Center for Inflammatory Bowel Disease Treatment and Research
Generic Names: mesalamine, sulfasalazine
Brand Names: Asacol®; Canasa®; Lialda®; Pentasa®; Rowasa®
Drug Class: 5-Aminosalicylic Acid derivative, anti-inflammatory agent
What do these medications do?
5-Aminosalicylates (5-ASA) are anti-inflammatory agents that are used to treat active disease and to help maintain remission in mild to moderate Crohn’s disease and ulcerative colitis. They can be given either by mouth or topically (as an enema or suppository). Most of these medications are given two or three times a day, though Lialda may be given once a day. It may take several days to weeks to see the full effect.
5-ASAs work at the level of the lining of the GI tract. The choice of which 5-ASA to use is based on the location of your/your child’s disease. Pentasa starts releasing 5-ASA in the small intestine, and continues to deliver it throughout the small and large intestine. Asacol releases 5-ASA from the end of the small intestine (the ileum) to the end of the large intestine. Sulfasalazine, Colazal and Lialda release 5-ASA only in the colon. Rowasa is a suspension enema that is administered topically to the lining of the rectum and the last portion of the large intestine. Sulfasalazine contains a sulfa component; therefore, it should not be used by those patients with a sulfa drug allergy.
What are the side effects?
5-ASAs have been used safely for many years to treat patients with Crohn’s disease and ulcerative colitis, and they are generally well tolerated by most patients. Possible side effects include kidney inflammation, headache, diarrhea, nausea, sore throat abdominal pain,constipation, mild hair loss, pancreatitis (inflammation of the pancreas), and rarely hepatitis (inflammation of the liver). Sulfasalazine may also cause a temporary decrease in sperm counts in men. Many of these side effects lessen or go away with a decrease in the dosage of this medication.
How to take your medication and miscellaneous facts:
- You should take these medications at the same time(s) everyday.
- You may take these medications with food.
- Make sure to drink lots of non-caffeinated fluids while taking these medications.
- If you miss a dose, take it as soon as you remember. You don’t have to make up for missed doses.
- Check with your doctor or nurse practitioner before starting any new medications, herbs, or vitamins while taking these medications.
- Patients taking Sulfasalazine may notice an orange color to their urine. In addition, sulfasalazine increases sensitivity to the sun, so be sure to use lots of sunscreen when outdoors.
- The rectal medicine can stain fabric, flooring, painted surfaces, marble, granite, vinyl, and enamel.
- You will also need to take a vitamin supplement called folic acid while taking sulfasalazine.