Experiences with

Mesalazine

Most adults and children aged 5 years old and older over can take mesalazine. But always check before taking it, as it's not suitable for everyone.

Mesalazine is not suitable for some people. For example, check with your doctor first if you’ve ever had kidney problems or have medicine allergies.

Mesalazine comes in different forms, including tablets and granules. Doses depend on why you need it but check with a doctor, or pack information.

Common side effects of mesalazine include indigestion, stomach pain and diarrhoea. More serious side effects can happen in rare cases.

Who can take mesalazine

Most adults and children aged 5 years old and older over can take mesalazine.

Who may not be able to take or use mesalazine

Although most adults and children aged 5 years old and older over can take mesalazine, it may not be suitable for some people. To make sure it's safe for you, tell a doctor before taking if you:

• have ever had an allergic reaction to mesalazine, aspirin, or any other medicines like it, such as methylsalicylate or choline salicylate
• have ever had an allergic reaction to any other medicine
• have ever had kidney problems while taking other medicines such as sulfasalazine
• have ever developed a severe skin rash, skin peeling, blistering or mouth sores after using mesalazine
• have problems with your kidneys or liver
• are trying to get pregnant, already pregnant, or breastfeeding

How to take mesalazine

You’ll either take mesalazine tablets or granules once a day, or as 2 or 3 smaller doses throughout the day.

Swallow the tablets whole with a drink of water. Do not break, chew or crush them. This is because some tablets have a special coating to protect the medicine from the acids in your stomach.

For granules, open the sachet and tip the granules onto your tongue. Swallow them whole with a drink of water or squash. Do not chew them, as some granules have a special coating.

Drink plenty of fluids when taking this medicine to help prevent dehydration and possible kidney problems. You can take some brands with food. Check the leaflet that comes with your medicine.

If you're also taking indigestion medicines or remedies, leave a 2-hour gap before and after taking mesalazine. Indigestion treatments can affect how well the medicine works.

Suppositories

Your doctor or pharmacist will tell you how many mesalazine suppositories to use each day. You can use some brands once a day before you go to bed, and use other brands several times a day with the last dose before you go to bed.

To use a suppository:

1. Wash your hands before using the suppository. Also clean around your bottom (anus) with mild soap and water, rinse and pat dry.
2. Unwrap the suppository.
3. Gently push the suppository into your anus with the pointed end first.
4. Sit or lie down. It should be left in place for as long as possible, so inserting it before going to sleep helps. The suppository will start to soften, as it melts with your body heat. This is normal.
5. Wash your hands again.

If the suppository comes out within 10 minutes of putting it in, you can insert another one.

Try not to do a poo for at least an hour after using a suppository. This gives the medicine time to work.

Enemas

There are 2 types of mesalazine enema with slightly different ways to use them. Read the instructions that come with your medicine before you start.

You’ll usually use mesalazine enemas once a day before you go to bed.

Before you use an enema:

1. Try to do a poo. The medicine works best when your bowels are empty.
2. Wash your hands.
3. Lie on your side, with your bottom slightly higher than the rest of your body. You can use a pillow to lift your bottom up. You may want to lie on a towel.
4. Put one of the disposable plastic bags provided over your hand (like a glove) and pick up the bottle.
5. Shake the bottle well.
6. Break the seal on the nozzle, or remove the protective cap.
7. Gently push the nozzle into your bottom (anus) as far as is comfortable.
8. Squeeze the bottle steadily to allow the liquid to empty into your anus quite quickly. This should take no more than 30 to 40 seconds. It's normal for some liquid to be left in the bottle afterwards.
9. Remove the nozzle from your bottom.
10. Peel the disposable plastic bag off your hand and use it to cover the bottle, ready to throw away.
11. Lie on your side This will stop any liquid coming out of your bottom.
12. Wash your hands.
13. For sleeping, find a comfortable position that keeps the liquid in your bottom for as long as possible. The longer it stays there, the better it will
14. work.

Rectal foam

You’ll usually use mesalazine rectal foam once a day before you go to bed. The dose is 2 full applicators.

Read the instruction leaflet first. The pictures show you exactly how to use the foam.

To use rectal foam:

1. If you need to do a poo, do it before using the rectal foam. This is because the medicine works best when your bowels are empty.
2. Wash your hands.
3. Remove the plastic flap (or safety lock) from underneath the dome-shaped pump at the top of the can, if you’re using it for the first time.
4. Push a new applicator onto the nozzle. This nozzle sticks out beneath the dome at the top of the can.
5. Shake the can for about 20 seconds.
6. There is a rounded gap at the base of the dome. Twist the dome until the gap lines up with the nozzle.
7. Put your finger on top of the dome and turn the can upside down. The spray will only work properly if you hold the can with the dome pointing straight down.
8. Either stand with one leg raised and resting on a chair, or lie down on your side with your lower leg stretched out and upper leg bent.
9. Gently put the tip of the applicator into your bottom (anus) as far as possible. You may want to use a lubricating jelly on the tip of the applicator.
10. Push the dome down. This fills the applicator with a dose of foam.
11. Release the dome very slowly, to push the foam out.
12. Wait 10 to 15 seconds and then slowly remove the applicator from your bottom. Do this slowly to prevent the foam coming out.

Remove the applicator from the nozzle. Put it in the plastic bag provided and throw the bag away (with your normal household rubbish).

After using the foam, try not to poo until the next morning. For the medicine to work properly it needs to stay inside your bowel as long as possible.

Common side effects of mesalazine

Side effects of mesalazine can vary depending on the type (such as tablets or granules), and the size of your dose. Check the leaflet that comes with your medicine before taking or using.

These common side effects happen in more than 1 in 100 people. There are things you can do to help cope with them:

Speak to a doctor or pharmacist if this advice on how to cope does not help and a side effect is still bothering you or does not go away.

Mesalazine and pregnancy

If you’re already taking mesalazine, you can continue to take it during pregnancy. It’s important to make sure that your inflammatory bowel disease (IBD) is well controlled. There's no evidence that taking mesalazine in pregnancy harms your baby.

If you become pregnant while taking mesalazine, speak to your doctor. Do not stop taking your medicine unless your doctor tells you to.

Your doctor can explain the risks and benefits of taking mesalazine and will help you choose the best treatment for you and your baby.

Mesalazine and breastfeeding

If your baby is healthy, then it's usually OK to take or use mesalazine while breastfeeding, but talk to your doctor first.

The small amounts of mesalazine that pass into breast milk should not cause any side effects in your baby. Many people have taken mesalazine while breastfeeding without any problems, although there have been some rare cases of diarrhoea in babies.

It's very rare for breastfed babies to have side effects from medicines you're taking. But it's important to keep monitoring your baby if you're taking any medicine while breastfeeding

Contact your healthcare professional or call 111 as soon as possible if you notice your baby is:

• not feeding as well as usual
• has diarrhoea
• is being sick (vomiting)
• has a rash
• is being irritable

If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.

Carry on taking the medicine, and keep breastfeeding as usual until you've got advice about your baby's symptoms

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