Asacol

Asacol is a drug used for treating ulcerative colitis. The exact mechanism of mesalamine is not known but is believed to be by reducing inflammation in the colon. Ulcerative colitis and other inflammatory diseases cause excessive production of chemicals, for example, prostaglandins, that produce inflammation in the colon. Prostaglandins are produced by the enzymes, cyclooxygenase and lipoxygenase. These enzymes are over-active in individuals with ulcerative colitis. Asacol may work by blocking the activity of cyclooxygenase and lipoxygenase, thereby, reducing the production of prostaglandins. Reduced production of prostaglandins decreases inflammation in the colon and the symptoms associated with ulcerative colitis. Available forms of mesalamine differ in their route of administration and how often they are administered.

Asacol is used for the treatment of mild to moderately severe ulcerative colitis. The suppositories are limited to use in ulcerative colitis involving only the rectum (proctitis) and the enemas to colitis involving only the part of the colon close to the rectum (distal colitis) or proctitis. While the benefits of mesalamine can be seen within 3 to 21 days of starting therapy, it may take up to three to six weeks for the enemas and suppositories, 6 weeks for the tablets, and eight weeks for the capsules to have maximum effect.
Oral mesalamine formulations are associated with several drug interactions. Combining mesalamine with drugs that affect kidney function, for example, nonsteroidal antiinflammatory drugs (NSAIDs) or ibuprofen may increase the likelihood of reduced function of the kidneys. Concurrent use of mesalamine and 6-mercaptopurine or azathioprine (Imuran) may increase the likelihood of disorders of the blood cells, particularly reduced numbers of cells. Mesalamine may increase the blood thinning effect of warfarin (Warfarin).

Side Effects:
The most common side effects of mesalamine are headache and flatulence. Hair loss and itching also may occur. Infrequent side effects include increased heart rate, acne, pancreatitis, back pain, fatigue, tremor, ear pain, and blood disorders.
Kidney dysfunction has been associated with mesalamine. Kidney function should be evaluated prior to and periodically during mesalamine therapy.

Asacol may cause an acute intolerance syndrome that resembles a flare of inflammatory bowel disease (Crohn's disease or ulcerative colitis) with cramping, abdominal pain, and bloody diarrhea. Fever, headache, itching, and rash also may occur. Symptoms usually subside once mesalamine is discontinued.

Asacol 100 enemas contain sulfites and should be avoided in persons who are sensitive to sulfites.
Since mesalamine is related to aspirin in structure, individuals who are allergic to aspirin should not take mesalamine.