Mesalamine DR
LIALDA
Pronunciation: me-SAL-a-meen
What it isPPAR-gamma agonist and 5-lipoxygenase inhibitor acting locally in bowel; ulcerative colitis induction and maintenance.
Why this oneIts multimatrix delayed release spreads mesalamine through the colon, and products are not freely interchangeable.
What limits itCheck renal function for interstitial nephritis; paradoxical acute intolerance causes worse pain, diarrhea, and bleeding.
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Ulcerative colitis — induction of remission | Adults | 2.4–4.8 g (two to four 1.2 g tablets) once daily | 4.8 g/day | |
| Ulcerative colitis — maintenance of remission | Adults | 2.4 g once daily | ||
| Ulcerative colitis (mildly-to-moderately active) — treatment | Pediatric ≥24 kg | 24–35 kg: 2.4 g→1.2 g QD; >35–50 kg: 3.6 g→2.4 g QD; >50 kg: 4.8 g→2.4 g QD (week 0–8, then after week 8) | 4.8 g/day |
Renal Substantially renally excreted; evaluate renal function before and periodically during therapy; discontinue if it deteriorates.
Hepatic Evaluate risks and benefits in patients with known liver impairment.
Instructions
- Swallow tablets whole; do not split or crush
- Take with food
- Drink an adequate amount of fluids
- Evaluate renal function prior to initiation
Available strengths
- DR tab 800, 1200 mg
- cap 250, 500 mg
- DR cap 400 mg
- ER cap 250, 375, 500 mg
- susp 4 g/60 mL
- enema 4 g/60 mL
- supp 1000 mg
Contraindications
- Hypersensitivity to salicylates or aminosalicylates
Cautions
- Renal impairment/renal failure
- Mesalamine-induced acute intolerance syndrome
- Hypersensitivity reactions (incl. myocarditis/pericarditis)
- Hepatic failure
- Severe cutaneous adverse reactions
- Upper GI tract obstruction
- Nephrolithiasis
Adverse reactions
- Headache
- Flatulence
- Abnormal liver function tests
- Abdominal pain
- Diarrhea
Pregnancy No reliably established association with major birth defects or miscarriage.
Lactation Undefined.
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 800 mg | DR tab | 30 qd | $120.61 | offered |
| 1200 mg | DR tab | 30 qd | $23.43 | offered |
Other forms: Mesalamine (PENTASA)
NO BOXED WARNINGS
Principal riskRenal impairment; acute intolerance syndrome