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Drug overview for LIALDA (mesalamine):
Generic name: MESALAMINE (me-SAL-a-meen/a-MEE-noe-sal-i-SIL-ik AS-id)
Drug class: Inflammatory Bowel Agents
Therapeutic class: Gastrointestinal Therapy Agents
Mesalamine, the 5-amino derivative of salicylic acid, is a GI anti-inflammatory agent.
No enhanced Uses information available for this drug.
Generic name: MESALAMINE (me-SAL-a-meen/a-MEE-noe-sal-i-SIL-ik AS-id)
Drug class: Inflammatory Bowel Agents
Therapeutic class: Gastrointestinal Therapy Agents
Mesalamine, the 5-amino derivative of salicylic acid, is a GI anti-inflammatory agent.
No enhanced Uses information available for this drug.
DRUG IMAGES
- LIALDA DR 1.2 GM TABLET
The following indications for LIALDA (mesalamine) have been approved by the FDA:
Indications:
Ulcerative colitis remission
Ulcerative colitis
Professional Synonyms:
Colitis ulcerativa in remission
Colitis ulcerativa
Ulcerative colitis in remission
Indications:
Ulcerative colitis remission
Ulcerative colitis
Professional Synonyms:
Colitis ulcerativa in remission
Colitis ulcerativa
Ulcerative colitis in remission
The following dosing information is available for LIALDA (mesalamine):
No enhanced Dosing information available for this drug.
Mesalamine is administered orally as delayed-release tablets and as extended-release capsules. Mesalamine is administered rectally as a retention enema or suppositories.
DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
---|---|---|
LIALDA DR 1.2 GM TABLET | Maintenance | Adults take 2 tablets (2.4 gram) by oral route once daily with a meal |
DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
---|---|---|
MESALAMINE DR 1.2 GM TABLET | Maintenance | Adults take 2 tablets (2.4 gram) by oral route once daily with a meal |
The following drug interaction information is available for LIALDA (mesalamine):
There are 0 contraindications.
There are 0 severe interactions.
There are 1 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
Drug Interaction | Drug Names |
---|---|
Azathioprine; Mercaptopurine/Aminosalicylate Derivatives SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: The exact mechanism is not known. Aminosalicylic acid and its derivatives (balsalazide, mesalamine, olsalazine, sulfasalazine) may inhibit azathioprine or mercaptopurine inactivation via the thiopurine methyltransferase (TPMT) pathway. Aminosalicylates, azathioprine and mercaptopurine are all associated risk for neutropenia, thrombocytopenia, and anemia and so these risks could be additive. CLINICAL EFFECTS: Concurrent use of azathioprine or mercaptopurine with aminosalicylates may increase the risk for anemia, neutropenia, or thrombocytopenia. PREDISPOSING FACTORS: Patients with reduced or absent thiopurine S-methyltransferase (TPMT) or nucleotide diphosphatase (NUDT15) activity are at higher risk of accumulating thiopurine metabolites and severe myelosuppression. Approximately 0.3 % of patients of European, Latino, or African descent have mutations of the TPMT gene resulting in little to no TPMT activity (homozygous deficiency), and approximately 10 % have intermediate TPMT activity (heterozygous deficiency). NUDT15 deficiency is not seen in patients of African descent and is seen in less than 1 % of patients of European descent. Approximately 1 % of patients of East Asian descent, 0.5 % of patients of central/south Asian descent, and 2 % of patients of Latino descent have homozygous NUDT15 deficiency. About 17 % of patients of East Asian descent, 13 % of patients of central/south Asian descent, and 8 % of patients of Latino descent have heterozygous NUDT15 deficiency. Added risk for myelosuppression would be expected in patients who also receive allopurinol or other agents which block xanthine oxidase (XO), the other major inactivation pathway for azathioprine and mercaptopurine. PATIENT MANAGEMENT: Use the lowest possible dose of each drug and monitor closely for myelosuppression. DISCUSSION: Manufacturer prescribing information states that concurrent use of aminosalicylates with azathioprine or mercaptopurine has been reported to cause bone marrow suppression. In a prospective study, 22 inflammatory bowel disease (IBD) patients on concurrent 5-aminosalicylate with (2 g daily and later increased to 4 g daily) with azathioprine had increased levels of 6-thioguanine (6-TGN) metabolites. One patient had signs of myelosuppression.(3) A prospective study in 183 IBD patients on concurrent 5-aminosalicylic acid and thiopurines found no significant interaction between thiopurines and 5-aminosalicylic acid.(4) A retrospective study in 199 IBD patients reported an increased rate of adverse events in the dual 5-aminosalicylates and azathioprine dual therapy group compared (48%) to the monotherapy azathioprine group (30%)(chi = 6.4, p = 0.05). Discontinuation of azathioprine because of adverse events was higher in the dual therapy group (52% vs. 24%).(5) In a prospective study, 16 Crohn's disease patients on a stable dose of azathioprine with sulfasalazine or mesalamine discontinued the aminosalicylate after 3 months, which resulted in an average decrease 0f 10% in 6-TGN levels. Myelosuppression may be related to increased levels of 6-TGN.(6) In a 8 week non-randomized parallel group drug interaction study, 34 patients with Crohn's disease receiving azathioprine or 6-mercaptopurine with mesalamine (4 g/day), or sulfasalazine (4 g/day), or balsalazide (6.75 g/day) had a high frequency of leukopenia (20-55%) and significant increases in whole blood 6-TGN levels.(7) A 16 year-old Crohn's disease patient on concurrent 6-mercaptopurine (75 mg) and olsalazine (1000 mg) developed leukopenia (WBC count 1.7 x 10*9/L, ANC 1.309 x 10*9/L, hemoglobulin 113 gm/L, platelet count 550 x 10*9/L) and required a dose reduction for 6-mercaptopurine. Another episode occurred later on after increasing her dose of olsalazine and 6-mercaptopurine which resulted in discontinuation of olsalazine.(8) An in vitro study showed that sulfasalazine and other aminosalicylate derivatives were able to inhibit recombinant human TPMT.(9) In a prospective study, 17 IBD patients on stable mercaptopurine and mesalamine therapy had a 23% reduction in 6-TGN levels after discontinuing mercaptopurine.(10) |
AZASAN, AZATHIOPRINE, AZATHIOPRINE SODIUM, IMURAN, MERCAPTOPURINE, PURIXAN |
The following contraindication information is available for LIALDA (mesalamine):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 0 contraindications.
There are 2 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
Severe List |
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Interstitial nephritis |
Minimal change glomerulonephritis |
There are 4 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
Moderate List |
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Atopic dermatitis |
Disease of liver |
Kidney disease with likely reduction in glomerular filtration rate (GFr) |
Kidney disease with reduction in glomerular filtration rate (GFr) |
The following adverse reaction information is available for LIALDA (mesalamine):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 43 severe adverse reactions.
More Frequent | Less Frequent |
---|---|
Abnormal hepatic function tests |
Anemia |
Rare/Very Rare |
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Acute generalized exanthematous pustulosis Acute pancreatitis Agranulocytosis Anaphylaxis Angioedema Aplastic anemia Asthma exacerbation Biliary calculus Cholecystitis Cholestatic hepatitis DRESS syndrome Eosinophilia Eosinophilic pneumonia Erythema nodosum Gastrointestinal hemorrhage Gastrointestinal perforation Gout Guillain-barre syndrome Hepatic failure Hepatitis Hypersensitivity pneumonitis Interstitial nephritis Intracranial hypertension Jaundice Kidney disease with reduction in glomerular filtration rate (GFr) Kidney stone Leukopenia Lupus-like syndrome Myelitis Myocarditis Nephrogenic diabetes insipidus Obstructive hyperbilirubinemia Pancytopenia Pericardial effusion Pericarditis Pleuritis Pyoderma gangrenosum Rectal bleeding Stevens-johnson syndrome Thrombocytopenic disorder Toxic epidermal necrolysis |
There are 66 less severe adverse reactions.
More Frequent | Less Frequent |
---|---|
Abdominal pain with cramps Cough Diarrhea Eructation Flatulence Headache disorder Nausea Pharyngitis Sinusitis Vomiting |
Alopecia Back pain Conjunctivitis Constipation Dizziness Dyspepsia General weakness Hypertension Lethargy Malaise Myalgia Pain Peripheral edema Skin rash Stomatitis Xerostomia |
Rare/Very Rare |
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Abdominal distension Acne vulgaris Acute cognitive impairment Anorexia Arthralgia Chest pain Cramps Drowsy Dyspnea Dysuria Earache Edema Epididymitis Facial edema Fatigue Fever Flu-like symptoms Gastritis Hematuria Hyperhidrosis Hypertriglyceridemia Hypotension Increased appetite Lymphadenopathy Menorrhagia Neck pain Ocular pain Oligospermia Peripheral neuropathy Pruritus of skin Renal failure Rhinitis Skin photosensitivity Sore throat Tachycardia Tenesmus Tinnitus Tremor Urticaria Vertigo |
The following precautions are available for LIALDA (mesalamine):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
None |
Severe Precaution
None |
Management or Monitoring Precaution
None |
Reproduction studies in rats and rabbits using oral mesalamine dosages of up to 1000 mg/kg daily and up to 800 mg/kg daily, respectively, have not revealed evidence of teratogenic effects or harm to the fetus. In addition, reproduction studies in rats and rabbits using oral mesalamine daily doses up to 5 and 8 times the maximum recommended human rectal dose, respectively, have not revealed evidence of fetal malformation. Sulfasalazine (a prodrug of mesalamine) has been used for the treatment of inflammatory bowel disease, including Crohn's disease and ulcerative colitis, during pregnancy.
Although fetal abnormalities have been reported in infants born to women with inflammatory bowel disease who received sulfasalazine alone or combined with corticosteroids during pregnancy, most evidence indicates that sulfasalazine is not associated with a substantial risk of teratogenicity. The effect of sulfasalazine on subsequent growth, development, and functional maturation in children whose mothers received sulfasalazine during pregnancy has not been determined. Although the relevance to mesalamine of the experience with sulfasalazine in pregnant women currently is not known, placental transfer of mesalamine, but not sulfasalazine or sulfapyridine, has been reported to be negligible in pregnant women receiving oral sulfasalazine.
Mesalamine crosses the placental barrier. Because there are no adequate and controlled studies to date using mesalamine or sulfasalazine in pregnant women, and animal studies are not always predictive of human response, the drugs should be used during pregnancy only when clearly needed.
Although fetal abnormalities have been reported in infants born to women with inflammatory bowel disease who received sulfasalazine alone or combined with corticosteroids during pregnancy, most evidence indicates that sulfasalazine is not associated with a substantial risk of teratogenicity. The effect of sulfasalazine on subsequent growth, development, and functional maturation in children whose mothers received sulfasalazine during pregnancy has not been determined. Although the relevance to mesalamine of the experience with sulfasalazine in pregnant women currently is not known, placental transfer of mesalamine, but not sulfasalazine or sulfapyridine, has been reported to be negligible in pregnant women receiving oral sulfasalazine.
Mesalamine crosses the placental barrier. Because there are no adequate and controlled studies to date using mesalamine or sulfasalazine in pregnant women, and animal studies are not always predictive of human response, the drugs should be used during pregnancy only when clearly needed.
Following oral administration, low concentrations of mesalamine and higher concentrations of its N-acetyl metabolite have been detected in human breast milk. Although the clinical importance of this effect is not known, mesalamine should be used with caution and only if the benefits outweigh the risks in nursing women. The manufacturer of mesalamine extended-release capsules states that hypersensitivity reactions (e.g., diarrhea) in the infant of a breast-feeding woman receiving mesalamine cannot be excluded. The manufacturer of mesalamine rectal suspension recommends that the drug not be used in nursing women.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for LIALDA (mesalamine):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for LIALDA (mesalamine)'s list of indications:
Ulcerative colitis | |
K51 | Ulcerative colitis |
K51.0 | Ulcerative (chronic) pancolitis |
K51.00 | Ulcerative (chronic) pancolitis without complications |
K51.01 | Ulcerative (chronic) pancolitis with complications |
K51.011 | Ulcerative (chronic) pancolitis with rectal bleeding |
K51.012 | Ulcerative (chronic) pancolitis with intestinal obstruction |
K51.013 | Ulcerative (chronic) pancolitis with fistula |
K51.014 | Ulcerative (chronic) pancolitis with abscess |
K51.018 | Ulcerative (chronic) pancolitis with other complication |
K51.019 | Ulcerative (chronic) pancolitis with unspecified complications |
K51.2 | Ulcerative (chronic) proctitis |
K51.20 | Ulcerative (chronic) proctitis without complications |
K51.21 | Ulcerative (chronic) proctitis with complications |
K51.211 | Ulcerative (chronic) proctitis with rectal bleeding |
K51.212 | Ulcerative (chronic) proctitis with intestinal obstruction |
K51.213 | Ulcerative (chronic) proctitis with fistula |
K51.214 | Ulcerative (chronic) proctitis with abscess |
K51.218 | Ulcerative (chronic) proctitis with other complication |
K51.219 | Ulcerative (chronic) proctitis with unspecified complications |
K51.3 | Ulcerative (chronic) rectosigmoiditis |
K51.30 | Ulcerative (chronic) rectosigmoiditis without complications |
K51.31 | Ulcerative (chronic) rectosigmoiditis with complications |
K51.311 | Ulcerative (chronic) rectosigmoiditis with rectal bleeding |
K51.312 | Ulcerative (chronic) rectosigmoiditis with intestinal obstruction |
K51.313 | Ulcerative (chronic) rectosigmoiditis with fistula |
K51.314 | Ulcerative (chronic) rectosigmoiditis with abscess |
K51.318 | Ulcerative (chronic) rectosigmoiditis with other complication |
K51.319 | Ulcerative (chronic) rectosigmoiditis with unspecified complications |
K51.5 | Left sided colitis |
K51.50 | Left sided colitis without complications |
K51.51 | Left sided colitis with complications |
K51.511 | Left sided colitis with rectal bleeding |
K51.512 | Left sided colitis with intestinal obstruction |
K51.513 | Left sided colitis with fistula |
K51.514 | Left sided colitis with abscess |
K51.518 | Left sided colitis with other complication |
K51.519 | Left sided colitis with unspecified complications |
K51.8 | Other ulcerative colitis |
K51.80 | Other ulcerative colitis without complications |
K51.81 | Other ulcerative colitis with complications |
K51.811 | Other ulcerative colitis with rectal bleeding |
K51.812 | Other ulcerative colitis with intestinal obstruction |
K51.813 | Other ulcerative colitis with fistula |
K51.814 | Other ulcerative colitis with abscess |
K51.818 | Other ulcerative colitis with other complication |
K51.819 | Other ulcerative colitis with unspecified complications |
K51.9 | Ulcerative colitis, unspecified |
K51.90 | Ulcerative colitis, unspecified, without complications |
K51.91 | Ulcerative colitis, unspecified, with complications |
K51.911 | Ulcerative colitis, unspecified with rectal bleeding |
K51.912 | Ulcerative colitis, unspecified with intestinal obstruction |
K51.913 | Ulcerative colitis, unspecified with fistula |
K51.914 | Ulcerative colitis, unspecified with abscess |
K51.918 | Ulcerative colitis, unspecified with other complication |
K51.919 | Ulcerative colitis, unspecified with unspecified complications |
Ulcerative colitis remission | |
K51.00 | Ulcerative (chronic) pancolitis without complications |
K51.20 | Ulcerative (chronic) proctitis without complications |
K51.30 | Ulcerative (chronic) rectosigmoiditis without complications |
K51.40 | Inflammatory polyps of colon without complications |
K51.50 | Left sided colitis without complications |
K51.80 | Other ulcerative colitis without complications |
K51.90 | Ulcerative colitis, unspecified, without complications |
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