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Mesalamine is used to treat an inflammatory bowel condition called ulcerative colitis. Common side effects include headache, nausea, stomach pain, diarrhea, or infection in the nose or throat. Rarely, mesalamine can cause kidney stones. It is important to drink plenty of liquid while taking mesalamine to reduce this risk. 

Uses

What is mesalamine used for?

Mesalamine is commonly used to treat an inflammatory bowel condition called ulcerative colitis that affects your large intestine.

Mesalamine may also be used for other conditions as determined by your health care provider.

How does mesalamine work (mechanism of action)?

Mesalamine may work by blocking certain natural substances in your large intestine, which reduces inflammation.

How is mesalamine supplied (dosage forms)?

Brands and other names

  • Apriso
  • Delzicol
  • Lialda
  • Pentasa

Dosage forms and strengths

  • 400 mg delayed-release oral capsules
  • 250 mg, 375 mg, 500 mg extended-release oral capsules
  • 800 mg, 1,200 mg delayed-release oral tablets

See also: Mesalamine rectal

How should I store mesalamine?

Mesalamine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect mesalamine from moisture.

Side Effects

What are the most common side effects of mesalamine?

The most common side effects of mesalamine are listed below. Side effects can vary based on your age and on the specific mesalamine product. Tell your health care provider if you have any of these side effects that bother you.

  • Headache
  • Nausea
  • Stomach pain
  • Diarrhea
  • Infection in the nose or throat, sore throat, or common cold symptoms

There may be other side effects of mesalamine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of mesalamine?

While less common, the most serious side effects of mesalamine are described below, along with what to do if they happen.

Severe Allergic Reactions. Mesalamine may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Shortness of breath, trouble swallowing, or throat tightness
  • Swelling in your feet, ankles, or legs
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored pee
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Mesalamine can cause severe skin reactions, called Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP), that can lead to death if not treated. If you develop a rash, stop mesalamine and call your health care provider right away. Get emergency help if you have any of the following symptoms.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Inflammation of the Heart Muscle. Myocarditis is when your heart muscle becomes inflamed or irritated. This can affect how well your heart pumps blood. Mesalamine can cause the immune system to cause more inflammation around the heart muscle. Contact your health care right away if you have chest pain, shortness of breath, or trouble breathing.

Kidney Problems. Mesalamine can cause swelling of a small part of your kidneys’ filters, called the tubules. This condition, known as tubulointerstitial nephritis (TIN), can cause your kidneys to not work as well as they should. Stop taking mesalamine and call your health care provider right away if you have any of the following symptoms of TIN. 

  • Increased or decreased amount of urine (pee)
  • Nausea or vomiting
  • Fever
  • Rash
  • High blood pressure
  • Irregular mood swings
  • Confusion or drowsiness
  • Swelling throughout your body or weight gain

Kidney Stones. Mesalamine may cause kidney stones. Drinking plenty of water can help prevent kidney stones. Tell your health care provider right away if you develop severe pain in your side or back or have blood in your urine (pee). Your pee may look pink, red, or brown.

Worsening of Ulcerative Colitis Symptoms. Mesalamine can cause worsening of ulcerative colitis symptoms. This happens when you develop a reaction to mesalamine. It may be difficult to tell if your symptoms are caused by ulcerative colitis or taking mesalamine. Tell your health care provider right away if you have any of the following symptoms or if they get worse while you are taking mesalamine.

  • Stomach cramps or pain
  • Bloody diarrhea
  • Fever
  • Headache
  • General feeling of being unwell, tired, or not having your usual energy
  • Skin itching or rash
  • Pink eye (conjunctivitis) 

Warnings & Precautions

Who should not use mesalamine?

Allergies to Ingredients. People who are allergic to any of the following should not take mesalamine.

  • Apriso
  • Delzicol
  • Lialda
  • Mesalamine
  • Pentasa
  • Any other medicine known as an aminosalicylate or a salicylate
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific mesalamine products they stock.

What should I know about mesalamine before using it?

Do not take mesalamine unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share mesalamine with other people, even if they have the same condition as you. It may harm them.

Keep mesalamine out of the reach of children.

Do not chew, cut, or crush mesalamine. Some mesalamine capsules can be opened, and the contents sprinkled onto applesauce or yogurt. Some mesalamine products need to be taken with food. Some need to be taken on an empty stomach. Follow any instructions given to you with your prescription. Ask your health care provider if you are unsure how to take your mesalamine.

Make sure to drink enough liquids while taking mesalamine. This can help prevent kidney stones. See the Side Effects section for more details. 

Sometimes you may see parts of a mesalamine tablet or capsule in your stool (poop). Tell your health care provider if this happens often.

Some mesalamine products may need to be separated from antacids. If you need to take antacids, talk to your health care provider about how to do so to limit any problems.

Mesalamine may cause your urine (pee) to turn reddish-brown if it comes into contact with bleach, such as in some toilet water. Tell your health care provider if your urine is reddish-brown when it leaves your body (before it touches the toilet water).

Mesalamine can make your skin more sensitive to light from the sun, sunlamps, and tanning beds. This is called photosensitivity. Exposure to this light can cause severe sunburns, blisters, and swelling. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin.

People who are 65 and older can be at greater risk for some side effects from mesalamine. Talk to your health care provider about your risks if you are in this age group. Keep all of your appointments for follow up with your health care provider, labs, or other testing. 

What should I tell my health care provider before using mesalamine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if mesalamine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Other Medicines and Supplements. Mesalamine may interact with other medicines and supplements. Before taking mesalamine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how mesalamine could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant.

Breastfeeding. Mesalamine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should take mesalamine while breastfeeding. If you breastfeed while taking mesalamine, watch for diarrhea in your infant.

Interactions

Does mesalamine interact with foods or drinks?

There are no known interactions between mesalamine and foods or drinks.

It is unknown if drinking alcohol will affect mesalamine.

Does mesalamine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking mesalamine.

  • Iron or any medicine that has iron in it
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
  • Azathioprine (Azasan), which is a medicine that suppresses your immune system
  • 6-mercaptopurine, which is a medicine to treat certain cancers

This may not be a complete list of medicines that can interact with mesalamine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much mesalamine?

If you or someone else has used too much mesalamine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of mesalamine?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.