How and when to take mesalazine - Brand names: Asacol, Mezavant, Octasa, Pentasa, Salofalk, Zintasa

Dosage

Always follow the instructions from a pharmacist, doctor or on the leaflet that comes with your medicine.

Your dose of mesalazine will depend on why you need it, and the brand you’re using. It also depends on whether you're taking it for a short or long time.

Once your symptoms start to get better, it's likely that your dose will be reduced. This lower dose is sometimes called a maintenance dose. If your symptoms return, your doctor may increase your dose again.

Your child's dose may be lower. Doctors usually prescribe child doses based on their weight.

How to take mesalazine

Tablets and granules

You’ll either take mesalazine tablets or granules once a day, or as 2 or 3 smaller doses throughout the day.

Swallow the tablets whole with a drink of water. Do not break, chew or crush them. This is because some tablets have a special coating to protect the medicine from the acids in your stomach.

For granules, open the sachet and tip the granules onto your tongue. Swallow them whole with a drink of water or squash. Do not chew them, as some granules have a special coating.

Drink plenty of fluids when taking this medicine to help prevent dehydration and possible kidney problems. You can take some brands with food. Check the leaflet that comes with your medicine.

If you're also taking indigestion medicines or remedies, leave a 2-hour gap before and after taking mesalazine. Indigestion treatments can affect how well the medicine works.

Suppositories

Your doctor or pharmacist will tell you how many mesalazine suppositories to use each day. You can use some brands once a day before you go to bed, and use other brands several times a day with the last dose before you go to bed.

To use a suppository:

1. Wash your hands before using the suppository. Also clean around your bottom (anus) with mild soap and water, rinse and pat dry.
2. Unwrap the suppository.
3. Gently push the suppository into your anus with the pointed end first.
4. Sit or lie down. It should be left in place for as long as possible, so inserting it before going to sleep helps. The suppository will start to soften, as it melts with your body heat. This is normal.
5. Wash your hands again.

If the suppository comes out within 10 minutes of putting it in, you can insert another one.

Try not to do a poo for at least an hour after using a suppository. This gives the medicine time to work.

Enemas

There are 2 types of mesalazine enema with slightly different ways to use them. Read the instructions that come with your medicine before you start.

You’ll usually use mesalazine enemas once a day before you go to bed.

Before you use an enema:

1. Try to do a poo. The medicine works best when your bowels are empty.
2. Wash your hands.
3. Lie on your side, with your bottom slightly higher than the rest of your body. You can use a pillow to lift your bottom up. You may want to lie on a towel.
4. Put one of the disposable plastic bags provided over your hand (like a glove) and pick up the bottle.
5. Shake the bottle well.
6. Break the seal on the nozzle, or remove the protective cap.
7. Gently push the nozzle into your bottom (anus) as far as is comfortable.
8. Squeeze the bottle steadily to allow the liquid to empty into your anus quite quickly. This should take no more than 30 to 40 seconds. It's normal for some liquid to be left in the bottle afterwards.
9. Remove the nozzle from your bottom.
10. Peel the disposable plastic bag off your hand and use it to cover the bottle, ready to throw away.
11. Lie on your side This will stop any liquid coming out of your bottom.
12. Wash your hands.
13. For sleeping, find a comfortable position that keeps the liquid in your bottom for as long as possible. The longer it stays there, the better it will
14. work.

Rectal foam

You’ll usually use mesalazine rectal foam once a day before you go to bed. The dose is 2 full applicators.

Read the instruction leaflet first. The pictures show you exactly how to use the foam.

To use rectal foam:

1. If you need to do a poo, do it before using the rectal foam. This is because the medicine works best when your bowels are empty.
2. Wash your hands.
3. Remove the plastic flap (or safety lock) from underneath the dome-shaped pump at the top of the can, if you’re using it for the first time.
4. Push a new applicator onto the nozzle. This nozzle sticks out beneath the dome at the top of the can.
5. Shake the can for about 20 seconds.
6. There is a rounded gap at the base of the dome. Twist the dome until the gap lines up with the nozzle.
7. Put your finger on top of the dome and turn the can upside down. The spray will only work properly if you hold the can with the dome pointing straight down.
8. Either stand with one leg raised and resting on a chair, or lie down on your side with your lower leg stretched out and upper leg bent.
9. Gently put the tip of the applicator into your bottom (anus) as far as possible. You may want to use a lubricating jelly on the tip of the applicator.
10. Push the dome down. This fills the applicator with a dose of foam.
11. Release the dome very slowly, to push the foam out.
12. Wait 10 to 15 seconds and then slowly remove the applicator from your bottom. Do this slowly to prevent the foam coming out.

Remove the applicator from the nozzle. Put it in the plastic bag provided and throw the bag away (with your normal household rubbish).

After using the foam, try not to poo until the next morning. For the medicine to work properly it needs to stay inside your bowel as long as possible.

How long to take it for

If you’re having a flare up, your doctor may prescribe you a higher dose of mesalazine for a short time. This should help control your symptoms.

You can also take it long term to keep inflammation under control and prevent symptoms from flaring up again. How long you use it for will depend on your condition and how severe it is.

Do not stop using mesalazine unless your doctor tells you to.

If you forget to take it

If you miss a dose of mesalazine, take or use it as soon as you remember, unless it's almost time for your next dose. In this case, skip the missed one and take the next dose at the usual time.

Do not take or use 2 doses together to make up for a forgotten dose.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking up to 1 extra dose of mesalazine is unlikely to cause problems.