About mesalazine

Ulcerative colitis causes inflammation of the intestine which leads to problems such as ulceration and bleeding. This causes symptoms such as abdominal pain and diarrhoea. Crohn's disease is a condition that causes inflammation of any part of the gastro-intestinal system. When the inflammation is in the area where the small intestine joins the large intestine, then it is called Crohn's ileo-colitis. Aminosalicylates are a group of medicines commonly used to treat inflammatory bowel diseases such as these. Mesalazine is one of the most commonly used aminosalicylates.

Although it is not clear exactly how mesalazine works, it is thought to act on cells lining the intestine to change the way these cells make and release certain chemicals. These chemicals are thought to be a factor in causing the symptoms of ulcerative colitis. Mesalazine allows the damaged intestine to recover and helps to prevent symptoms from flaring up again.

There are a number of different mesalazine preparations and brands. The way the manufacturers make each of these brands differs and allows the mesalazine to be released in specific areas of the intestine. You will be prescribed the brand that allows mesalazine to be released in the part of your intestine which requires it most.

Mesalazine can be taken by mouth as granules or tablets, or it can be given into the back passage as a suppository, rectal foam or enema.

Before taking mesalazine

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking mesalazine it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have any problems with your liver or kidneys.
• If you have ever had an allergic reaction to a medicine. It is particularly important that you tell your doctor if you have had an unusual reaction to aspirin or salicylates.
• If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.

How to take mesalazine

• Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about mesalazine and a full list of side-effects which you may experience from taking it.
• Your dose will depend upon which brand of mesalazine has been prescribed for you. Your doctor will tell you how much to take and when to take it, and your dose will also be on the label of the pack to remind you. Take it exactly as your doctor tells you to.
• Some mesalazine tablets and granules are specially coated to pass through your stomach before they are absorbed. These must be swallowed whole and not broken, chewed or crushed. Check the label on your pack carefully and follow any advice it gives. Also, do not take any indigestion remedies within 2 hours (before or after) of taking these, as this will interfere with the coating on them.
• If you have been given the Mezavant® XL brand of tablets, you should take these after a meal. If you have been given any other brand of tablet, it is unimportant whether you take them before or after a meal.
• If you have been given granules, place the correct amount on your tongue and wash them down with a drink of water. Do not chew the granules. You can take them before or after meals.
• If you forget to take a dose, take it as soon as you remember. If when you remember it is nearly time for your next dose, then leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a missed dose.

How to use mesalazine suppositories:

1. Remove the suppository from the packaging.
2. Using your finger, gently push the suppository into your back passage, pointed end first. (Some people find it helps to squat, or to lie down on one side and draw their knees up towards their chest to do this.)
3. Push the suppository in as far as possible. You may have the urge to pass the suppository out again but this should ease after a few minutes.
4. Wash your hands.

How to use mesalazine enema:

1. Shake the enema and break the seal on the nozzle.
2. Lie down on one side and draw your top knee up towards your chest. Insert the enema nozzle into your back passage.
3. Squeeze the bottle gently to completely empty the contents and then remove the nozzle. Remain where you are until the urge to pass the enema has eased.
4. Throw away the empty enema bottle in one of the bags provided.

How to use mesalazine rectal foam:

1. Shake the can well to mix the contents.
2. Before you use the can for the first time, remove the plastic safety lock.
3. Push the plastic applicator on to the nozzle of the can.
4. Stand up and place one foot on a firm surface, such as a chair.
5. Hold the canister upside down (with the dome facing down) in the palm of your hand.
6. Insert the applicator in to your back passage as far as is comfortable.
7. Push the dome once and release it. This will release one dose of the foam. Repeat if you need two doses.
8. Remove the applicator and place it in one of the plastic bags provided and dispose of it in a bin.

Getting the most from your treatment

• Each time you collect a prescription, make sure you have been given the same brand of mesalazine. If you are unsure, ask your pharmacist to check for you.
• Try to keep your regular appointments with your doctor and clinic. This is so your doctor can check on your progress. Your doctor will want you to have regular blood tests during this treatment.
• Treatment with mesalazine may be long term to prevent symptom flare-ups. Continue to take/use it unless you are advised otherwise.
• Your doctor may advise you make some changes to your diet as part of your treatment. This may include a special diet or a nutritional supplement.

Can mesalazine cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Important: rarely, mesalazine can cause problems with your blood. You should contact your doctor immediately if you have any unexplained bleeding, bruising, red or purple discolorations of your skin, a sore throat, fever, or if you feel generally unwell during this treatment.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store mesalazine

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines