Asacol

Asacol is used to treat and prevent an inflammatory bowel disease called ulcerative colitis. It works inside the intestines (bowel) to reduce the inflammation and other symptoms of the disease.

Product dosage: 400mg
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Synonyms Apriso Asacolon Asalazin medichrom Asalex Asalit Asamax Asavixin Asazine Bufexan Canasa Claversal Colitan Colitofalk Crohnax Crohnezine Ectospasmol Enteraproct Enterasin Etiasa Favorat Fivasa Ipocol Jucolon Laboxantryl Lextrasa Lialda Lixacol Mesacol Mesaflor Mesagin Mesagran Mesalamina Mesalazine Mesalazinum Mesasal Mesatec Mesazin Mesren Mezavant Pentacol Pentasa Proctasacol Prozylex Rafassal Rowasa Salofalk Samezil Sfrowasa Tidocol Xalazin Xalazina Yolecol

Asacol (mesalamine) is a first-line, prescription medication specifically formulated for the treatment of mild to moderate ulcerative colitis. It belongs to the 5-aminosalicylate (5-ASA) class of drugs, designed to deliver its active anti-inflammatory agent directly to the site of colonic inflammation. This targeted action helps reduce symptoms such as diarrhea, rectal bleeding, and abdominal pain, while also working to induce and maintain clinical remission. Its delayed-release formulation ensures the medication is effective where it is needed most, offering a cornerstone therapy for managing this chronic condition.

Features

• Active Ingredient: Mesalamine (also known as mesalazine or 5-aminosalicylic acid/5-ASA).
• Formulation: Delayed-release tablets, designed to begin dissolution in the terminal ileum and release the active ingredient throughout the colon.
• Delivery System: A pH-dependent acrylic-based resin coating (Eudragit S) that ensures targeted delivery to the colon, minimizing upper GI absorption.
• Dosage Strengths: Available in 400 mg and 800 mg delayed-release tablets.
• Mechanism: Acts locally within the colonic mucosa to exert a topical anti-inflammatory effect.

Benefits

• Targeted Symptom Relief: Effectively reduces the core symptoms of ulcerative colitis flares, including decreased stool frequency, less urgency, and reduced rectal bleeding.
• Induction of Remission: Clinically proven to help achieve clinical remission in patients experiencing active, mild to moderate disease.
• Maintenance of Remission: A primary therapy for maintaining symptom-free periods, helping to prevent future flares and prolong the time between episodes.
• Localized Action: The delayed-release design minimizes systemic absorption, focusing the drug’s effect on the inflamed colon and potentially reducing the risk of broader systemic side effects.
• Well-Established Safety Profile: As a long-standing therapy, it has a well-documented and generally favorable safety and tolerability spectrum for long-term use.
• Non-Steroidal: Provides anti-inflammatory benefits without the side effects associated with corticosteroid use.

Common use

Asacol is indicated for the treatment of mildly to moderately active ulcerative colitis in adults. It is used both to treat acute flares of the disease and, at a maintenance dose, to keep the disease in remission. It is not indicated for Crohn’s disease, as its targeted delivery is specific to the colon.

Dosage and direction

Dosage is individualized based on the patient’s condition (active flare vs. maintenance) and response to therapy. The tablets must be swallowed whole and must not be crushed, chewed, or broken, as this will damage the protective coating and prevent targeted delivery.

• Treatment of Active Ulcerative Colitis: The typical dosage is 1.6 grams (e.g., two 800 mg tablets or four 400 mg tablets), administered orally three times daily for a total of 4.8 grams per day for a duration of 6 weeks.
• Maintenance of Remission: The typical maintenance dosage is 1.6 grams per day, administered in divided doses (e.g., two 800 mg tablets once daily or one 800 mg tablet twice daily).

Always follow the specific dosage instructions provided by the prescribing healthcare professional.

Precautions

• Renal Function: Mesalamine has been associated with renal toxicity, including rare cases of interstitial nephritis. Renal function should be evaluated prior to starting therapy and monitored periodically during treatment.
• Hypersensitivity Reactions: Some patients may experience hypersensitivity reactions, including myocarditis, pericarditis, pneumonitis, and hepatitis. Discontinue therapy if such reactions occur.
• Phenylketonuria (PKU): Some formulations of mesalamine may contain aspartame, which is a source of phenylalanine. Patients with PKU should check the product labeling.
• Pyloric Stenosis: The delivery of mesalamine to the colon may be impaired in patients with pyloric stenosis or other conditions causing delayed gastric emptying.
• Sun Exposure: Mesalamine may increase photosensitivity. Patients should use sun protection measures (sunscreen, protective clothing) while taking this medication.

Contraindications

Asacol is contraindicated in patients with:

• A known hypersensitivity to mesalamine (mesalazine), any other aminosalicylates (e.g., sulfasalazine), or any component of the formulation.
• A history of hypersensitivity to salicylates (e.g., aspirin).

Possible side effect

Most side effects are mild and may subside with continued use. Common side effects can include:

• Headache
• Abdominal pain, cramps, or discomfort
• Nausea, diarrhea, vomiting, and flatulence
• Rash and pruritus (itching)
• Fever and flu-like symptoms
• Dizziness

Serious side effects require immediate medical attention. These include:

• Signs of kidney problems: changes in urine output, blood in urine, swelling in feet or ankles, unusual fatigue.
• Signs of a hypersensitivity reaction: chest pain, shortness of breath, unexplained rash or fever, severe headache.
• Signs of liver problems: jaundice (yellowing of the skin or eyes), dark urine, severe nausea.
• Severe abdominal pain or cramping.
• Worsening of colitis symptoms.

Drug interaction

Inform your doctor of all medications you are taking. Potential interactions include:

• Azathioprine or 6-Mercaptopurine: Concurrent use may increase the risk of blood disorders.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): (e.g., ibuprofen, naproxen) may increase the potential for renal adverse effects.
• Anticoagulants: (e.g., warfarin) Mesalamine may potentially enhance the anticoagulant effect, increasing the risk of bleeding. Close monitoring of INR is recommended.
• Lactulose: May lower the colonic pH, potentially causing premature release of mesalamine in the small intestine.

Missed dose

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.

Overdose

Symptoms of overdose may include severe headache, confusion, nausea, vomiting, diarrhea, sweating, tinnitus (ringing in the ears), and hyperventilation. Severe overdose may lead to metabolic acidosis and renal failure. In case of suspected overdose, contact a poison control center or seek emergency medical attention immediately.

Storage

• Store at room temperature between 20°C to 25°C (68°F to 77°F).
• Keep in the original container, tightly closed, and away from moisture and light.
• Keep out of reach of children and pets.
• Do not use after the expiration date printed on the bottle.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

• “Asacol has been my maintenance medication for over a decade. It has successfully kept my UC in remission with minimal side effects. The key for me was finding the right maintenance dose with my GI.”
• “It took about 4 weeks to really notice a significant difference during a flare, but the gradual reduction in bleeding and urgency was a relief. I experienced some initial headaches that subsided.”
• “While effective for my symptoms, the pill burden was high (multiple large tablets multiple times a day). I later switched to a higher-dose formulation for convenience, but Asacol provided a solid foundation for my treatment.”
• “My gastroenterologist started me on Asacol as a first-line treatment. It worked well to control my moderate flare and I’ve been on a maintenance dose ever since. I get regular blood tests to monitor my kidney function, which is a necessary precaution.”