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Pharmacologic class: Salicylate
Therapeutic class: Anti-inflammatory
Pregnancy risk category C
Unknown. Converts to active form, mesalamine, which blocks cyclooxygenase and inhibits prostaglandin production in colon.
Capsules: 250 mg
Indications and dosages
➣ Ulcerative colitis in patients who can't tolerate sulfasalazine
Adults: 500 mg P.O. b.i.d.
• Hypersensitivity to drug or other salicylates
Use cautiously in:
• hepatic or renal impairment, severe allergy, bronchial asthma
• pregnant or breastfeeding patients
• children younger than age 14.
• Give with meals to reduce GI irritation.
CNS: headache, fatigue, depression, vertigo
GI: nausea, vomiting, diarrhea, abdominal pain, cramps, dyspepsia, bloating, stomatitis
Musculoskeletal: joint pain
Respiratory: upper respiratory infection
Skin: rash, itching
Drug-drug. Anticoagulants, coumarin derivatives: prolonged prothrombin time, increased International Normalized Ratio
Drug-food. Any food: decreased GI irritation
• Monitor neurologic status. Stay alert for depression.
• Assess GI symptoms. Encourage adequate fluid intake to avoid dehydration.
• Monitor urinalysis, blood urea nitrogen, and creatinine in patients with renal impairment.
• Instruct patient to take with food and to continue taking drug even after symptoms improve.
• Tell patient to eat appropriate foods in small, frequent servings to minimize GI upset.
• Advise patient to contact prescriber if symptoms worsen or don't improve after 1 to 2 months of therapy.
• Tell patient he may require periodic proctoscopy and sigmoidoscopy to determine response to drug.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects mood and wakefulness.
• As appropriate, review all significant adverse reactions and interactions, especially those related to the drugs and foods mentioned above.