Mesalamine

Last Reviewed: Oct 23, 2024

Warnings

Mesalamine (Lialda) Risks, Warnings, and Complications

Mesalamine can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatment options for ulcerative colitis if you are at an increased risk of adverse effects from this drug.

KIDNEY INJURY: There are reports of renal impairment (kidney damage) after taking Lialda (mesalamine), including minimal change disease, acute interstitial nephritis, chronic interstitial nephritis, and, rarely, kidney failure. Your doctor will evaluate your renal function before starting mesalamine therapy and periodically while you are on this drug. Tell your doctor if you have a history of kidney problems or are taking other nephrotoxic drugs that can damage the kidneys. You may need to stop mesalamine if your kidney function worsens during treatment.
KIDNEY STONES: There are reports of nephrolithiasis (kidney stones) with mesalamine use, including stones that are 100% mesalamine in content. This type of kidney stone can be difficult to detect on standard imaging studies. Stay well hydrated while on this medicine.
MESALAMINE-INDUCED ACUTE INTOLERANCE SYNDROME: Mesalamine has been linked to acute intolerance syndrome which can be difficult to tell apart from worsening ulcerative colitis. Symptoms of acute intolerance syndrome include stomach cramps, abdominal pain, and bloody diarrhea, which may be accompanied by rash, fever, and headache. Tell your doctor if you develop any of these symptoms. You will need to stop treatment with mesalamine if it is acute intolerance syndrome.
LIVER FAILURE: There are reports of liver failure in people with pre-existing liver disease after taking mesalamine. Tell your doctor if you have a history of liver problems. Call your doctor immediately if you develop signs and symptoms such as abdominal pain, nausea, loss of appetite, or yellowing of the skin or eyes.
ALLERGIC REACTIONS: Rarely, mesalamine can cause severe hypersensitivity reactions, including severe skin reactions such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic symptoms (DRESS). Stop taking mesalamine and seek emergency medical attention if you develop a skin rash, hives, itching, blistering or peeling skin, swelling, or difficulty breathing. Tell your doctor if you have a history of allergies to salicylates, for example, aspirin or bismuth subsalicylate (Pepto-Bismol).
UPPER GASTROINTESTINAL TRACT OBSTRUCTION: People with pyloric stenosis or other types of obstruction in the upper gastrointestinal tract should avoid taking mesalamine because the medicine may be retained in the stomach for a prolonged period of time in such individuals.
PHOTOSENSITIVITY: Mesalamine can make your skin more sensitive to sunlight. Avoid unnecessary sun exposure, use sunscreen, and wear protective clothing. Tell your doctor if you have skin conditions such as eczema or atopic dermatitis as they can put you at risk of more severe photosensitivity reactions.
INTERFERENCE WITH LABORATORY TEST RESULTS: Mesalamine can lead to falsely elevated results for certain lab tests such as urinary normetanephrine. Tell all laboratory personnel you are on this medicine before any lab tests.

Precautions Before Starting Mesalamine (Lialda)

Tell your doctor if you are allergic to mesalamine, aspirin, balsalazide (Colazal), olsalazine (Dipentum), choline magnesium trisalicylate, magnesium salicylate, diflunisal, sulfasalazine (Azulfidine), any of the active or inactive ingredients in mesalamine formulations, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of all your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal remedies. This can help avoid possible interactions.

Give your doctor a complete medical history. Mesalamine may not be safe for people with certain medical conditions such as inflammation in the heart (myocarditis, pericarditis), eczema, atopic dermatitis, gastrointestinal obstruction, blood disorders, kidney stones, kidney disease, or liver disease.

Tell your doctor if you are currently pregnant, might be pregnant, planning a pregnancy soon, or nursing an infant with breast milk.

Precautions During Use of Mesalamine (Lialda)

Keep all your medical and lab appointments while taking mesalamine.

Avoid unnecessary sun exposure and protect your skin with sunscreen and protective clothing.

Do not take mesalamine if you have had the varicella (chicken pox) vaccine in the last 6 weeks as it can increase your risk of Reye’s syndrome (swelling in the brain and liver).

Mesalamine can cause a serious drug-induced acute intolerance syndrome in some people. Call your doctor immediately if you experience symptoms that resemble worsening ulcerative colitis (stomach pain and other symptoms like fever, bloody diarrhea, weakness, headache, and rash).

Do not take the extended release capsules (Apriso brand) if you have phenylketonuria. This formulation contains aspartame that forms phenylalanine in the body.

Tell your doctor if you become pregnant while on mesalamine. This drug has been linked to low birth weight in babies.

Tell all your doctors and laboratory personnel you are on mesalamine, especially before any surgery, including dental procedures.

Mesalamine (Lialda) Drug Interactions

Taking mesalamine with certain other medications can affect how it works. Drug interactions with other medicines can also increase the risk of severe side effects. Tell your doctor if you are on any of the following medications:

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Aleve, Naprosyn)
Antacids such as calcium carbonate (Tums), aluminum hydroxide and magnesium hydroxide (Maalox), and calcium carbonate and magnesium (Rolaids)
Iron supplements

The above list may not describe all the potential interactions of mesalamine. Give your doctor or pharmacist a complete list of your medications, including prescription medications, over-the-counter medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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