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mesalamine (rectal)

Generic Name: mesalamine (rectal) (me SAL a meen)
Brand Name: Canasa, Canasa Pac, Rowasa, sfRowasa

What is mesalamine rectal?

Mesalamine affects a substance in the body that causes inflammation, tissue damage, and diarrhea.

Mesalamine rectal is used to treat ulcerative colitis, proctitis, and proctosigmoiditis.

Mesalamine rectal may also be used for purposes not listed in this medication guide.

What is the most important information I should know about mesalamine rectal?

Call your doctor at once if you have severe stomach pain, cramping, and bloody diarrhea (may occur with fever, headache, and skin rash).

What should I discuss with my health care provider before using mesalamine rectal?

You should not use mesalamine if you are allergic to it.

To make sure mesalamine rectal is safe for you, tell your doctor if you have:

  • asthma or sulfite allergy;

  • kidney disease; or

  • liver disease.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether mesalamine passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

How should I use mesalamine rectal?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Do not take rectal medicine by mouth. It is for use only in your rectum.

For best results, use mesalamine rectal at bedtime. Try to empty your bowel and bladder just before using the medicine.

Wash your hands before and after inserting the rectal suppository.

Remove the wrapper before inserting the suppository. Avoid handling the suppository too long or it will melt in your hands. Lie on your back with your knees up toward your chest. Gently insert the suppository into your rectum about 1 inch, pointed tip first.

For best results, stay lying down for a few minutes. The suppository will melt quickly and you should feel little or no discomfort while holding it in. Avoid using the bathroom for at least an hour after using the suppository.

Shake the rectal enema liquid well just before each use.

To use the enema, lie on your left side with your left leg extended and your right leg slightly bent. Remove the cap from the applicator tip and gently insert the tip into your rectum. Slowly squeeze the bottle to empty the contents into the rectum.

For best results, try to hold in the enema for at least 30 minutes, or all night if possible, to allow the liquid to distribute throughout your intestines. Avoid using the bathroom during this time.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Store at cool room temperature away from moisture and heat.

The rectal enema liquid may darken in color after it has been removed from the foil pouch. This should not affect the medicine. However, throw away any enema liquid that has turned dark brown.

What happens if I miss a dose?

Skip the missed dose and wait until your next bedtime to use the medicine. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using mesalamine rectal?

Avoid getting the rectal suppositories or enema liquid on clothing, flooring, painted surfaces, vinyl, marble, granite, and other surfaces. Mesalamine rectal products may stain surfaces.

Mesalamine rectal side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have severe stomach pain, cramping, and bloody diarrhea (may occur with fever, headache, and skin rash).

Common side effects may include:

  • stomach pain, nausea, gas;

  • fever, cold or flu symptoms;

  • rash; or

  • feeling tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

Mesalamine dosing information

Usual Adult Dose for Ulcerative Colitis -- Active:

ORAL:
250 and 500 mg capsules: 1 g orally 4 times a day
Duration of therapy: Up to 8 weeks

400 mg tablets: 800 mg orally 3 times a day
Duration of therapy: 6 weeks

400 mg delayed release capsules: 800 mg orally 3 times a day
Duration of therapy: 6 weeks

800 mg delayed release tablets: 1600 mg orally 3 times a day
Duration of therapy: 6 weeks

1200 mg tablets: 2.4 to 4.8 g orally once a day with food

Uses: Treatment of mildly to moderately active ulcerative colitis and induction of remission of ulcerative colitis.
---
RECTAL:
Enema: 1 rectal installation (4 gm), once a day, preferably at bedtime

Duration of therapy: 6 weeks

Comments:
-Shake well before use.
-Retain for approximately 8 hours.
-Effects may be seen in 3 to 21 days.
-Therapy usually lasts 3 to 6 weeks, depending on symptoms and sigmoidoscopic findings.

Uses: Treatment of active mild to moderate distal ulcerative colitis, proctosigmoiditis, or proctitis.

Usual Adult Dose for Ulcerative Colitis -- Maintenance:

375 mg extended release capsules: 1.5 g (4 capsules) orally once a day in the morning
400 and 800 mg tablets and capsules: 1.6 g orally daily in divided doses
1200 mg tablets: 2.4 g (2 tablets) orally once a day with food

Comments:
-Do not co-administer 375 mg extended release capsules with antacids.

Use: Maintenance of remission of ulcerative colitis in adults.

Usual Adult Dose for Ulcerative Proctitis:

Suppository:
1 suppository (1000 mg) rectally once a day at bedtime

Duration of therapy: 6 weeks

Comments:
-Retain suppository for 1 to 3 hours or longer, if possible.
-Therapy usually lasts 3 to 6 weeks, depending on symptoms and sigmoidoscopic findings.

Use: Treatment of mild to moderately active ulcerative proctitis.
---
Enema:
1 rectal installation (4 gm), once a day, preferably at bedtime

Duration of therapy: 6 weeks

Comments:
-Retain for approximately 8 hours.
-Effects may be seen in 3 to 21 days.
-Therapy usually lasts 3 to 6 weeks, depending on symptoms and sigmoidoscopic findings.
-Shake well before use.

Uses: Treatment of active mild to moderate proctosigmoiditis or proctitis.

Usual Pediatric Dose for Ulcerative Colitis -- Active:

400 mg tablets or capsules, dosing is weight based:

17 to less than 33 kg: 36 to 71 mg/kg/day, orally, divided into 2 doses a day
Maximum dose: 1.2 g/day

33 to less than 54 kg: 37 to 61 mg/kg/day, orally, divided into 2 doses a day
Maximum dose: 2 g/day

54 to 90 kg: 27 to 44 mg/kg/day, orally, divided into 2 doses a day
Maximum dose: 2.4 gm/day

Duration of therapy: 6 weeks

Use: Treatment of mildly to moderately active ulcerative colitis in patients 5 years of age or older (tablets) or 12 years of age and older (capsules).

What other drugs will affect mesalamine rectal?

Other drugs may interact with mesalamine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about mesalamine rectal.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.01.

Last reviewed: September 11, 2017
Date modified: November 15, 2017

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