What is it?

Pentasa is a slow release tablet form of mesalazine containing ethylcellulose coated granules of 5-Aminosalicylic acid which are broken down in the stomach releasing the granules throughout the small and large intestine. Unlike other drugs in the group, it is unaffected by changes in the gut flora, pH of the surroundings or transit time (speed in which a substance takes to pass through the intestines).

What is it used for?

Pentasa is used for the treatment and maintenance of remission in ulcerative colitis and Crohn's disease. Due to its early breakdown in the stomach, it is particularly useful in small bowel Crohn’s disease.

How do I take them?

Pentasa is presented in the following forms:

• Slow release tablets These should be taken with plenty of water and swallowed whole. They can be put into a small amount of water if you have difficulty in swallowing whole tablets. This causes dispersion of the granules but they do not completely dissolve. Alternatively 1g sachets are now available. (Tablets should be stored at room temperature away from direct light).

• Enema These are used to act directly on inflammation affecting the left side of the colon. This is given at bedtime. It has been shown to reach inflammation beyond the splenic flexure in 67% of cases. (Enemas should be stored at room temperature out of direct light and used immediately after opening).

• Suppositories These are used to act directly on inflammation affecting the rectum and sigmoid colon. Taken once daily, after a bowel motion.

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

Once symptoms have been controlled, you will be given a lower maintenance dose. Although you might feel better, you must continue taking the medication as instructed to prevent the symptoms from coming back.

Are there any special precautions?

You should not take Pentasa if you are allergic to aspirin. It is not recommended if the kidneys are not working properly.

Pentasa can be used safely during pregnancy. 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. Negligible amounts may also be detected in breast milk but it is safe to continue.

Are there any side effects?

Because of its slow release form, pentasa has had few reported side effects, the most common of these being:

• Diarrhoea
• Nausea
• Headaches

It may also cause a worsening of the colitis in sensitive people. If side effects occur, the dose can be reduced and gradually built up to tolerance levels. If they continue, the drug should be stopped.

NB: If you have any unexplained bleeding, bruising, sore throat, fever or generally feel unwell taking the medication, you should see your doctor for a blood test and further advice stop who may stop treatment.