Aminosalicylates (Formulary)

TAM (Treatments and Medicines) NHS Highland
NHS Highland
  • Note Blood disorders: advise patients receiving an aminosalicylate to report any unexplained bleeding, bruising, purpura, sore throat, fever or malaise that occurs during treatment. Perform a blood count and stop the drug immediately if a blood dyscrasia is suspected.
  • Check U&Es and renal function 2 weeks after starting therapy due to the risk of nephritis.
  • Aminosalicylates are ineffective in Crohn’s disease.
  • The delivery characteristics of enteric-coated mesalazine preparations vary widely. Specify the brand to be dispensed and continue patients on the same brand. Pentasa® is the preferred mesalazine m/r preparation.

MESALAZINE - (First line)

Therapy notes

Monitor in accordance with DMARD Monitoring.

Formulation and dosage details

Formulation:

Modified release tablets (Pentasa®) 500mg, 1 gram

Dosage:

By mouth, 1 to 2 grams twice daily or 4 grams once daily, reducing to maintenance dose depending on response.

Formulation and dosage details

Formulation:

Modified release granules (Pentasa®) 1 gram/sachet, 2 grams/sachet, 4 grams/sachet

Dosage:

By mouth, 1 to 2 grams twice daily or 4 grams once daily, reducing to maintenance dose depending on response.

Formulation and dosage details

Formulation:

Suppositories (Pentasa®) 1 gram

Dosage:

By rectum, suppositories, ulcerative proctitis, acute attack, 1 gram daily for 2 to 4 weeks; maintenance, 1 gram daily.

Formulation and dosage details

Formulation:

Retention enema  (Pentasa®) 1 gram/100mL

Dosage:

By rectum, one enema at bedtime.

Formulation and dosage details

Formulation:

Modified release tablets (Octasa®) 400mg, 800mg

Dosage:

By mouth, 800mg 3 times daily or 2·4 grams once daily, reducing depending on response, to as low as 400mg twice daily or 800mg once daily. 

OLSALAZINE

Therapy notes

Monitor in accordance with DMARD monitoring.

Formulation and dosage details

Formulation:

Tablets 500mg

Dosage:

By mouth, acute attack, 500mg twice daily after meals increased if necessary over 1 week to maximum 1 gram 3 times daily. Maintenance dose, 500mg twice daily after meals. May be useful in distal colitis complicated by constipation.

SULFASALAZINE

Therapy notes

MHRA advice: Drug-name confusion: reminder to be vigilant for potential errors (January 2018) (www.gov.uk)

  • Sulfasalazine may cause staining of soft contact lenses and may colour urine.
  • Both standard and enteric-coated formulations are licensed in inflammatory bowel disease but only the enteric-coated version is licensed in  rheumatoid arthritis.
  • Sulfasalazine is useful for enteropathic arthritis with colitis. 
  • Monitor in accordance with DMARD monitoring.

Formulation and dosage details

Formulation:

Enteric coated tablets 500mg

Dosage:

By mouth, Acute attack, 3 grams daily in divided doses, reducing to a maintenance dose of 2 grams daily in divided doses.

Formulation and dosage details

Formulation:

Tablets 500mg

Dosage:

By mouth, Acute attack, 3 grams daily in divided doses, reducing to a maintenance dose of 2 grams daily in divided doses.

Formulation and dosage details

Formulation:

Suspension 250mg/5mL

Dosage:

By mouth, Acute attack, 3 grams daily in divided doses, reducing to a maintenance dose of 2 grams daily in divided doses.

Editorial Information

Document Id: F225