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 BRAND NAMES
 MECHANISM OF ACTION
The mechanism of action of mesalazine (5-ASA) appears to be local to the colonic mucosa rather than systemic. Mucosal production of arachidonic acid metabolites, both through the cyclooxygenase pathways, i.e., prostanoids, and through the lipoxygenase pathways, i.e., leukotrienes and hydroxyeicosatetraenoic acids, is increased in patients with chronic inflammatory bowel disease, and it is possible that 5-ASA diminishes inflammation by blocking production of arachidonic acid metabolites in the colon.
Treatment of mildly to moderately active ulcerative colitis, a disease of the colon and rectum in which the lining of the bowel becomes inflamed. Symptoms can include rectal bleeding, frequent diarrhea and abdominal pain
- Initial Daily Dose is 800 mg, three times a day for a total daily dose of 2.400 mg for a duration of 6 weeks.
- Maintenance of remission of ulcerative colitis: The recommended dosage is 1500-1600 mg daily. Treatment duration in the prospective, well-controlled trial was 6 months.
- Asacol HD (U.S.): Initial Daily Dose is Two 800 mg tablets three times daily for 6 week
- Hypersensitivity to salicylates
 WARNINGS AND PRECAUTIONS
- Acute exacerbation of colitis symptoms can occur
- Renal impairment may occur. Monitor renal function at the beginning of treatment and periodically during therapy
- Do not co-administer with antacids
 PREGNANCY AND LACTATION
- Pregnancy Category B (US). Mesalazine should be used during pregnancy only if clearly needed.
- Nursing Mothers: Low concentrations of mesalamine and higher concentrations of its N-acetyl metabolite have been detected in human breast milk. While the clinical significance of this has not been determined, caution should be exercised when mesalamine is administered to a nursing woman.
 SIDE EFFECTS
The most common adverse reactions (incidence ≥3%) are headache, diarrhea, upper abdominal pain, nausea, nasopharyngitis, flu or flu-like illness, sinusitis