Mesalamine adverse effects

Oral sulfasalazine or mesalamine is effective in maintaining remission in patients with more extensive disease.1,26 Lower daily doses (e.g., 2 to 4 g sulfasalazine or 1.6 to 2.4 g mesalamine) may be used for disease maintenance. As with distal UC, oral corticosteroids are not effective for maintaining remission and should be avoided due to the high incidence of adverse effects. 

Oral mesalamine derivatives may impose a lower frequency of adverse effects compared with sulfasalazine. Up to 90% of patients who are intolerant to sulfasalazine will tolerate oral mesalamine derivatives. Olsalazine may cause watery diarrhea in up to 25% of patients. 

Hypersensitivity to balsalazide, mesalamine, or salicylates Adverse effects ... 

Azathioprine and mercaptopurine are effective for long-term treatment of Crohn s disease and ulcerative colitis." These agents are generally reserved for patients who are refractory to steroids, and they may be associated with serious adverse effects such as lymphomas, pancreatitis, or nephrotoxicity. They are usually used in conjunction with mesalamine derivatives and/or steroids, and must be used for long periods of time (from a few weeks up to 6 months) before benefits may be observed." Remission can be prolonged by azathioprine in steroid-dependent patients with ulcerative colitis." Cyclosporine... 

Drug intolerance often limits the usefulness of agents used to treat IBD. Many patients receiving sulfasalazine, mesalamine, corticosteroids, metronidazole, azathioprine, mercaptopurine, or infliximab experience some undesired effects. In some cases, these adverse effects can be significant and require discontinuation of the therapy. Knowledge of the common or important adverse reactions will assist in avoiding or minimizing their effects. 

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