Mesalmin (Mesalazine)

Mesalmin is an aminosalicylate used in the management of inflammatory bowel disease. It helps control intestinal inflammation and maintain remission.

• Ulcerative colitis: reduces mucosal inflammation and promotes remission.
• Crohn's disease: alleviates gastrointestinal inflammation in affected segments.
• Maintenance of remission: helps prevent disease flare‑ups after induction therapy.

• Mesalazine acts locally in the gastrointestinal tract by inhibiting cyclooxygenase and lipoxygenase pathways, which reduces prostaglandin and leukotriene synthesis. It also modulates immune cell activity, decreasing cytokine release and limiting leukocyte infiltration, thereby lowering intestinal inflammation associated with ulcerative colitis and Crohn's disease.

Mesalmin may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Abdominal pain: cramping or discomfort in the abdomen.
• Headache: transient headache episodes.
• Flatulence: increased intestinal gas.
• Rash: mild skin irritation or erythema.
• Altered taste: temporary metallic or bitter taste.

Serious or Rare Side Effects

• Myocarditis: inflammation of the heart muscle.
• Pancreatitis: severe abdominal pain with elevated enzymes.
• Severe allergic reaction: anaphylaxis, angioedema, or urticaria.
• Blood dyscrasias: neutropenia, leukopenia, or thrombocytopenia.
• Hepatic enzyme elevation: signs of liver injury.
• Worsening colitis: paradoxical increase in disease activity.

Before initiating therapy, clinicians should consider several safety aspects.

• Monitor renal function: adjust dose or discontinue if significant impairment occurs.
• Assess hepatic function: use with caution in patients with liver disease.
• Avoid in known hypersensitivity: discontinue immediately if allergic reaction develops.
• Use with caution in pregnancy: limited data, weigh benefits against potential risks.
• Avoid concomitant NSAIDs: increased risk of renal toxicity.
• Store at room temperature: keep in the original pack, protect from moisture and light.

Mesalmin can interact with several medicines, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Azathioprine: increased risk of myelosuppression.
• Methotrexate: additive toxicity, especially to the liver.
• Warfarin: potential alteration of anticoagulant effect.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: reduced hormonal efficacy.
• Sulfasalazine: overlapping gastrointestinal toxicity.
• Corticosteroids: heightened risk of infection and gastrointestinal bleeding.