Pentasa (mesalamine) is designed to help alleviate the inflammation, pain, diarrhea, and other symptoms associated with Crohn's disease, ulcerative colitis, and other forms of inflammatory bowel disease (IBD).

The medication is not a cure. It can help put an active episode into remission and help maintain remission; episodes are fewer, less severe, and shorter than without the medication. If treatment ends, however, the condition will most likely revert to its former state.

Pentasa is suitable for all ages, but younger patients will most likely need modified dosing.

Choosing a Formulation

Pentasa comes in a variety of formulations; the ideal choice depends on personal preference as well as the condition. All formulations can help treat active episodes or maintain remission. Dosage is largely the same regardless of the formulation. Options include:

• Tablets - Good for Crohn's disease and ulcerative colitis. Tablets must not be split or chewed.
• Granules - Similar to tablets, treats Crohn's disease and ulcerative colitis. Patients who have difficulty, or an aversion to, swallowing whole tablets may prefer granules. Very small, they're simply placed on the tongue and swallowed.
• Enemas - A fluid applied to the rectum; patients with distal ulcerative colitis or ulcerative proctitis will likely find enemas work quicker than tablets or granules; this is a more direct administration method.
• Suppositories - Very similar to enemas, suppositories are a solid instead of fluid. Also ideal for distal ulcerative colitis or ulcerative proctitis.

Dietary changes can also help ease or prevent symptoms. In addition to triggering foods, avoiding foods that promote bowel movements, such as caffeine, may also help. Patients should take care to avoid becoming dehydrated when diarrhea is present.

Taking Pentasa

Most patients learn about Pentasa when seeking relief from an active episode. The medication soothes the inflammation and irritation in the bowels, reducing symptoms within a few days to two weeks. Once the symptoms are reduced, continuing to take the medication every day helps keep the condition in remission.

In remission, patients have no or very few symptoms of IBD. Avoiding triggering foods can help keep it in remission; taking Pentasa also helps prevent inflammation and irritation from forming. While some patients will still have the occasional active episode, these episodes should be less frequent, less severe, and easier to resolve.

Standard treatment with all formulations is:

• To treat an active episode, take 4 g (4000 mg) once per day.
• To keep IBD in remission, take 2 g (2000 mg) once per day.
• Children who weigh less than 40 kg (88 lbs) should take 2 mg to treat an active episode and 1 mg to keep IBD in remission.
• Children under age 6 should be seen by a doctor.

Ideally treatment will be individualized. Factors such as weight and other medical conditions can influence dosage and effectiveness, as well as individual response to treatment. For example, some patients have better effects dividing the daily dose into two smaller doses taken throughout the day, rather than one large dose.

In all cases, if an active episode is not significantly better within two weeks of starting treatment or at any time becomes worse, treatment with Pentasa should end and a doctor should be consulted.

Precautions Before Use

Individuals with certain other medical conditions are poor candidates for Pentasa; speak with a doctor before use if there is a history of:

• Allergic reaction to aspirin or any salicylates
• Severe kidney or liver issues
• Peptic ulcer
• Bleeding disorders
• Breathing disorders

The above don't necessarily mean Pentasa can't be used, but patients should be aware of---and alert for---warning signs that the conditions are worsening. In some cases, however, Pentasa use should be avoided entirely.

Other medications can also cause problems. Patients may not be able to use Pentasa if taking:

• Medications that suppress the immune system
• Medications that inhibit clotting or thin the blood
• Chemotherapy medications

The above are only the most concerning medications. Other treatments---including over-the-counter versions---can also interact with Pentasa, reducing effectiveness or causing other complications. Always double-check with a doctor or pharmacist before taking any other medication with Pentasa.

Side effects from Pentasa can be quite difficult to distinguish from those produced by IBD, including abdominal discomfort, diarrhea, and nausea. These symptoms should stop occurring as the body adjusts to treatment. If persistant or severe, speak with a doctor.