. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin; red or irritated eyes; sores in your mouth, throat, nose, eyes, genitals, or any areas of skin; fever; chills; body aches; shortness of breath; or swollen glands.

Rectal enema:

  • Bleeding from rectum or rectal pain.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

  • Constipation, diarrhea, stomach pain, upset stomach, or throwing up.
  • Heartburn.
  • Gas.
  • Burping.
  • Nose or throat irritation.
  • Dizziness or headache.
  • Back pain.
  • Cough.

All rectal products:

  • Rectal irritation.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

Tablets:

  • Some drugs may need to be taken with food or on an empty stomach. For some drugs it does not matter. Check with your pharmacist about how to take this drug.
  • Take with a full glass of water.
  • Swallow whole. Do not chew, break, or crush.
  • If you have trouble swallowing, talk with your doctor.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.

Long-acting capsules:

  • Take with or without food.
  • Take with a full glass of water.
  • Swallow whole. Do not chew or crush.
  • Some products may be opened and sprinkled right in the mouth or on applesauce or yogurt. Some products must be swallowed whole. If you cannot swallow this drug whole, be sure you know how to take this drug.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.

Long-acting capsules (Apriso):

  • Do not take antacids at the same time as this drug. Talk with your doctor.

All rectal products:

  • This drug is for rectal use only. Do not take this drug by mouth.
  • You could be on both a tablet or capsule and a rectal product at the same time.
  • Keep using this drug as you have been told by your doctor or other health care provider, even if you feel well.

Rectal enema:

  • Shake suspension well before use.
  • Keep suspension in your rectum as long as you can.
  • The enema may turn darker over time after the foil pouch has been opened. An enema may still be used if it has turned slightly darker. Do not use if it has turned dark brown. Ask your doctor or pharmacist if you have questions about whether an enema is still good to use.

Suppository:

  • Use at bedtime.
  • Wash your hands before and after use.
  • If suppository is soft, chill in a refrigerator or run cold water over it.
  • Take foil off the suppository and put in, pointed end first. Do not handle too much. Keep the suppository in for 1 to 3 hours or longer if you can. Do not cut or break the suppository.

Rectal foam:

  • Use at bedtime.
  • Shake well before use.
  • Use an applicator to put in rectal foam.
  • Wash your hands and applicator after use.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

All oral products:

  • Store at room temperature in a dry place. Do not store in a bathroom.
  • Some products may come with a desiccant (protects the product from moisture) in the container, if the container comes with a desiccant, keep it in the bottle. Some brands may be stored without the desiccant for some time. Talk with the doctor or pharmacist if you are not sure.

Rectal enema:

  • Store at room temperature.
  • Store rectal suspension in foil until ready to use. Do not refrigerate.
  • Protect rectal suspension from heat.

Suppository:

  • Store at room temperature. Do not freeze.
  • Some brands may be stored in the refrigerator. Ask your pharmacist or check the package label.
  • Protect from heat and light.
  • Store in a dry place. Do not store in a bathroom.

Rectal foam:

  • Store at room temperature. Do not refrigerate or freeze.
  • Protect from heat and sunlight.
  • Do not puncture or burn even if it seems empty.
  • After opening, throw away any part not used after 12 weeks.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2023-11-17

Copyright

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Last Updated

Monday, December 12, 2022