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Mesalamine vs Pentasa
Introduction
For patients dealing with inflammatory bowel diseases, such as ulcerative colitis, certain medications can help in reducing inflammation and managing symptoms. Mesalamine and Pentasa are two such drugs that are commonly prescribed for this condition. They both work by targeting the substances in the body that cause inflammation, tissue damage, and diarrhea. However, they differ slightly on how they deliver medication to different parts of the gastrointestinal tract.
Mesalamine is an aminosalicylate anti-inflammatory drug designed to affect areas throughout your colon. On the other hand, Pentasa is essentially a brand name for mesalamine but formulated differently enabling it to target not just the colon but also higher up into the small intestines where Crohn's disease primarily affects.
It should be noted though that while these drugs do have positive effects on controlling symptoms of inflammatory bowel diseases like ulcerative colitis or Crohn's disease, potential side effects may include abdominal pain, cramping or nausea which should be discussed with your healthcare provider.
Mesalamine vs Pentasa Side By Side
| Attribute | Mesalamine | Pentasa |
|---|---|---|
| Brand Name | Mesalamine | Pentasa |
| Contraindications | Allergy to aspirin or kidney disease. Certain NSAIDs require a 2-week clearance period to prevent dangerous interactions. | Allergy to aspirin or kidney disease. Certain NSAIDs require a 2-week clearance period to prevent dangerous interactions. |
| Cost | For brand-name, around $700 for 120 tablets of 500 mg. Generic versions start from as low as $.70 per day up to about $2.00 per day. | For brand-name, approximately $190 for 30 capsules of 250 mg. No generic version available, hence prices remain high. |
| Generic Name | Mesalamine | Mesalamine |
| Most Serious Side Effect | Severe stomach or abdominal pain, bloody diarrhea, chest pain or breathlessness, allergic reactions, changes in vision, unusual bleeding or bruising under skin. | Signs of an allergic reaction, unusual bleeding or bruising under the skin, severe stomach pain or cramping, bloody diarrhea, fever, sore throat and headache with a severe blistering rash, pale skin, feeling light-headed or short of breath, rapid heart rate, liver problems. |
| Severe Drug Interactions | Not specified in the article, but typically involves interactions with NSAIDs and other drugs affecting kidney function. | Not specified in the article, but typically involves interactions with NSAIDs and other drugs affecting kidney function. |
| Typical Dose | Oral dosages range from 1.2–4.8 g/day for adults. Maximum dosage should not exceed 4.8 g/day. | Typically initiated with a dosage of 1 g/day for mild to moderate active ulcerative colitis, can be increased to 2-4 g/day. Maximum dose is 4g/day. |
What is Mesalamine?
Mesalamine (also known as 5-aminosalicylic acid or 5-ASA) was a significant advancement in the treatment of inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease. This drug works by reducing inflammation in the intestines which can lead to symptoms like diarrhea and abdominal pain. It was first approved by the FDA in the late '80s under various brand names, including Asacol and Lialda.
Pentasa is one specific formulation of mesalamine. What sets Pentasa apart from other formulations of mesalamine is its unique delivery system; it has a multi-matrix system that allows for gradual release throughout different parts of your digestive tract. This makes it particularly useful for treating inflammation that occurs not just in the lower part of your colon but also your small intestine.
Both drugs have similar side effects, which are generally mild and include headache, nausea, rash or itching skin. However, they may cause kidney problems in rare cases.
What conditions is Mesalamine approved to treat?
Mesalamine is approved for the treatment of various forms of inflammatory bowel diseases:
- Ulcerative colitis, including mild to moderate active ulcerative colitis and as maintenance therapy in remission
- Crohn's disease, particularly for preventing flare-ups and maintaining remission
Pentasa, which also contains mesalamine as its main ingredient, has similar indications but is specifically designed with a special delivery system to target areas affected by Crohn’s disease.
How does Mesalamine help with these illnesses?
Mesalamine assists in managing inflammatory bowel diseases such as ulcerative colitis by reducing inflammation in the colon and rectum. It acts locally in the gut, inhibiting the production of prostaglandins and leukotrienes, two key chemicals involved in inflammation. By doing so, it helps to maintain higher levels of these substances for extended periods of time. Prostaglandins and leukotrienes are like neurotransmitters for the immune system; they act as messengers that play crucial roles not just in inflammation but also pain perception, swelling, fever response among other things. In conditions like ulcerative colitis where there is an excessive inflammatory reaction inside the intestines, decreasing their levels with mesalamine can help control symptoms and bring about remission.
Pentasa is actually a brand name for mesalamine, designed to deliver medication throughout the entire length of the intestine. The drug is encased within microgranules which slowly release it as they travel through your digestive tract - this ensures that all parts affected by disease receive treatment.
What is Pentasa?
Pentasa is a brand name for mesalamine, which is an anti-inflammatory medicine used to treat ulcerative colitis and other inflammatory bowel conditions. The drug works by inhibiting the action of cyclooxygenase and lipoxygenase enzymes, thus reducing the production of pro-inflammatory eicosanoids. Pentasa was first approved by the FDA in 1987.
Unlike some other forms of mesalamine, Pentasa is designed to work throughout the entire length of the colon. It has a special coating that allows it to dissolve slowly as it moves through your digestive tract. Its lack of selectivity means its side-effect profile may vary compared to other similar drugs like Asacol or Lialda (other brands of mesalamine).
The effects on inflammation can be beneficial for managing symptoms in patients suffering from Inflammatory Bowel Disease (IBD), especially those who do not respond well to standard treatment options.
What conditions is Pentasa approved to treat?
Pentasa, a brand name for Mesalamine, is approved by the FDA to manage and treat:
- Ulcerative colitis (UC), an inflammatory bowel disease that causes long-lasting inflammation and ulcers in your digestive tract.
- Crohn's disease - although it's not officially approved for this use, some doctors may prescribe it off-label.
How does Pentasa help with these illnesses?
Pentasa, whose active ingredient is mesalamine, acts as an anti-inflammatory agent in the body and plays a crucial role in managing symptoms of inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. It works by releasing mesalamine throughout the entire length of the colon, thereby reducing inflammation, which alleviates some symptoms for patients. Its action on prostaglandins and leukotrienes may also play roles in Pentasa's effectiveness at treating these conditions. Because it directly targets the inflamed tissue without significant systemic effects, it can be preferred when a patient does not respond well to other treatments or has severe side-effects from systemic drugs like corticosteroids or immunosuppressants.
How effective are both Mesalamine and Pentasa?
Both mesalamine and Pentasa (a brand of mesalamine) have a long-standing history in the effective management of inflammatory bowel diseases, particularly ulcerative colitis. They were both approved by the FDA in close succession and since they are essentially the same drug, they are prescribed under similar circumstances. The effectiveness of mesalamine and Pentasa in alleviating symptoms associated with inflammatory bowel disease was directly studied; both drugs exhibited similar efficacy as well as promising safety profiles.
A review demonstrated that mesalamine is effective from early on during treatment for managing symptoms related to ulcerative colitis, including abdominal pain and diarrhea. Its side effect profile is favorable compared to many other anti-inflammatory medications used for this purpose, with fewer incidences of serious adverse events reported. Mesalamine has been widely accepted globally due to its proven efficacy and tolerance among different patient populations.
Pentasa, a specific formulation of mesalamine designed for controlled release throughout the gastrointestinal tract, appears similarly effective at reducing symptoms associated with inflammatory bowel disease when compared against other treatments or placebo. Nonetheless, because there are multiple brands/formulations available each delivering medication differently within the GI tract (e.g., Asacol releases mainly in ileum/ascending colon), clinicians may prefer one over another based on specifics about an individual’s condition or response to therapy.
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At what dose is Mesalamine typically prescribed?
Oral dosages of Mesalamine range from 1.2–4.8 g/day for the treatment of ulcerative colitis in adults, while children's dosage is to be determined by a healthcare professional based on their weight and disease severity. For Pentasa, a common regimen for adults starts at 1g four times daily up to a maximum dose of 4g/day. In both cases, if there is no response after several weeks, a doctor may consider adjusting the dosage or switching treatments. The maximum dosage that should not be exceeded in any case is 4.8 g/day for Mesalamine and 4g/day for Pentasa.
At what dose is Pentasa typically prescribed?
Pentasa treatment is typically initiated with a dosage of 1 g/day for mild to moderate active ulcerative colitis. The dose can then be increased to 2-4 g/day, divided into two doses and taken every twelve hours. The maximum dose is 4g/day, divided into four doses of 1g each and taken six hours apart, which may be trialed if there is no response to the initial mesalamine treatment at lower dosages after a few weeks. It's important that the intake of Pentasa should always align with physician’s instructions as it varies based on individual patient condition.
What are the most common side effects for Mesalamine?
It's important to note that both Mesalamine and Pentasa are actually the same medication, as Pentasa is a brand name of the drug mesalamine. Therefore, they share an identical side effect profile. Common potential side effects include:
- Nausea
- Vomiting
- Stomach pain or cramping
- Diarrhea
- Gas
- Fever
- Sore throat
- Muscle or joint pain
- Dizziness
More severe but less common side effects can occur such as chest pain, shortness of breath, bloody diarrhea, skin rash and itching. Always consult with your healthcare provider if you experience any concerning symptoms while taking this medication.
Are there any potential serious side effects for Mesalamine?
Both Mesalamine and Pentasa are forms of the same medication, used to treat inflammatory bowel disease. However, they may have different side effects. For both drugs, potential serious side effects can include:
- Severe stomach or abdominal pain
- Bloody diarrhea
- Chest pain or breathlessness
- Allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- Changes in vision
- Unusual bleeding or bruising under skin
In rare cases you might experience symptoms such as mood swings indicating mental/mood changes (like confusion and forgetfulness) which should be reported to your doctor immediately.
If you notice any signs indicative of kidney problems such as a change in the volume of urine produced - either too little or too much – see your healthcare provider urgently.
Lastly remember that an allergic reaction to these medications is unlikely but seek medical help right away if it occurs showing symptoms such as rash; itching/swelling notably on face/tongue/throat; severe dizziness; breathing issues.
What are the most common side effects for Pentasa?
Like Mesalamine, the medication Pentasa also has its fair share of side effects. These can include:
- Dry mouth or a sore throat
- Stuffy nose and ringing in the ears
- Unusual tiredness or weakness
- Headache, dizziness, and blurred vision
- Upset stomach with symptoms like nausea, vomiting, and loss of appetite
- Abdominal pain or constipation may also occur due to gastrointestinal disturbances.
- Some people might experience sleep issues such as insomnia.
- Agitation along with feelings of anxiety or nervousness could also be present. -Pentasa may cause rash in some individuals. -In rare cases there might be unexplained weight loss. -More frequent urination than usual is another possible side effect that should not be ignored if persistent. -Tremors and excessive sweating are less common but possible side effects.
Are there any potential serious side effects for Pentasa?
While Pentasa is generally well-tolerated by most patients, it's important to be aware of potential serious side effects that could occur. These may include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Unusual bleeding or bruising under the skin
- Severe stomach pain or cramping
- Bloody diarrhea
- Fever, sore throat and headache with a severe blistering rash
- Pale skin, feeling light-headed or short of breath
- Rapid heart rate (tachycardia)
- Liver problems - nausea, upper stomach pain, itching tiredness loss of appetite dark urine clay-colored stools jaundice.
If you experience any unusual symptoms while taking Pentasa reach out to your healthcare professional right away for evaluation and guidance.
Contraindications for Mesalamine and Pentasa?
Both mesalamine and Pentasa, along with most other medications for treating inflammatory bowel disease (IBD), may worsen symptoms of IBD in some people. If you notice your IBD symptoms worsening, or an increase in abdominal pain, cramping, bloody diarrhea or fever please seek immediate medical attention.
Neither mesalamine nor Pentasa should be taken if you are allergic to aspirin or have a kidney disease. Always tell your physician which medications you are taking; certain NSAIDs will require a period of about 2 weeks to clear from the system to prevent dangerous interactions with Mesalamine and Pentasa.
It's also important to note that while both drugs contain mesalamine as their active ingredient, they deliver the medication differently within the digestive tract. This leads to differences in where they act within the gut, so one might be more effective than another depending on your specific condition.
How much do Mesalamine and Pentasa cost?
For the brand-name versions of these drugs:
- The price for 120 tablets of Mesalamine DR (500 mg) averages around $700, which works out to about $11.66 - $23.33/day, depending on your dose.
- The price for 30 capsules of Pentasa (250 mg) is approximately $190, working out to roughly $6.33/day.
Therefore, if you are in a higher dosage range for Mesalamine i.e., 1500 mg/day or more, then brand-name Pentasa might be less expensive on a per-day treatment basis. However, cost should not be the primary consideration when determining which drug suits your needs best.
As far as generic versions go:
- Generic Mesalamine comes in packs from 30 up to 1000 capsules (500 mg), with the cost starting from as low as $.70 per day (if you buy the largest pack upfront), and not exceeding about $2.00 per day.
- Unfortunately there's no generic version available yet for Pentasa; hence its prices remain high compared with those of mesalamine.
Remember that prices can vary greatly based on location and pharmacy used. It's also worth noting that while generics tend to be cheaper than their branded counterparts they aren't always available or may not be right choice due some other factors like side-effects profile etc., so it’s important to discuss options thoroughly with your healthcare provider before making any decisions regarding medication changes based only on cost difference alone.
Popularity of Mesalamine and Pentasa
Mesalamine, a medication used primarily to treat inflammatory bowel diseases (IBD), was prescribed to approximately 1.5 million people in the US in 2020. It accounts for nearly 60% of all prescriptions written for IBD treatments and is generally considered as first-line therapy due to its proven efficacy and safety profile.
Pentasa, which is a specific brand-name formulation of mesalamine, accounted for about 20% of these prescriptions within the same year. Despite being essentially the same drug compound, Pentasa has been less frequently prescribed than generic mesalamine over recent years - largely due to cost considerations with generics typically being more affordable. Nevertheless, both medications have maintained an overall steady presence in the management of conditions like ulcerative colitis and Crohn's disease.
Conclusion
Both mesalamine and Pentasa (a brand name for mesalamine) have long-standing records of usage in patients with inflammatory bowel disease, particularly ulcerative colitis. They are backed by numerous clinical studies indicating that they are more effective than placebo treatments at reducing inflammation and promoting healing in the gut lining. Mesalamine works primarily by inhibiting the production of certain chemicals in the body that cause inflammation.
Pentasa is a specific formulation of mesalamine designed to act throughout the entire length of the colon, whereas other brands may be targeted at different parts of the gastrointestinal tract. This makes it suitable for treating conditions affecting any part of this area.
Both drugs are available as generics, which can represent significant cost savings especially for patients who must pay out-of-pocket. Both mesalamine and Pentasa may require an adjustment period where effects might not be noticeable right away due to their mechanism focused on chronic rather than acute inflammation reduction.
The side effect profile is similar between these two medications since they contain essentially the same active ingredient - both being generally well-tolerated but with some common side effects such as headache, abdominal pain or cramps, gas, nausea or vomiting etc. For both drugs, patients should monitor their symptoms closely when starting treatment and seek medical help immediately if they notice worsening abdominal pain or blood in stools.
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Refrences
- Wilding, Kenyon, & Hooper. (2000, February). Gastrointestinal spread of oral prolonged‐release mesalazine microgranules (Pentasa) dosed as either tablets or sachet. Alimentary Pharmacology & Therapeutics. Wiley.http://doi.org/10.1046/j.1365-2036.2000.00696.x
- Mantzaris, G. J., Petraki, K., Sfakianakis, M., Archavlis, E., Christidou, A., Chadio-Iordanides, H., & Triadaphyllou, G. (2003, March). Budesonide versus mesalamine for maintaining remission in patients refusing other immunomodulators for steroid-dependent Crohn's disease. Clinical Gastroenterology and Hepatology. Elsevier BV.http://doi.org/10.1053/cgh.2003.50015
- Claussen, D. W. (1993, December). Pentasa (Mesalamine). Gastroenterology Nursing. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.1097/00001610-199312000-00010
- Marshall, J. K., & Irvine, J. E. (2000, July). Putting Rectal 5-Aminosalicylic Acid in Its Place: The Role in Distal Ulcerative Colitis. American Journal of Gastroenterology. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.1111/j.1572-0241.2000.02180.x
- Sonu, I., Lin, M. V., Blonski, W., & Lichtenstein, G. R. (2010, September). Clinical Pharmacology of 5-ASA Compounds in Inflammatory Bowel Disease. Gastroenterology Clinics of North America. Elsevier BV.http://doi.org/10.1016/j.gtc.2010.08.011
- Mulder, C. J. J., Tytgat, G. N. J., Weterman, I. T., Dekker, W., Blok, P., Schrijver, M., & Heide, H. V. D. (1988, December). Double-Blind Comparison of Slow-Release 5-Aminosalicylateand Sulfasalazine in Remission Maintenance in Ulcerative Colitis. Gastroenterology. Elsevier BV.http://doi.org/10.1016/s0016-5085(88)80061-1