Mesalazine (5-Amino-salicylic-acid)

Question 1

Class

Answer 1

• Aminosalicylates (5-ASA)

Question 2

Mechanism

Answer 2

• COX Inhibitor -> decrease PG

Question 3

Indications

Answer 3

• Induction and maintenance of remission of ulcerative colitis
• Induction of remission of Crohn’s disease
• Rheumatoid arthritis (Sulfasalazine only, under expert guidance)

Question 4

SE

Answer 4

Common: GI upset (diarrhoea, nausea, vomiting, abdominal pain)

Important: Acute pancreatitis; Blood disorders including agranulocytosis; Lupus erythematosus-like syndrome (sulfasalazine); Renal dysfunction

Question 5

CI

Answer 5

• Elderly, pregnancy and breastfeeding, patients with a history of asthma and those with hepatic or renal impairment (avoid if severe)
• Caution with SULFASALAZINE in patients with G6PD deficiency – observe closely for signs of haemolytic anaemia

Question 6

Monitoring

Answer 6

• Check renal Fn, FBC - Stop aminosalicylate if it is suspected that the patient has developed a blood issue