Mesalazine tablets and granules

Sounds like 'me-SAL-a-zeen'

Mesalazine is used to treat bowel conditions such as Crohn's disease and ulcerative colitis. Find out how to take it safely and the possible side effects. Mesalazine is also called Asacol or Pentasa.

Type of medicine Also called
  • Anti-inflammatory (to reduce inflammation in the gut)
  • Asacol tablets 
  • Pentasa tablets
  • Pentasa granules

What is mesalazine?

Mesalazine is used to treat bowel conditions such as ulcerative colitis and Crohn's disease. It works by reducing inflammation in your gut and may lessen symptoms of pain and diarrhoea. It allows the damaged areas to heal and helps to prevent symptoms from flaring up.

Mesalazine tablets and granules are specially designed to release mesalazine in your gut, to treat inflammation. In Aotearoa New Zealand there are different brands of mesalazine tablets and granules.

  • Asacol tablets (400 mg and 800 mg)
  • Pentasa tablets (500 mg)
  • Pentasa granules 1 gram per sachet.

The different brands of tablets are designed differently. Do not change brands without checking with your doctor or pharmacist. If you are changed to a different brand of tablet, let your doctor know if you notice any changes to your symptoms when you change brands.

Note: Mesalazine is also available as suppositories and enemas which are used to treat inflammation in the lower bowel or rectum. Read more about mesalazine suppositories and enemas. 

Dose

  • The dose of mesalazine will be different for different people.
  • Take your dose at the same times each day. If you need to take your tablets in divided doses, space the doses evenly throughout the day.
  • If you forget to take your dose, take it as soon as you remember. But, if it is nearly time for your next dose, take the next dose at the right time. Do not take extra doses to make up for a forgotten dose. If you are not sure what to do, ask your healthcare provider.
  • Always take your mesalazine exactly as your doctor has told you. The pharmacy label will tell you how much mesalazine to take, how often to take it, and any special instructions.
  • Mesalazine will start working straight away but it may take a week or so for your symptoms to improve. It will take a few months for the symptoms to go away completely, as it takes time for the gut to heal.

How to take mesalazine granules

  • Do not crush or chew the granules.
  • Place the granules onto your tongue and wash them down with water or juice. 
  • You can take mesalazine granules with or without food.

How to take mesalazine tablets

Do not break, crush or chew the tablets. 

  • Asacol tablets®: Take before food and swallow the tablets whole with a glass of water (200–250 mLs).
  • Pentasa tablets®: Take with or without food. Swallow the tablets whole with a glass of water (200–250 mLs). If you have trouble swallowing the tablets, you can put them in 50 mL of cold water, stir rapidly and drink straight away.

Take your tablets at the same times each day. If you need to take your tablets in divided doses, space the doses evenly throughout the day.

What are the side effects of mesalazine?

Like all medicines, mesalazine can cause side effects, but not everyone gets them. Often side effects improve as your body gets used to the new medicine. You will need to have blood tests to make sure it is not affecting your blood or kidneys.

Side effects What should I do?
  • Tummy pain
  • Feeling nauseous (sick) or being sick (vomiting)
  • Gas or wind in the tummy or feeling bloated
  • Diarrhoea (runny poo)
  • These are quite common when you first start taking mesalazine, and usually go away with time.
  • Tell your doctor if they bother you.
  • Signs of problems with your liver such as severe tummy pain, yellowing of the eyes and skin, dark urine.
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Signs of an allergic reaction such as skin rash, itching, blisters, peeling skin, swelling of the face, lips, mouth or breathing problems
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Signs of problems with your blood cells such as bruising or bleeding easily, ongoing sore throat, mouth ulcers, dizziness and feeling tired and fever.
  • Tell your doctor immediately or ring Healthline 0800 611 116.
For more information on side effects, see the Medsafe consumer information leaflets below. 

Did you know that you can report a medicine side effect to the Centre for Adverse Reactions Monitoring (CARM)? Report a side effect to a product.

Learn more

The following links have more information on oral mesalazine.

Mesalazine NZ Formulary 
Asacol® Medsafe Consumer Information Sheet, NZ
Asamax 500® Medsafe Consumer Information Sheet, NZ
Pentasa® Medsafe Consumer Information Sheet, NZ

References

Mesalazine NZ Formulary
Asacol® Medsafe, NZ
Asamax 500®  Medsafe, NZ
Pentasa® Medsafe, NZ

Credits: Sandra Ponen, Pharmacist. Reviewed By: Maya Patel, MPharm PGDipClinPharm, Auckland Last reviewed: 27 Jan 2022