Mesalazine is used to treat and prevent recurrence of ulcerative colitis. This disease cause inflammation in the lower part of the colon (large intestine) and the rectum.
Use Mesalazine exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.
This medicine is available as a rectal suppository, rectal suspension enema and foam enema.
Mesalazine suppository is to be inserted into the rectum. Do not eat, chew or swallow it. Do not use it in any other way. Try to go to the toilet before you insert the suppository.
If you are using a Mesalazine suppository:
- Wash your hands thoroughly.
- Remove the suppository from the foil wrapper.
- If you are right-handed, lie on your left side and pull right knee up to your chest.
- Gently insert the suppository with the pointed end first into your rectum. Gently push the suppository as far as it would go.
- Remain lying in this position for 10-15 minutes to allow suppository to melt. If you feel that the suppository is slipping out, press your buttocks together. The suppository must remain in the rectum for 1-3 hours or longer so that the medicine can be absorbed.
Mesalazine suspension and foam enemas may only be used by inserting it into the rectum. Do not take it by mouth or use it in any other way. Try to go to the toilet before using the enema. This medicine may cause staining of direct contact surfaces such as fabrics, flooring, and painted surfaces, if possible, carefully choose a location for administration.
If you are using a Mesalazine suspension enema:
- Use this medicine only at bedtime, just before you sleep.
- Shake the bottle well before using.
- Take out the protective cap from the nozzle.
- Hold the bottle by the neck, otherwise the medicine may leak out when you tip the bottle.
- Lie down on your left side with your left leg stretched out while the right leg bent forward.
- Insert the nozzle gently into your rectum.
- Tilt the bottle gently so that the nozzle is aimed towards your back.
- When you are sure that the nozzle is safely in your rectum, squeeze the bottle slowly to release the medicine until empty into your rectum.
- When completed, slowly withdraw the nozzle from your rectum.
- Stay in the same position for at least 30 minutes. Try not to move your lower body to allow the medicine to be distributed through your lower bowel.
- Do not get up from the bed. Remain in a lying down position if possible to retain the medicine in your body while you are sleeping all night.
If you are using a Mesalazine foam enema:
- Wash your hands thoroughly.
- Shake the can well before using. Rest it for a few seconds then shake again.
- Push the applicator firmly onto the spout of the spray can.
- Before your first use, remove the safety tag (plastic flap) from under the pump dome.
- Twist the dome on top of the spray can until the semi-circular gap underneath is aligned with the applicator.
- Hold the can in the palm of your hand and place your index finger on the top of the pump dome. Turn the can upside-down. The spray can will only work properly if it is upside-down.
- Stand with one foot raised on a stool or chair, or you may lie down on your side with your lower leg stretched out while the other bent forward.
- Gently insert the applicator into your rectum as far as you are comfortable.
- Push the pump dome fully once then slowly release it. The foam only comes out of the spray can when you release the dome. To administer your second spray, push the pump dome again then release slowly.
- Keep the applicator in place for at least 10-15 seconds before pulling it out to ensure that you delivered your full dose without spilling. Try not to go to the toilet until next morning.
- When you have removed the applicator, place it in the plastic bag provided for disposal. Use a new applicator for your next administration.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type and severity of your condition.
Mesalazine must be used regularly to be effective. Continue to use this medicine even when you feel better. Do not stop using it unless instructed otherwise by your doctor, as stopping it suddenly may worsen your condition.
Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to use your medicine, let your doctor and pharmacist know.
Alert your doctor if you have severe kidney or liver disease as Mesalazine may not be suitable for you.
Do not use Mesalazine if you ever had an allergic reaction (rashes, breathlessness, swollen eyes) to similar medicines such as sulfasalazine and salicylates (e.g. aspirin).
Inform your doctor if you have the following conditions:
- mild to moderate kidney disease
- mild to moderate liver disease
- with or a history of blood disorders
- lung problem e.g. asthma
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor before giving this medicine to a child or elderly. Children and elderly people may be more sensitive to the side effects.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
You may need to have regular blood and urine tests to check your blood count, kidney and liver function while you are being treated with Mesalazine. Your doctor will advise you about how often you will need to have these tests.
Mesalazine may cause any of the following: headache, cough, colds, nausea, vomiting, diarrhoea, nose or throat irritation, constipation, stomach pain, stomach wind, rectal pain and irritation, itch and skin sensitivity to sunlight.
If you develop rashes, breathlessness, swollen mouth or eyes, stop using Mesalazine and inform your doctor quickly. These could be signs of an allergic reaction.
Some side effects may be serious, although they are not common. Inform your doctor immediately if you experience:
- chest pain, shortness of breath, swollen limbs, flank pain
- severe persistent stomach pain and tiredness, yellowing of the skin or eyes
- signs of intolerance reaction e.g. rash, fever, severe headache, stomach cramps or pain
- frequent fever with sore throat, unexplained bleeding or bruising
- hair loss, numbness or tingling sensation in the hands and feet, muscle pain
- rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
Inform your doctor if any of these side effects do not go away or are severe, or of you experience other side effects.
Do not use Mesalazine if you ever had an allergic reaction (rashes, breathlessness, swollen eyes) to similar medicines such as sulfasalazine and salicylates (e.g. aspirin).
Inform your doctor and pharmacist if you are taking any of these medicines:
- blood-thinning medicine e.g. warfarin
- medicines used in organ transplant or certain immune disorders e.g. azathioprine, mercaptopurine, thioguanine
- non-steroidal anti-inflammatory drugs (medicines for pain and inflammation) e.g. diclofenac, naproxen
- methotrexate (anti-cancer medicine)
- medicine to treat TB (lung infection known as tuberculosis) e.g. rifampicin
- diuretics or “water pills” e.g. spironolactone, furosemide
- medicines for gout e.g. probenecid, sulfinpyrazone
- medicine for heart disease e.g. digoxin
This list does not include all medicines that may interact with Mesalazine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicine, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Store suppository in the refrigerator, between 2-8°C. Do not allow to freeze. Protect from light and heat.
Store the foam enema below 25°C outside of refrigerator. Keep away from direct sunlight, heat, open flame, or lighted cigarettes as it is a pressurised container.
Medicines must not be used past the expiry date.
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