MESACOL (MESALAZINE | AMINOSALICYLIC ACID 400MG) – 50 TABS

KSh6,890.00

Mesalazine is an anti-inflammatory drug structurally related to the salicylates and active in inflammatory bowel disease. Kenya Online Meds Shop – ePharmacy provides it to you without the need of a prescription

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Description

Uses and Administration of Mesacol in Kenya

Synonyms: 5-ASA; 5-Aminosalicylic Acid; Fisalamine; Mesalazina; Mesalazinum

Mesalazine/Mesacol is an anti-inflammatory drug structurally related to the salicylates and active in inflammatory bowel disease; it is considered to be the active moiety of sulfasalazine. Its mode of action is uncertain, but may be due, at least in part, to its ability to inhibit local prostaglandin and leukotriene synthesis in the gastrointestinal mucosa.

Mesacol/Mesalazine is given by mouth or rectally in the treatment of acute attacks of mild to moderate ulcerative colitis or the maintenance of remission of ulcerative colitis or Crohn’s disease. An oral dose of 400 mg of mesalazine is theoretically equivalent to 1 g of sulfasalazine.

Adverse Effects and Precautions of 5-ASA Mesacol

Mesalazine in Kenya Online Drug Shop may cause headache and gastrointestinal disturbances, such as nausea, diarrhoea, and abdominal pain. Hypersensitivity reactions may occasionally occur. Some patients may experience exacerbation of symptoms of colitis. There are some reports of myocarditis, pericarditis, pancreatitis, interstitial nephritis, nephrotic syndrome, allergic lung reaction, increased liver enzyme values, hepatitis, lupus-like syndrome, skin reactions, alopecia, myalgia, and arthralgia. There have been rare reports of blood disorders including aplastic anaemia, agranulocytosis, leucopenia, neutropenia, thrombocytopenia, and methaemoglobinaemia.

Mesalazine should not be given to patients in Kenya with severe renal or hepatic impairment, or salicylate hypersensitivity. It should be used with caution in the elderly, and in mild to moderate renal or hepatic impairment, active peptic ulceration, or sulfasalazine allergy.

If a blood dyscrasia is suspected treatment should be stopped immediately and a blood count performed. Patients or their carers should be told how to recognise signs of blood toxicity and should be advised to seek immediate medical attention if symptoms such as fever, sore throat, mouth ulcers, bruising, or bleeding develop. It is recommended that renal function is monitored before and during therapy.

Many of the adverse effects associated with sulfasalazine therapy have been attributed to the sulfapyridine moiety and most patients unable to tolerate sulfasalazine because of hypersensitivity or adverse reactions can be transferred to mesalazine without adverse effects occurring.1-4 However, a small number of patients also experience adverse effects while taking mesalazine and these are often very similar to those seen with sulfasalazine.1-4 They may include nausea, abdominal discomfort or pain, exacerbation of diarrhoea, headache, fever, and rashes. Mesalazine is not associated with sulfasalazine’s adverse effects on sperm. An analysis of adverse reactions reported to the UK Committee on Safety of Medicines between 1991 and 1998 found no evidence of a significant difference in the frequency of serious adverse effects for mesalazine and sulfasalazine in the treatment of inflammatory bowel disease.5 Reports of pancreatitis and interstitial nephritis, were more common with mesalazine. However, it has been pointed out that 80% of patients intolerant to sulfasalazine will tolerate mesalazine without problems.6

Mesalazine therapy should be initiated cautiously in patients with a history of sulfasalazine hypersensitivity and it should be withdrawn if signs of sensitivity develop or if there is diarrhoea or rectal bleeding. It has been suggested2 that patients with a history of sulfasalazine hypersensitivity should be given test doses of mesalazine before starting a full course.

Mesacol and Breast feeding

The concentrations of mesalazine in maternal plasma and breast milk in a lactating woman taking 500 mg three times daily, were 410 and 110 nanograms/mL respectively.1 Although it was considered that the amount of mesalazine distributed into breast milk was small and that it was safe during breast feeding,2,3 maternal use of mesalazine 500 mg suppositories twice daily has been associated with watery diarrhoea in a breast-fed infant2 and for this reason the American Academy of Pediatrics considers that mesalazine should be given with caution to breast-feeding mothers.4

Pregnancy and the use of Mesalazine

Renal insufficiency in a neonate whose mother received mesalazine 2 to 4 g daily by mouth during the second trimester of pregnancy was suggested to be due to the drug,1 although the proposed mechanism, inhibition of prostaglandin synthesis in the neonatal kidney, has been questioned.2 A subsequent case-control study3 found that use of oral mesalazine in 165 pregnant women with inflammatory bowel disease was not associated with a greater incidence of malformations. However, women treated with mesalazine were more likely to have preterm deliveries and newborns with decreased birth-weights, although the disease may have been a factor in this finding. A commentator on this study,4 considered that active inflammatory bowel disease was a greater risk to pregnancy than drug treatment. In a further cohort of 123 pregnancies,5 oral mesalazine at doses of 3 g daily or less did not increase the risk of fetal malformations or affect pregnancy outcome. The researchers concluded that further information was required on doses higher than 3 g daily. In another study,6 all of 19 pregnancies in women receiving rectal mesalazine were full-term with no fetal abnormalities.

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