What to know about mesalamine for ulcerative colitis

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Mesalamine is a type of aminosalicylic acid or aminosalicylate. A doctor may prescribe this kind of medication to either treat mild to moderate UC or help a person with UC stay in remission by reducing inflammation.

Scientists do not know exactly how mesalamine works. However, some suspect it helps regulate the inflammatory response from the cyclooxygenase and lipoxygenase pathways. If it affects these enzyme pathways, it may help decrease the production of prostaglandins and leukotrienes.

Prostaglandins are lipids, or fatty substances, that play a role in the body’s inflammatory response. Leukotrienes are chemicals that play a role in inflammation and the body’s allergic response.

Another theory suggests that mesalamine interferes with the production of inflammatory cytokines, which are signaling molecules that help with the body’s inflammatory response.

A final theory is that it may act as a free radical scavenger and antioxidant, which help protect cells from the damage free radicals cause. Free radicals may cause inflammation and lead to an increased risk of developing certain diseases.

Learn more about IBD medications.

Many people with UC tolerate mesalamine well. However, some people may experience side effects, which may include:

• abdominal pain
• nausea
• gastrointestinal upset
• rash
• headaches
• nasopharyngitis, which people may also refer to as the common cold
• joint pain
• agranulocytosis, which is when the body does not make enough of a type of white blood cell called granulocytes
• oligospermia, or low sperm count
• aplastic anemia
• muscle pain
• myelosuppression, which is when reduced bone marrow activity leads to lower red and white blood cells and platelet counts
• hematuria, or blood in the urine
• cholestatic hepatitis, which is when the flow of bile becomes slowed or blocked, leading to inflammation of the liver

Mesalamine may also cause impairments in the kidneys, which can include kidney failure. Some people may also be hypersensitive to the medication. Hypersensitivity may cause reactions in the lungs, liver, and other areas of the body.

Other individuals may be intolerant to the medication and may experience:

• abdominal pain
• cramping
• headaches
• fever
• itchy skin
• malaise
• rash

People should speak with a healthcare professional for further information about the potential side effects and risks of mesalamine.

Drug interactions

A person should discuss any other medications they are taking with a doctor before taking mesalamine. Some drugs it can interact with include:

• proton pump inhibitors
• H2 receptor blockers
• heparin
• antacids
• myelosuppressive agents, which reduce bone marrow activity to help control blood cell counts
• cardiac glycosides, which help the heart muscles contract
• nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
• chickenpox vaccine
• thiopurine analogs, such as mercaptopurine, which helps treat cancer

Learn more about drug interactions.

Doctors may recommend several options to help treat UC. There is no cure for UC, so the focus is to reduce symptom severity and prevent flares.

Treatment often consists of medical treatments and dietary adjustments.

A healthcare professional may prescribe medications to help reduce inflammation in the large intestine (colon). These include:

• corticosteroids
• biologics
• immunosuppressants, which are drugs that weaken the immune system to decrease its effects on the body, such as inflammation
• new small molecule medications, such as Janus kinase inhibitors

In some cases, doctors may recommend a person undergoes surgery to remove the colon and rectum and change how the body stores and passes stool.

Learn more about surgery for ulcerative colitis.

Healthcare professionals may also recommend different medical treatments for UC symptoms and complications. These treatments may vary based on a person’s symptoms and risks but may include:

• non-NSAID pain relief medications, such as acetaminophen
• vitamin D and calcium supplements to prevent osteoporosis
• antibiotics, if severe UC or complications lead to an infection
• intravenous fluids and electrolytes to prevent dehydration
• blood transfusions, if a person has severe anemia

There is no specific diet for UC, but experts generally recommend eating a well-balanced diet. A person should also consider keeping a food journal to record the foods they eat and their symptoms. This may help them identify and avoid potentially triggering foods.

Read more about foods to eat and avoid with ulcerative colitis.

A person should talk with a doctor if they experience symptoms that may indicate mesalamine intolerance, such as:

• abdominal pain
• cramping
• itchy skin
• malaise
• headaches
• rash
• fever

People can also report any other side effects of mesalamine they experience to a healthcare professional. Similarly, if UC symptoms persist or worsen, a person should inform their doctor.

A doctor may be able to adjust the mesalamine dose or recommend additional or alternative therapies to help treat a person’s UC symptoms.

Mesalamine is a type of medication doctors use to help treat mild to moderate ulcerative colitis (UC). Scientists do not understand exactly how it works, but similar to other medications for UC, it reduces inflammation in the colon.

Some people who take mesalamine may experience side effects, such as joint pain or fever. A person should talk with a doctor if they develop unusual or severe symptoms while taking mesalamine.

In addition to this medication, a doctor may recommend other treatments to help manage UC symptoms and potential complications, such as other medications and surgical procedures. Healthcare professionals may also recommend a person makes changes to their diet.

People can speak with a doctor if their UC symptoms worsen or do not resolve.