||Asacol, Canasa, Rowasa
How It Works
These medicines may relieve symptoms and
inflammation in the intestines and help IBD go into
remission (a period without symptoms). They also may
help prevent the disease from becoming active again.
Why It Is Used
Aminosalicylates usually are the
first medicines used to treat
inflammatory bowel disease (IBD). These medicines have
been used to treat IBD for more than 30 years.
- Oral and topical aminosalicylates are used to
treat mild to moderate
ulcerative colitis. They also are used to help keep
the disease in remission.
- Oral aminosalicylates are used to treat
mild to moderate extensive disease (pancolitis).
(Canasa, Rowasa) is placed in the rectum as a retention enema or suppository.
Enemas are useful if the disease affects only the lower third of the
large intestine . Suppositories may be used if the disease affects only the
lower rectum (proctitis).
How Well It Works
These medicines are effective for
mild to moderate ulcerative colitis and mild Crohn's disease. Their use depends
on the type of medicine (oral or topical) and whether it treats disease that is
active or in remission.
Treatment for mild to moderate ulcerative
colitis often begins with sulfasalazine. Sulfasalazine works
40% to 80% of the time to make ulcerative colitis symptoms better or keep them
from coming back.1 But it cannot be used by people who
are allergic to or cannot tolerate sulfa drugs.
Mesalamine, olsalazine, and balsalazide do not contain sulfa. So they may be used to treat mild to moderate ulcerative colitis if you cannot
Mesalamine enemas are effective in treating
symptoms of mild to moderate distal (left-sided) ulcerative colitis and in
maintaining remission.1 Mesalamine suppositories are preferred for people who
have proctitis. The combination of
a mesalamine pill (oral) and a mesalamine enema, foam, or suppository (topical)
works better to treat left-sided colitis than either oral or topical mesalamine
These medicines can be used to maintain remission in ulcerative colitis.
Aminosalicylates do not seem to keep symptoms
from coming back when a person is in remission caused by drugs (like
corticosteroids). But aminosalicylates sometimes keep symptoms from coming back
in people who have had surgery.2 Some people are allergic to sulfa drugs and cannot take
Mesalamine has been shown to stop the symptoms of
Crohn's disease in some people. Studies show that about 45% to 55% of people
treated with mesalamine go into
remission (a period without symptoms).3
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
Call your doctor right away if you have:
Call your doctor right away if you have:
- Severe belly pain or cramps.
- Bloody diarrhea.
- Itching or a rash.
- A severe headache.
Common side effects of aminosalicylates include:
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
What To Think About
Sulfasalazine can make your skin more sensitive to the sun.
- Stay out of the sun, if possible.
- Wear long pants, long-sleeved shirts, and hats, if possible.
- Use sunscreen with an SPF that your doctor recommends.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Friedman S, Lichtenstein GR (2006). Ulcerative colitis. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 803–817. Philadelphia: Saunders Elsevier.
Akobeng AK, Gardener E (2005). Oral 5-aminosalicylic
acid for maintenance of medically-induced remission in Crohn's disease.
Cochrane Database of Systematic Reviews (1). Oxford:
Friedman S, Lichtenstein GR (2006). Crohn's disease. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 785–801. Philadelphia: Saunders Elsevier.
Primary Medical Reviewer
||E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
||Arvydas D. Vanagunas, MD - Gastroenterology
Current as of
||October 8, 2012