1.5.1 Aminosalicylates

For guidance on the management of inflammatory bowel disease see Inflammatory Bowel Disease

Aminosalicylates may cause blood dyscrasias and patients should be told to report any unexplained bleeding, bruising, purpura, sore throat, fever or malaise.

All aminosalicylates are classified as 'Specialist' drugs to reflect the need for specialist input but continuation supplies may be prescribed in primary care.

Mesalazine

Octasa®

  • Tablets modified-release 400mg, 800mg (£18.20 = 1.2g daily)

Pentasa®

  • Tablets modified-release 500mg, 1g (£34.43 = 2g daily)
  • Granules 1g, 2g sachets (£34.43 = 2g daily)
  • Retention enema 1g/100mL (£17.73 = 7 enemas)
  • Suppositories 1g (£40.01 = 1g daily)

Indications

Notes

  1. Octasa® is used where release in the distal bowel is required. Pentasa® is used where release in the proximal bowel is required.
  2. Mesalazine intolerance occurs in up to 15% of patients, symptoms include diarrhoea, headache, nausea, thrombocytopenia and rash.
  3. Acute intolerance occurs in 3% of patients and may mimic an acute flare with bloody diarrhoea.
  4. Renal impairment (including interstitial nephritis) is rare and idiosyncratic. It may be related to disease severity rather than dose or type of mesalazine. Renal function should be monitored every three months for the first year of treatment and annually thereafter.
  5. Mesalazine is contra-indicated in severe renal impairment and should be used with caution in less severe impairment.
Sulfasalazine
  • Tablets EC 500mg (£11.08 = 500mg four times a day)

Indications

Notes

  1. See Shared Care Guideline Sulfasalazine for the treatment of inflammatory bowel disease

 

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