Meprobamate
23 June, 2023
MetFORMIN (Eqv-Glumetza)
23 June, 2023
Mesalamine Delayed Release Tablets
Description
Generic name:
Mesalamine
Drug class:
Aminosalicylates
Dosage form:
Delayed-release oral tablets (e.g., 400 mg, 800 mg)
Root of administration:
Oral
Dose:
Varies by indication; consult label. Typical adult doses:
- Ulcerative colitis induction: 2.4–4.8 g/day in divided doses
- Maintenance: 2.0 g/day
- Pouchitis: 2.4 g/day
- Crohn’s disease (colonic): 2.4–4.8 g/day
Mechanism of action:
Mesalamine acts topically in the colon to modulate inflammatory mediators, inhibit cyclooxygenase and lipoxygenase pathways, scavenge free radicals, and reduce leukotriene production, thereby decreasing inflammation.
Drug usage cases:
- Ulcerative colitis (induction and maintenance)
- Pouchitis (maintenance)
- Off-label: Mild to moderate Crohn’s disease (colonic)
- Off-label: Proctitis and proctosigmoiditis
- Off-label: Prevention of colorectal cancer in UC patients (adjunctive)
Drug contra indications:
- Hypersensitivity to mesalamine, sulfasalazine, or other salicylates
- History of acute intolerance syndrome to 5-aminosalicylic acid drugs
- Severe renal impairment (creatinine clearance < 30 mL/min)
- Severe hepatic impairment
Side effects:
- Common: Headache, nausea, abdominal pain, diarrhea, flatulence, dyspepsia
- Rash, pruritus, photosensitivity
- Elevated liver enzymes
- Interstitial nephritis, renal impairment
- Pancreatitis
- Blood dyscrasias: leukopenia, thrombocytopenia, anemia
- Pericarditis, myocarditis
- Arthralgia, myalgia
- Acute intolerance syndrome: fever, chest pain, worsening diarrhea
- Alopecia
- Respiratory: dyspnea, bronchospasm
Warnings:
- Monitor renal function (creatinine) before and during therapy
- Obtain baseline and periodic CBC and liver function tests
- Risk of acute intolerance syndrome—discontinue if severe symptoms occur
- Use caution in patients with preexisting renal or hepatic disease
- Avoid use in aspirin‐allergic patients
- May worsen colitis or cause paradoxical inflammation
- Use caution in elderly due to risk of renal impairment
Use during pregnancy or breastfeeding:
Pregnancy: Category B. Studies have not shown risk to the fetus. Use if potential benefit justifies potential risk. Low systemic absorption minimizes fetal exposure.
Breastfeeding: Mesalamine and its metabolites are excreted in breast milk in small amounts. Monitor infant for diarrhea or rash. Use only if benefits outweigh risks.
