1.5.1.2 Maintenance of remission of ulcerative colitis

Oral Treatment

ChoiceDrugDosage
Prescribe by brand
1st choiceOctasa® (mesalazine M/R) tablets 400mg, 800mgDose: maintenance of remission of ulcerative colitis, 1.2-2.4g once daily or in divided doses
Doses of up to 4.8g Octasa® M/R daily may be required for some patients [unlicensed]
Or
Pentasa® (mesalazine M/R) Tablets 500mg, 1g; Sachets 1g, 2g, 4gDose: maintenance, 2g once daily; Doses of up to 4g Pentasa® daily may be required for some patients [unlicensed]
Or
Salofalk (mesalazine m/r) granules 500mg,1g, 1.5g, 3g sachets

Standard dose: 500mg three times a day
Patients at increased risk of relapse*: 3g given as a single daily dose preferably in the morning

* increased risk of relapse for medical reasons or due to difficulties with adherence to three daily doses

Prescribing Notes

  • There is no evidence to show that any one oral preparation of mesalazine is more effective than another however, the delivery characteristics of oral mesalazine preparations may vary. If it is necessary to switch a patient to a different brand of mesalazine the patient should be advised to report any changes in symptoms.
  • Pentasa® tablets may be dispersed in water without losing the M/R effect. They should not be chewed.
  • Mesalazine has very little benefit in maintaining remission in Crohn’s disease and therefore is not recommended for use in Crohn’s, except for perhaps Crohn’s colitis.

 

Cautions

  • Aminosalicylates can cause blood disorders; patients should report any unexplained bleeding, bruising, purpura, sore throat, fever or malaise occurring during therapy. A blood count should be performed and the drug stopped immediately if a blood dyscrasia is suspected.
  • Avoid aminosalicylates (mesalazine, olsalazine, sulfasalazine) in patients allergic to aspirin, and those with renal disease.
  • Renal function should be monitored before starting an oral aminosalicylate, at 3 months of treatment and then annually during treatment (more frequently in renal impairment).