What is it?
Asacol is mesalazine in a resin coated designed to release the active ingredient 5-Aminosalicylic acid (5-ASA) in the terminal ileum where the pH is above 7. The active ingrdients are then dispersed throughout the colon.

What is it used for?
Asacol is used in the treatment and maintenance of mild to moderately acute ulcerative colitis and Crohn’s disease

How do I take them?
Asacol is presented in several forms:
• Tablet: to be swallowed whole with plenty of water.
• Suppositories: inserted into the rectum up to 3 times daily, last dose at bedtime.
• Enema: mesalazine foam with disposable applicators and plastic bags. The applicator is inserted into the rectum and the foam is introduced in a metered aerosol.

The above medications will be prescribed according to the site and severity of the inflammation and may be used in combination.

The enemas are used to act directly on inflammation in left-sided disease and suppositories for rectal inflammation. Once the symptoms have been controlled, you will be given a lower maintenance dose. Although you might feel better it is important to continue taking the medication as instructed to prevent the symptoms from coming back.

Are there any precautions?
Asacol should not be taken if you are allergic to aspirin. It is not recommended if the kidneys are not working properly.

Its effect may be reduced by medications, which alter the pH of the intestine e.g. lactulose.

Asacol is safe to use during pregnancy and it is better for both you and your baby that active disease is treated vigorously and effectively. The lowest effective dose will always be used. Low levels of mesalazine have been detected in breast milk, but it is safe to continue.

Are there any side effects?
Asacol is generally well tolerated but, if side effects were to happen, these could include:
• Nausea
• diarrhoea
• Abdominal pain
• Headache

It may also cause a worsening of the colitis in a very few sensitive people. Impairment of kidney function occurs very rarely but everyone on mesalazine should have an annual blood test to check their kidneys.

Side effects tend to be related to the dose and can be minimised by gradually building it up. If side effects continue, the drug should be stopped.

*Important note
If you have any unexplained bleeding, bruising, a sore throat, fever or generally feel unwell whilst taking the medication, you should stop immediately and see your doctor for a blood test and further advice.

You may see what appears to be the tablet in your motions but should be reassured that the active molecules have usually been released, leaving the resin case. If you consistently see the grey powder still contained within the case, it will probably be worth while switching to a different 5-ASA preparation.