Mesalamine
Brand Names: Rowasa, Lialda, Pentasa, Apriso, Canasa, Asacol HD
Methodology & AI Transparency ⓘ
Mesalamine Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: Mesalamine extended-release capsules are indicated for the maintenance of remission of ulcerative colitis in adults.
- 2 Real-world patient consensus: 80% patient "Worth It" rating across 9 anonymous logs for Mesalamine (RxNorm 825130).
- 3 Typical cash cost range: Uninsured 30-day outlay compares $27.63 wholesale mail-order against $67.69 retail pharmacy pricing.
- 4 Top reported side effects / signs: Primary clinical safety signals tracked in FAERS for Mesalamine include nausea (11.4%), headache (10%), diarrhea (8.7%).
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Mesalamine Mechanism, CYP450 Pathways & DailyMed Monograph
Mesalamine extended-release capsules are indicated for the maintenance of remission of ulcerative colitis in adults. Mesalamine extended-release capsules are an aminosalicylate indicated for the maintenance of remission of ulcerative colitis in adults. ( 1 )
12.1 Mechanism of Action The mechanism of action of mesalamine (5-ASA) is not fully understood, but appears to be a local anti-inflammatory effect on colonic epithelial cells. Mucosal production of arachidonic acid metabolites, both through the cyclooxygenase pathways, i.e., prostanoids, and through the lipoxygenase pathways, i.e., leukotrienes and hydroxyeicosatetraenoic acids, is increased in patients with ulcerative colitis, and it is possible that 5-ASA diminishes inflammation by blocking production of arachidonic acid metabolites.
Systemic exposure to Mesalamine reflects Estimated 58%–70% oral systemic absorption for Mesalamine absorption kinetics and phase i/ii hepatic conjugation of mesalamine coupled with glomerular and tubular renal excretion, sustaining receptor engagement across a Approximately 9–14 hours terminal plasma half-life for Mesalamine half-life window (peak plasma concentration (tmax) reached 1–3 hours post-dose for mesalamine response profile).
Dosing protocols (500 mg/1 Capsule, Extended Release or .375 g/1 Capsule, Extended Release or 1.2 g/1 Tablet, Delayed Release or 1000 mg/1 Suppository or 4 g/60mL Enema) balance efficacy (80.00% patient satisfaction across 9 logs) against nausea (11.4% of reports), headache (10% of reports), diarrhea (8.7% of reports), with strict avoidance in known or suspected hypersensitivity to salicylates, aminosalicylates, or any component of mesalamine extended-release capsules.; known hypersensitivity to mesalamine or structurally related aminosalicylate compounds.
Avoid overlapping aminosalicylate prescriptions alongside Mesalamine to prevent cumulative receptor toxicity.
Unstandardized herbal extracts may interact pharmacodynamically with Mesalamine maintenance therapy.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- Known or suspected hypersensitivity to salicylates, aminosalicylates, or any component of mesalamine extended-release capsules.
- Known hypersensitivity to Mesalamine or structurally related aminosalicylate compounds
Logged Side-Effect Incidence (9 Reports)
Mesalamine Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Mesalamine)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| Can This Approach Help? Inside the Latest Research on Similar Efficacy of Mesalazine in Adult and Older Adult Ulcerative Colitis We observed similar efficacy of mesalazine in adult and older adult UC patients. Inflammatory bowel diseases • 2025-04-10 • Phase III Randomized Trial | Multi-cohort | 88/100 | PMID 38902993 ↗ |
| Can This Approach Help? Inside the Latest Research on Optimising carotegrast methyl use in ulcerative colitis: patient profiling, Carotegrast methyl appears most effective in patients with moderately active ulcerative colitis with low disease activity, with week 2 and beyond as an appropriate time point for assessing efficacy. Journal of gastroenterology • 2025-12-15 • Phase III Randomized Trial | Multi-cohort | 88/100 | PMID 40982097 ↗ |
Mesalamine Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $0.4196/unit (~$12.59/30u) | Wholesale baseline |
| Mark Cuban Cost Plus Drugs (Mail-Order Generic) | Public Wholesale Price List (NADAC + 15% + pharmacy fee) | $27.63 / mo | Formulary listing ↗ |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $67.69 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 9 Anonymous DotMD Community Micro-Logs | $31.77 / mo | View logs ↓ |
| Sesame Direct Cash-Pay Prescriber Network (Licensed Telehealth Cash Program) | State-licensed clinician review • ~1d mail fulfillment | $29.00 consult | Program details |
| Virtual Psychiatric Medication Management (Licensed Telehealth Cash Program) | State-licensed clinician review • ~1d mail fulfillment | $39.00 consult | Program details |
Mesalamine Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Mesalamine RxNorm Concept ID | 825130 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $0.4196 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $67.69 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $27.63 / mo (Cost Plus Drugs) | Mark Cuban Cost Plus Public API |
| Real-World Patient Consensus | 80.00% Worth It (9 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Mesalamine Patient Community, Cohort Filters & Dosage Logs
Deterministic Mesalamine reference combining NIH RxNorm (825130), Medicaid NADAC ($0.4196/unit), and anonymous cohort outcomes (80% Worth It).
Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.
Filter Mesalamine community threads and patient logs by age, biological sex, dosage, and treatment duration.