Asacol (Mesalamine Delayed‑Release Tablets)
Compared with: Blackmores Conceive Well Gold 28 Tablets + 28 Capsules
Asacol® (Mesalamine delayed‑release) 400 mg tablets deliver targeted 5‑aminosalicylic acid (5‑ASA) to the colon for induction and maintenance of mild to moderate ulcerative colitis. By inhibiting prostaglandin and leukotriene synthesis, Asacol reduces mucosal inflammation and promotes clinical remission with a favorable safety profile.
Mesalamine (5‑Aminosalicylic Acid) – 400 mg per delayed‑release tablet

Other Popular and Common Names
5‑ASA

Mesalazine

Pentasa® (modified formulation)

Salofalk® (alternate brand)

Colazide®
Mesalamine exerts a topical anti‑inflammatory effect on the colonic mucosa by:

Inhibiting cyclooxygenase and lipoxygenase pathways, reducing prostaglandin and leukotriene production.

Scavenging free radicals and reducing oxidative stress.

Modulating cytokine release, including tumor necrosis factor‑α and interleukin‑1.

Delayed‑release coatings ensure release of active drug at pH 7 in the terminal ileum and colon for maximal local effect.
Induction of Remission in mild to moderate ulcerative colitis

Maintenance of Remission in ulcerative colitis to reduce relapse risk

Proctitis and Proctosigmoiditis: Off‑label higher dosing for distal disease
Indication Adult Dose Frequency Duration
Induction of Remission 2.4–4.8 g/day (6–12 tablets) Divided 3 times daily 6–8 weeks or until remission
Maintenance of Remission 2.0–2.4 g/day (5–6 tablets) Divided 2–3 times daily Up to 12 months or longer as directed
Distal Ulcerative Colitis (Proctitis/Proctosigmoiditis) 2.4 g/day in divided doses 3 times daily 4–6 weeks, then taper per response

Administration: Swallow tablets whole; do not crush or chew. Take with food to reduce gastrointestinal discomfort.

Missed Dose: Take as soon as remembered; if near next dose, skip the missed dose—do not double.
Formulation: Delayed‑release oral tablets

Strength: 400 mg mesalamine per tablet

Route: Oral

Legal Status: Prescription Only Medicine

Pregnancy: Category B – Use only if clearly needed; systemic absorption is low.

Breastfeeding: Limited excretion in milk; monitor infant for diarrhea or rash.

Pediatric Use: Safe in children ≥6 years; weight‑based dosing recommended.

Elderly: No dose adjustment; monitor renal function.
Headache

Abdominal pain, nausea

Flatulence, diarrhea

Rash

Serious (rare):

Interstitial nephritis (monitor renal function)

Pancreatitis

Severe hypersensitivity reactions (fever, rash, arthralgia)

Hepatotoxicity (elevated liver enzymes)
Renal Monitoring: Assess serum creatinine at baseline and periodically; discontinue if interstitial nephritis suspected.

Hypersensitivity: Discontinue for severe rash or bronchospasm; cross‑reactivity may occur in sulfasalazine allergy.

Blood Dyscrasias: Monitor complete blood count in long‑term use.

Cardiac: Caution in patients with pre‑existing cardiomyopathy; rare myocarditis has been reported.
Therapeutic Class: Gastrointestinal Anti‑inflammatory

Pharmacologic Class: 5‑Aminosalicylic Acid Derivative

Legal Category: Prescription Only

Azathioprine/6‑Mercaptopurine: May increase myelotoxicity; monitor blood counts.

Methotrexate: Potential additive hepatotoxicity; monitor liver enzymes.

Antacids (high‑dose): May alter tablet dissolution; separate timing by ≥1 hour.

Warfarin: Monitor INR; potential alteration of vitamin K metabolism in the gut.

Clinical Evidence:

A pivotal randomized trial showed mesalamine 4.8 g/day induced remission in 45 % of patients versus 27 % with placebo at 8 weeks (Sandborn et al., Gastroenterology 2000).

Maintenance studies demonstrate mesalamine reduces relapse rates to <30 % at 12 months compared to >60 % with placebo.

FAQs – Asacol® (Mesalamine)
Q1. How long until I feel symptom relief?
A: Abdominal pain and bleeding often improve within 2–4 weeks; full mucosal healing may take up to 8 weeks.

Q2. Can I stop treatment if I feel better?
A: No. Continuing maintenance dosing reduces relapse risk. Consult your physician before changing therapy.

Q3. What monitoring is required?
A: Check renal function at baseline, then every 3–6 months. Monitor CBC and liver enzymes periodically.

Q4. Can I use Asacol® for Crohn’s disease?
A: Not generally. Mesalamine has limited efficacy in Crohn’s; consult a specialist for appropriate therapy.

Q5. Are there alternative formulations?
A: Yes. Other brands and prodrugs include Pentasa® (pH‑dependent release) and Lialda® (once‑daily dosing).

Q6. Is Asacol® safe long term?
A: Yes, with regular monitoring. Long‑term use maintains remission with an acceptable safety profile.

Q7. What if I miss multiple doses?
A: Resume your maintenance dose; discuss any prolonged interruptions with your healthcare provider.
Asacol, Mesalamine, Ulcerative Colitis Treatment, 5‑ASA Delayed Release, Induce Remission Ulcerative Colitis, Maintain Remission UC, Gastrointestinal Anti‑inflammatory, EZ Chemist, Scalp Healing, IBD Management