Aminosalicylates (Formulary)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

Notes

  • Blood disorders: Patients receiving aminosalicylates, and their carers, should be advised 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.
  • Aminosalicylates are ineffective in Crohn’s disease.
  • EC preparations: 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

  • MHRA advice: Idiopathic intracranial hypertension (IIH) has been very rarely reported in patients treated with mesalazine. Following a recent review, warnings for IIH are being added to the product information for all mesalazine products (December 2025) (www.gov.uk).
  • 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

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

Version: 1.1

Document Id: F225