Mezavant tablets release their mesalazine as they pass through the large intestine colon. The scheme below demonstrates the areas of 5-ASA action depending on the form of the drug being used:. Search Login. Inflammatory Bowel Disease Clinic. How do I take 5-ASA? One very rare side effect can be problems with your blood. Tell your doctor immediately if you get unexplained bleeding, bruising or red or purple marks on your skin, or if you have a sore throat, high temperature or feel generally unwell.
Adults and children aged 5 years and older can take mesalazine. To make sure it's safe for you, tell a pharmacist or doctor before taking or using it if you: have ever had an allergic reaction to mesalazine, aspirin, or any other salicylates such as methylsalicylate or choline salicylate have ever had an allergic reaction to any other medicine have any problems with your kidneys or liver have a rare blood condition called porphyria are trying to get pregnant, already pregnant, or breastfeeding.
Dosage Your dose will depend on why you need it and on the type and brand of mesalazine that your doctor has prescribed for you.
How to take tablets and granules You will either take the tablets or granules once a day, or as 2 or 3 smaller doses throughout the day. How to use suppositories Your doctor or pharmacist will tell you how many suppositories to use each day. Wash your hands before and after using the suppository. Also clean around your bottom anus with mild soap and water, rinse and pat dry.
Unwrap the suppository. Gently push the suppository into your anus with the pointed end first. It needs to go in about 3 centimetres 1 inch. Sit or lie still for about 15 minutes. The suppository will start to soften, as it melts with your body heat. This is normal. How to use enemas You will usually use mesalazine enemas once a day before you go to bed.
Wash your hands before and after using the enema. Lie on your side, with your bottom slightly higher than the rest of your body. You can use a pillow to lift your bottom up. You may want to lie on a towel. Put one of the disposable plastic bags provided over your hand like a glove and pick up the bottle.
Shake the bottle. Break the seal on the nozzle, or remove the protective cap. Gently push the nozzle into your bottom anus as far as is comfortable. Squeeze the bottle steadily to allow the liquid to empty into your anus quite quickly. This takes about 30 to 40 seconds.
It's normal for some liquid to be left in the bottle afterwards. Remove the nozzle from your bottom. Peel the disposable plastic bag off your hand and use it to cover the bottle, ready to throw away. Roll onto your front and wait for 5 minutes. This will stop any liquid coming out of your bottom.
For sleeping, find a comfortable position that keeps the liquid in your bottom for as long as possible. The longer it stays there, the better it will work. How to use rectal foam You will usually use mesalazine rectal foam once a day before you go to bed. Wash your hands before and after using the foam. Push a new applicator onto the nozzle. This nozzle sticks out beneath the dome at the top of the can. Shake the can for about 20 seconds. There is a rounded gap at the base of the dome.
Twist the dome until the gap lines up with the nozzle. Put your finger on top of the dome and turn the can upside down. The spray will only work properly if you hold the can with the dome pointing straight down. Either stand with one leg raised on a chair, or lie down on your side with your lower leg stretched out and upper leg bent.
Gently put the tip of the applicator into your anus as far as possible. You may want to use a lubricating jelly on the tip of the applicator. Push the dome down. This fills the applicator with a dose of foam.
Release the dome very slowly, to push the foam out. Wait 10 to 15 seconds and then slowly remove the applicator from your bottom. Do this slowly to prevent the foam coming out. Remove the applicator from the nozzle. Put it in the plastic bag provided and throw the bag away with your normal household rubbish.
Will my dose go up or down? What if I forget to take it? Do not take 2 doses together to make up for a forgotten dose. What if I take too much? Taking too much mesalazine as a one-off is unlikely to cause problems. Urgent advice: Contact for advice now if:. Common side effects Common side effects happen in more than 1 in people.
Keep taking the medicine, but tell your doctor if these side effects bother you or do not go away: indigestion, stomach pain or wind feeling or being sick nausea or vomiting diarrhoea headaches, muscle aches and pains Serious side effects Serious side effects are rare and happen in less than 1 in 1, people. Information: You can report any suspected side effect using the Yellow Card safety scheme.
Visit Yellow Card for further information. What to do about: indigestion, stomach pain or wind — try not to eat foods that cause wind like lentils, peas, beans and onions.
Eat smaller meals, and eat and drink slowly. Check the instructions that come with your medicine to see if you can take it after you've eaten. Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.
Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. Tell your doctor if the aches continue despite taking painkillers or if they last for more than a few days. Mesalazine and pregnancy You may be advised to continue using mesalazine during pregnancy to make sure that your inflammatory bowel disease remains well controlled.
Mesalazine and breastfeeding If your doctor or health visitor says your baby is healthy, then it's usually OK to take mesalazine while breastfeeding. Non-urgent advice: Tell your doctor if you're:. Tell a pharmacist or doctor if you are taking: medicines that make your poo more acidic, like the laxative lactulose medicines that affect the way your kidneys work, such as azathioprine , mercaptopurine or thioquanine, and non-steroidal anti-inflammatory drugs NSAIDs , such as aspirin or ibuprofen certain medicines that help to prevent blood clots, like warfarin Mixing mesalazine with herbal remedies or supplements There's very little information about taking herbal remedies and supplements while taking or using mesalazine.
Important: Medicine safety Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. How does it work? Knowing that 5-ASAs have been around for decades makes me feel more comfortable about their long term usage. As some 5-ASAs work best in certain parts of the gut, you may be prescribed a particular type or brand depending on where you have inflammation. Though all types of 5-ASAs are equally safe and effective, they have slightly different formulations.
Many IBD specialists believe that if a particular brand or type of 5-ASA is working well, you should not be switched to another without a good clinical reason. Your doctor should discuss any need to switch medicines with you, giving you an opportunity to have input into the decision.
If it is necessary to switch brands, it is a good idea to report any changes in symptoms to your doctor. The best form for you will depend on how severe your condition is and how much of your colon is affected. A combination of oral and rectal treatment is often more effective than one approach alone. It is therefore important to not chew, cut or crush the tablets, as this will destroy the coating and stop the medicine being released in the right area.
A select few brands, such as Pentasa, can be cut but not crushed. Check with your doctor or read the information leaflet that comes with your medicine. Oral 5-ASAs are often prescribed in two or three doses during the day. However, taking these together in a single daily dose may be just as effective, and there are once-a-day brands available. If you feel this could be helpful for you, discuss this with your doctor. This can be helpful if you have difficulty swallowing tablets. Suppositories are small, waxy bullet-shaped capsules of the drug that are inserted through the anus and dissolve at body temperature.
Enemas can come in a liquid or foam form, and are put into the rectum through the anus using a specially designed applicator. Foam enemas are often easier to retain than liquid enemas, so they can be particularly useful at the beginning of a flare-up, when the gut is most sensitive. Liquid enemas can usually travel farther along the colon, reaching more of the inflammation.
Taking an enema or suppository can often be quite uncomfortable in the beginning, and take a while to get used to. Read the patient information leaflet that comes with your medicine for instructions on how to administer the treatment, and talk to your doctor or IBD nurse if you are struggling. For more details about the different forms drugs come in, see our information sheet Taking Medicines.
At first, the suppositories were very difficult to use as it felt uncomfortable and embarrassing to me, but after a while, I found that it became just another part of my bedtime routine. I find that taking Pentasa granules also helps as they can be swallowed quickly. The dose you take will be decided by your doctor. It usually depends on which brand of 5-ASA you are taking, as well as how active your disease is. The dose may be increased or decreased depending on how you respond.
This dose may be slightly lower than the dose you started with. It is important that you do not change your dosage without first speaking to your IBD team. It is important to know the difference between your dosage for maintaining remission, and your dosage for managing a flare-up. This has given me opportunities for early intervention when I feel like I am about to become unwell.
You will probably be advised to take 5-ASAs long-term to keep your condition under control and reduce the risk of flare-ups. If you respond well to 5-ASAs you should be able to keep taking them for some years. Our information sheet Taking Medicines has some helpful guidance about taking drugs for your Crohn's or Colitis long-term.
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