1. What’s mesalazine

Mesalazine is used to deal with ulcerative colitis and Crohn’s illness and different kinds of inflammatory bowel illness.

It belongs to a gaggle of medicines known as aminosalicylates. These assist to scale back redness and swelling (irritation) and will help with therapeutic. Some individuals take mesalazine along with steroids.

Mesalazine is barely obtainable on prescription. It comes as:

  • tablets
  • granules
  • rectal foam
  • suppositories
  • enemas

2. Key info

  • Totally different manufacturers of mesalazine tablets and granules work on totally different components of your intestine. Rectal foam, suppositories or enemas are prescribed for the decrease a part of your intestine.
  • When you and your physician discover a model of mesalazine that works for you, it is often finest to stay to the identical one.
  • When your signs are below management you possibly can often go onto a decrease dose.
  • Widespread unwanted side effects of mesalazine embrace upset abdomen, and muscle aches and pains.
  • One very uncommon facet impact will be issues along with your blood. Inform your physician instantly if you happen to get unexplained bleeding, bruising or pink or purple marks in your pores and skin, or when you’ve got a sore throat, excessive temperature or really feel usually unwell.

3. Who can and can’t take mesalazine

Adults and kids aged 5 years and older can take mesalazine.

Mesalazine might not be appropriate for some individuals. To verify it is protected for you, inform a pharmacist or physician earlier than taking or utilizing it if you happen to:

  • have ever had an allergic response to mesalazine, aspirin, or another salicylates corresponding to methylsalicylate or choline salicylate
  • have ever had an allergic response to another medication
  • have any issues along with your kidneys or liver
  • have a uncommon blood situation known as porphyria
  • are attempting to get pregnant, already pregnant, or breastfeeding

4. How and when to take mesalazine

At all times comply with the directions from a pharmacist or physician, or the leaflet that comes along with your medication.

Dosage

Your dose will rely upon why you want it and on the sort and model of mesalazine that your physician has prescribed for you. It additionally is determined by whether or not you take it for a brief or very long time.

For youngsters, the dose could also be decrease, and it’s calculated based on their weight.

Find out how to take tablets and granules

You’ll both take the tablets or granules as soon as a day, or as 2 or 3 smaller doses all through the day.

Swallow the tablets complete with a drink of water or juice. Don’t break, chew or crush them. It’s because some tablets have a particular coating to delay once they begin to work, or to guard the medication from the acids in your abdomen.

For granules, open the sachet and tip the granules onto your tongue. Swallow them complete with a drink of water or juice. Don’t chew them, as some granules have a particular coating.

You possibly can take some manufacturers with meals. Examine the leaflet that comes along with your medication.

For those who’re additionally taking indigestion medicines or cures, depart a 2 hour hole earlier than and after taking mesalazine. Indigestion remedies can have an effect on how effectively the medication works.

Find out how to use suppositories

Your physician or pharmacist will let you know what number of suppositories to make use of every day. Some varieties you utilize as soon as a day earlier than you go to mattress, and others you utilize a number of instances a day with the final dose earlier than you go to mattress. Use them after you do a poo.

  1. Wash your palms earlier than and after utilizing the suppository. Additionally clear round your backside (anus) with gentle cleaning soap and water, rinse and pat dry.
  2. Unwrap the suppository.
  3. Gently push the suppository into your anus with the pointed finish first. It must go in What’s 3 centimetres (1 inch).
  4. Sit or lie nonetheless for What’s quarter-hour. The suppository will begin to soften, because it melts along with your physique warmth. That is regular.

Strive to not do a poo for a minimum of an hour after utilizing a suppository. This offers the medication time to work.

Find out how to use enemas

You’ll often use mesalazine enemas as soon as a day earlier than you go to mattress.

Use the enema after doing a poo. It’s because the medication works finest when your bowels are empty.

  1. Wash your palms earlier than and after utilizing the enema.
  2. Lie in your facet, along with your backside barely larger than the remainder of your physique. You should utilize a pillow to carry your backside up. Chances are you’ll need to lie on a towel.
  3. Put one of many disposable plastic luggage offered over your hand (like a glove) and decide up the bottle.
  4. Shake the bottle.
  5. Break the seal on the nozzle, or take away the protecting cap.
  6. Gently push the nozzle into your backside (anus) so far as is snug.
  7. Squeeze the bottle steadily to permit the liquid to empty into your anus fairly shortly. This takes What’s 30 to 40 seconds. It is regular for some liquid to be left within the bottle afterwards.
  8. Take away the nozzle out of your backside.
  9. Peel the disposable plastic bag off your hand and use it to cowl the bottle, able to throw away.
  10. Roll onto your entrance and wait for five minutes. This can cease any liquid popping out of your backside.
  11. For sleeping, discover a snug place that retains the liquid in your backside for so long as potential. The longer it stays there, the higher it’s going to work.

Find out how to use rectal foam

You’ll often use mesalazine rectal foam as soon as a day earlier than you go to mattress. The dose is 2 full applicators.

Use the rectal foam after doing a poo. It’s because the medication works finest when your bowels are empty.

After you apply the froth, attempt to not poo once more till the subsequent morning. For the medication to work correctly it wants to remain inside your bowel so long as potential.

First learn the instruction leaflet. The photographs present you precisely learn how to use the froth.

Earlier than utilizing it for the primary time, take away the plastic flap (or security lock) from beneath the dome-shaped pump on the prime of the can.

  1. Wash your palms earlier than and after utilizing the froth.
  2. Push a brand new applicator onto the nozzle. This nozzle stands proud beneath the dome on the prime of the can.
  3. Shake the can for What’s 20 seconds.
  4. There’s a rounded hole on the base of the dome. Twist the dome till the hole traces up with the nozzle.
  5. Put your finger on prime of the dome and switch the can the wrong way up. The spray will solely work correctly if you happen to maintain the can with the dome pointing straight down.
  6. Both stand with one leg raised on a chair, or lie down in your facet along with your decrease leg stretched out and higher leg bent.
  7. Gently put the tip of the applicator into your anus so far as potential. Chances are you’ll need to use a lubricating jelly on the tip of the applicator.
  8. Push the dome down. This fills the applicator with a dose of froth.
  9. Launch the dome very slowly, to push the froth out.
  10. Wait 10 to fifteen seconds after which slowly take away the applicator out of your backside. Do that slowly to stop the froth popping out.
  11. Take away the applicator from the nozzle. Put it within the plastic bag offered and throw the bag away (along with your regular family garbage).

Repeat from step 1 utilizing a brand new applicator, so that you simply use 2 full applicators of froth.

Will my dose go up or down?

As soon as your signs begin to get higher, it is probably that your dose shall be lowered. This decrease dose is typically known as a upkeep dose.

Your physician might need to improve your dose in case your signs begin to worsen once more.

What if I neglect to take it?

  • For those who miss a dose of mesalazine, take it as quickly as you bear in mind, except it is nearly time in your subsequent dose. On this case, skip the missed one and take the subsequent dose on the regular time.
  • Don’t take 2 doses collectively to make up for a forgotten dose.
  • For those who usually neglect doses, it could assist to set an alarm to remind you. You may additionally ask your pharmacist for recommendation on different methods that will help you bear in mind to take your medication.

What if I take an excessive amount of?

Taking an excessive amount of mesalazine as a one-off is unlikely to trigger issues.

Pressing recommendation:

  • you’ve got taken as much as 1 further dose of mesalazine and you are feeling unwell
  • you’ve got taken greater than double your regular dose of mesalazine, even if you happen to really feel effectively.

5. Negative effects

Like all medicines, mesalazine may cause unwanted side effects, however not everybody will get them. The upper the dose of mesalazine that you simply take, the higher the possibility of unwanted side effects.

Widespread unwanted side effects

Widespread unwanted side effects occur in additional than 1 in 100 individuals. Your threat of getting a selected facet impact varies, relying on whether or not you’re prescribed tablets, granules, suppositories, foam or enemas.

Hold taking the medication, however inform your physician if these unwanted side effects hassle you or don’t go away:

  • indigestion, abdomen ache or wind
  • feeling or being sick (nausea or vomiting)
  • diarrhoea
  • complications, muscle aches and pains

Critical unwanted side effects

Critical unwanted side effects are uncommon and occur in lower than 1 in 1,000 individuals.

Inform your physician right away if you happen to get:

  • any unexplained bleeding, an unexplained sore throat or excessive temperature, bruising, pink or purple marks in your pores and skin (these could also be much less apparent on black or brown pores and skin), or if you happen to really feel usually unwell through the remedy – these will be indicators of issues along with your blood
  • a excessive temperature, chills, a sore throat, ear or sinus ache, a cough, ache when peeing, mouth sores or a wound that won’t heal – these will be indicators of an an infection
  • a change within the color of your pee or the quantity you pee – these will be indicators of kidney issues
  • chest ache, a quicker heartbeat or feeling extra drained than regular – these will be indicators of coronary heart issues
  • yellowing of your eyes or pores and skin (this can be much less apparent on black or brown pores and skin), darkish pee, abdomen ache, excessive temperature, feeling drained or feeling sick – these will be indicators of liver issues
  • again or abdomen ache, fever, feeling sick or being sick – these will be indicators of an infected pancreas

Critical allergic response

In uncommon circumstances, it is potential to have a critical allergic response (anaphylaxis) to mesalazine.

Speedy motion required:

  • you get a pores and skin rash that will embrace itchy, pink, swollen, blistered or peeling pores and skin
  • you are wheezing
  • you get tightness within the chest or throat
  • you might have hassle respiration or speaking
  • your mouth, face, lips, tongue or throat begin swelling

You may be having a critical allergic response and might have speedy remedy in hospital.

These aren’t all of the unwanted side effects of mesalazine.

6. How to deal with unwanted side effects of mesalazine

What to do What’s:

  • indigestion, abdomen ache or wind – attempt to not eat meals that trigger wind (like lentils, peas, beans and onions). Eat smaller meals, and eat and drink slowly. Placing a warmth pad or coated sizzling water bottle in your abdomen might also assist with abdomen ache.
  • feeling or being sick – persist with easy meals and don’t eat wealthy or spicy meals. Examine the directions that include your medication to see if you happen to can take it after you’ve got eaten. For those who’re being sick, attempt having small, frequent sips of water or squash to keep away from dehydration. Don’t take another medicines to deal with vomiting with out chatting with a pharmacist or physician.
  • diarrhoea – drink loads of fluids, corresponding to water or squash, to keep away from dehydration. Don’t take another medicines to deal with diarrhoea with out chatting with a pharmacist or physician.
  • complications, muscle aches and pains – drink loads of water and ask your pharmacist to suggest an appropriate painkiller. Inform your physician if the aches proceed regardless of taking painkillers or in the event that they final for quite a lot of days.

7. Being pregnant and breastfeeding

Mesalazine and being pregnant

Chances are you’ll be suggested to proceed utilizing mesalazine throughout being pregnant to be sure that your inflammatory bowel illness stays effectively managed. There is no proof that taking mesalazine in being pregnant harms your child.

For those who grow to be pregnant whereas taking mesalazine, communicate to your physician. Don’t cease taking your medication except your physician tells you to.

Your physician can clarify the dangers and advantages of taking mesalazine and can aid you select the very best remedy for you and your child.

Mesalazine and breastfeeding

In case your physician or well being customer says your child is wholesome, then it is often OK to take mesalazine whereas breastfeeding.

Small quantities of mesalazine cross into breast milk, and are unlikely to trigger any unwanted side effects in your child. Many individuals have taken mesalazine whereas breastfeeding with none issues, though there have been some uncommon circumstances of diarrhoea in infants.

Inform your midwife, well being customer, pharmacist or physician as quickly as potential if you happen to discover your child will not be feeding in addition to regular, or has diarrhoea, or when you’ve got another issues What’s your child.

Non-urgent recommendation: Inform your physician if you happen to’re:

  • making an attempt to get pregnant
  • pregnant
  • breastfeeding

8. Cautions with different medicines

There are some medicines that have an effect on the way in which mesalazine works. Inform a pharmacist or physician if you’re taking:

  • medicines that make your poo extra acidic, just like the laxative lactulose
  • medicines that have an effect on the way in which your kidneys work, corresponding to azathioprine, mercaptopurine or thioquanine, and non-steroidal anti-inflammatory medicine (NSAIDs), corresponding to aspirin or ibuprofen
  • sure medicines that assist to stop blood clots, like warfarin

Mixing mesalazine with natural cures or dietary supplements

There’s little or no info What’s taking natural cures and dietary supplements whereas taking or utilizing mesalazine. Ask a pharmacist for recommendation.

Necessary:

Inform your physician or pharmacist if you happen to’re taking another medicines, together with natural medicines, nutritional vitamins or dietary supplements.

9. Widespread questions What’s mesalazine

  1. How does it work?

    Nobody is aware of precisely how mesalazine works. It's thought to behave on the infected lining of the intestine (gut) by stopping the physique producing chemical substances that trigger irritation.

    Mesalazine helps by lowering the redness and swelling (irritation) in your gut. This improves your signs. Mesalazine has the same impact to immunosuppressants. It will probably scale back the numbers of white cells in your blood, lowering your physique's capacity to struggle an infection.

  2. How lengthy does it take to work?

    Mesalazine doesn't work right away. Relying on how dangerous your signs are, it could take from a couple of hours to some weeks for them to begin bettering. It might take up to some months in your signs to be utterly handled if they're extreme.

  3. How lengthy will I take it for?

    Mesalazine can be utilized at the next dose for a short while to deal with flare-ups. You may also take it long run to maintain irritation below management and stop signs from flaring up once more. How lengthy you utilize it for will rely upon how dangerous your situation is. Don't cease utilizing mesalazine except your physician tells you to.

  4. Why is it vital to stay to the identical model?

    Totally different manufacturers and types of mesalazine (tablets, granules, rectal foam, suppositories and enemas) work on totally different components of your intestine. Your physician will prescribe the model that releases mesalazine within the a part of your intestine that wants it most.

    You'll often keep on the identical model and sort of mesalazine if it is working to manage your signs. Nonetheless, if it doesn't assist your signs, your physician might attempt you on a unique one.

    At all times use the model that your physician has prescribed for you. It is vital to verify the pharmacist offers you the proper model whenever you gather your prescription.

  5. Is it protected to take for a very long time?

    Mesalazine will be taken long run. Nonetheless your physician will need to test how your kidneys are working throughout remedy. In uncommon circumstances mesalazine may cause kidney issues.

    These checks often occur as soon as each 3 months for the primary 12 months. They'll often be annually after that or as usually as your physician recommends.

  6. Can I cease taking mesalazine?

    In case you are considering of stopping mesalazine, talk about this along with your physician first as your signs might come again. If unwanted side effects are bothering you and also you're considering of stopping your mesalazine, speak to your physician first. They might need to evaluation your remedy. Don't cease taking or utilizing mesalazine except your physician tells you to.

  7. Can I take mesalazine earlier than surgical procedure?

    Inform the specialists who're going to hold out your surgical procedure that you're taking mesalazine. They'll let you know if you could cease taking it.

  8. Can I take painkillers with mesalazine?

    You possibly can take paracetamol with mesalazine. Nonetheless, it is best to keep away from non-steroidal anti-inflammatory medicine (NSAIDs) corresponding to aspirin or ibuprofen.

    Like mesalazine, NSAIDs may cause issues with the way in which your kidneys work. They will additionally irritate the intestine and so improve the chance of ulceration and bleeding. Ask a pharmacist or physician for recommendation if paracetamol will not be working for you.

  9. Alkohola edan al dezaket horrekin?

    You possibly can drink alcohol whereas taking mesalazine. Nonetheless, alcohol can irritate your intestine so might make signs worse.

    It is best to stay to the nationwide tips of not more than 14 items per week. A regular glass of wine (175ml) is 2 items. A pint of lager or beer is often 2 to three items of alcohol.

  10. Is there any meals or drink I have to keep away from?

    You possibly can often eat and drink usually whereas taking or utilizing mesalazine. When you've got indigestion or really feel sick, it is best to stay to easy meals, and keep away from alcohol and spicy meals.

    For inflammatory bowel illness, your physician might advise you to make some modifications to your weight loss plan as a part of your remedy. This may embrace following a particular weight loss plan or including a dietary complement.

  11. Will it have an effect on my fertility?

    There is no clear proof to recommend that taking mesalazine will scale back fertility in both males or ladies.
    Communicate to your physician if you happen to're making an attempt to get pregnant. They might need to evaluation your remedy.

  12. Will it have an effect on my contraception?

    Mesalazine doesn't have an effect on any kind of contraception, together with the mixed capsule and emergency contraception.

    Nonetheless, if taking or utilizing mesalazine makes you vomit or have extreme diarrhoea for greater than 24 hours, your contraceptive capsules might not shield you from being pregnant. Look on the capsule packet to search out out what to do.

    Learn extra What's what to do if you happen to're taking the capsule and also you're being sick or have diarrhoea.

  13. Can I drive or trip a motorbike?

    Mesalazine is unlikely to have an effect on your capacity to drive, trip a motorbike or function instruments and equipment.

  14. Are there different remedies for Crohn's illness and ulcerative colitis?

    Different medicines used to deal with Crohn's illness and ulcerative colitis embrace:
    -immunosuppressants, corresponding to azathioprine and methotrexate
    -steroids, corresponding to prednisolone and budesonide
    -organic medicines, corresponding to adalimumab and infliximab

    Learn extra What's the totally different remedies for Crohn's illness. Learn extra What's the totally different remedies for ulcerative colitis.

Associated circumstances

  • Crohn’s illness
  • Inflammatory bowel illness
  • Ulcerative colitis

Helpful assets

  • HealthUnlocked: mesalazine discussion board
  • Crohn’s & Colitis UK: charity
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