Last Updated on June 3, 2023
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The active ingredient Mesalazine is an anti-inflammatory agent for the treatment of chronic inflammatory bowel disease. It derives from the salicylic acid – as well as the well-known painkiller acetylsalicylic acid (ASA). Preparations containing Mesalazine are fewer side effects than those using the drug Sulfasalazine previously used, however, expensive to produce. Here you can read more about the impact and application of Mesalazine, side effects and interactions.
How Mesalazine works
The active ingredient Mesalazine inhibits be like) occur mitigated or completely suppressed.
In addition, Mesalazine reactive oxygen species (ROS) neutralize. This also “free radicals” are referred to aggressive oxygen compounds in inflammatory processes often increasingly available and cause tissue damage. That Mesalazine with inflammatory bowel disease reduces the risk of long-term consequences such as cancer patients, possibly due to the ability to make ROS harmless.
Often can be attributed to chronic inflammatory diseases to an over immune function, by which the immune system attacks the body’s own tissue. Also this mechanism acts Mesalazine contrary: It inhibits the formation and function of certain white blood cells and the secretion of interleukins that stimulate the immune system and promote inflammation
Pharmacokinetics and metabolism of Mesalazine
After taking or local application (as a suppository or rectal), the active ingredient is absorbed in the intestine and inactivated in the intestinal mucosa or the liver. The ineffective degradation product is then largely excreted through the kidneys into the urine.
When is Mesalazine used?
The active ingredient Mesalazine is approved for:
- Treatment of an acute relapse in Crohn’s disease
- the prevention and treatment of an acute attack in ulcerative colitis
Outside the scope of accreditation (so-called “off-label” ease of use) is the active ingredient also used against other, rarer inflammatory bowel disease.
In acute attacks, the treatment is carried out briefly until improvement. To push-preventing agent can also be taken over a longer period.
How Mesalazine is taken?
The anti-inflammatory drug is depending on the nature of the disease in different dosage forms for application. Are – as frequently in ulcerative colitis – affected rather the rectum and the rectum from inflammation to Mesalazine leaves well in the form of suppositories, enemas and rectal (solution for an enema) apply. Affected are higher lying parts of the intestine, the active ingredient usually in the form of enteric-coated tablets, prolonged-release tablets (tablets with delayed or prolonged release) or Retardgranulat occupied. As a normal tablet Mesalazine would be included at the beginning of the small intestine into the bloodstream and do not reach the inflamed bowel segments.
Depending on the disease and stage of the disease varies high doses are taken. Are usual two to four grams of Mesalazine in divided doses taken throughout the day. Optionally, various dosage forms are used in combination.
In severe cases a potent glucocorticoid (“cortisone”) is for acute flare-ups often also prescribed.
What are the side effects of Mesalazine?
In general, the treatment with Mesalazine quite few side effects. The most common side effects are headache Mesalazine, and weakness.
What should be considered when administering Mesalazine?
The active ingredient can affect blood clotting as a descendant of salicylic acid may. Especially in combination with anticoagulants of the coumarin type (warfarin and phenprocoumon) reported excessive anticoagulation.
The immune-suppressive effects of immunosuppressive drugs such as Azathioprine and mercaptopurine may be increased under certain circumstances, if these drugs are combined with Mesalazine.
In addition, the nephrotoxic effect of non-steroidal anti-inflammatory drugs (NSAIDs such as Ibuprofen, Diclofenac, acetylsalicylic acid) and immunosuppressants can (such as Azathioprine and Methotrexate = MTX) be increased if at the same time or shortly also Mesalazine is taken.
There is limited data on the use of the drug during pregnancy and lactation. Although these data do not indicate a risk to mother and child, a doctor should decide on an application in the individual case.
The active ingredient may also be applied to children aged six years and older patients without renal impairment.
How to obtain medication with Mesalazine
preparations containing the active substance Mesalazine are prescription. You can therefore only be purchased by a doctor at the pharmacy.
Since when Mesalazine is known?
Already in the 1950s, active ingredients such as Sulfasalazine were used against inflammatory bowel disease that release locally in the gut Mesalazine. After it was demonstrated that the main effect of Mesalazine is based, this was individually applied in a suitable dosage form – with the result that the side effect profile of the drug was significantly improved. Today there are numerous preparations containing the active substance Mesalazine on the German market.