The action of drugs Asacol 400 mg.
Pharmacodynamics. In preparation Asacol contains mesalazine, which is a 5-aminosalicylic acid that has anti-inflammatory effect. The mechanism of action at present completely unclear. Mesalazine inhibits migration of polymorphonuclear leukocytes and the activity of lipoxygenase. Therefore inhibiting the synthesis of leukotrienes, inflammatory macrophages in the intestinal wall. Mesalazine inhibits platelet activating factor (PAF), except that it is also an antioxidant: it reduces the synthesis of substances that contain active oxygen free radicals, and associates.
Pharmacokinetics. Asacol tablets are coated with a polymer membrane that allows the release of the active substance in the lower intestine Klubova and large intestine, which are the main foci of inflammation. Picked up the tablets so as to minimize the absorption of mesalazine in the digestive tract. Absorption after oral administration is almost 26%. 74% of the administered dose remains in the lower intestine Klubova and large intestines, and rectum, showing there a local inflammatory effect. Metabolism by the liver and intestinal mucosa, forms an inactive metabolite N-acetyl-5-amino salicylic acid. The half-life of less than an hour. Excretion is derived mainly from faeces and urine in unchanged form and in the form of N-acetyl-5-amino salicylic acid.
Indications for use Asacol 400 mg .
Ulcerative colitis:
- Treatment of lung diseases and high levels of gravity;
- Maintenance treatment in remission.
Crohn’s disease:
maintenance treatment in remission.
The method of use and dose Asacol 400 mg.
Ulcerative colitis: the treatment of lung disease severity and the average daily dose levels of 2.4 – 4.8 g, divided into several stages.
Supportive care in remission dose is 1.2 – 2.4 g, divided into several stages.
Crohn’s disease: supportive care in remission dose is 2.4 grams, divided into several stages.
Doses for adults and children alike.
Patients older age group drug is given with caution and only when normal renal function preservation.
Tablets are taken before eating, swallowing them whole, without breaking the and not liquid.
Side effects Asacol 400 mg.
In some cases, hypersensitivity reactions occur: increased body temperature, bronchospasm, hair loss (1 case in 1000 – 10 000 patients). Hair loss may also be a manifestation of chronic inflammatory bowel disease. Rarely observed as abdominal pain and diarrhea.
Very rare below side-effects systems and organs.
Blood and lymph: dyscrasia, inhibition of bone marrow function, which leads to leukopenia, neutropenia, thrombocytopenia, pancytopenia up to aplastic anemia.
Nervous system: headache, dizziness, arthralgia.
Cardiovascular system: myocarditis, pericarditis.
Musculature: myalgia.
The respiratory system: allergic reaction from the lungs, bronchospasm, eosinophilic pneumonia.
Gastrointestinal tract: nausea, vomiting, pancreatitis, hepatitis, colitis.
Skin: volchankopodobny syndrome with pericarditis and plevroperikarditom as the main symptoms and a rash on the skin, and arthralgia.
Urinary system: interstitial nephritis, nephrotic syndrome, renal failure, which is sometimes normal after discontinuing the drug.
Contraindications Asacol 400 mg.
Hypersensitivity to salicylates, the hypersensitivity to any component of the drug Asacol anything; expressed by the human liver and kidneys, stomach ulcer and duodenal ulcer increased tendency to bleed, and children under 2 years.
Overdose Asacol 400 mg.
In general, the symptoms of an overdose of analogical signs of poisoning by salicylates: a violation of the acid-base balance (acidosis, alkalosis), hyperventilation, pulmonary edema, dehydration due to increased sweating, vomiting, hypoglycemia. No specific antidote.
Treatment: If necessary – the resumption of the acid-alkaline balance, transfusion of electrolytes, replenish lost fluids, glucose administration.
Appointed by the stimulation of gastric lavage and urine output.
Features of use Asacol 400 mg.
It is not recommended for patients with impaired renal function.
Caution should be used in patients with a high concentration of urea in the blood and proteinarieyu. If mesalazine in the treatment period marked renal dysfunction, it may be a manifestation of nephrotoxicity of the drug. It is recommended to monitor renal function in all patients before treatment Asacol, as well as during treatment according to the scheme within 14 days of therapy, then another 2 – 3 times with a 4-week intervals. In normal control tests repeated results on a quarterly basis. With signs of renal dysfunction need further investigation.
Saw monitoring of the patient required respiratory disorders, especially with the appearance of asthmatic attacks.
If a patient hypersensitive to sulfasalazine treatment is carried out only under constant medical supervision and immediately suspended him for the development of acute symptoms of intolerance to the drug, such as cramping, abdominal pain, increased body temperature, severe headache, rash on the skin.
The patient should have a blood test before starting treatment, then blood taken for analysis at the discretion of the physician, usually within 14 days of therapy, then another 2 – 3 times with a 4-week intervals. Under normal results of the analysis was repeated on a quarterly basis. With signs of renal dysfunction need further investigation. It is particularly important to monitor blood picture with the appearance of the patient during the treatment of these symptoms: bleeding unclarified origin, bruising, purpura, anemia, fever that persists for a long time, as well as complaints of pain in the throat. In such cases, treatment must be stopped immediately and give patients the necessary medical care.
Patients older age group drug is given only for maintaining normal kidney function with caution.
Use during pregnancy and lactation. Asacol is prescribed during pregnancy and lactation only by clear indications, given the benefits of treatment for the mother and the potential risk to the fetus.
The effect on driving ability and mechanisms. The drug has no effect on the ability to concentrate.
Interaction with other medicinal products .
With the simultaneous use of mesalazine and digoxin reduced the absorption of digoxin. Under the action of mesalazine may increase immunosuppressive activity of azathioprine and 6-mercaptopurine. Before starting combination therapy should be monitored blood formula, particularly the number of white blood cells, periodically repeating the blood tests during treatment.
Mesalazine in treatment may reduce sovmestimyei effect of probenecid and sulfinpyrazone, spironolactone, furosemide and.
Severity of side effects of glucocorticoids with respect to the gastrointestinal tract when combined with the use of mesalazine is growing.
Terms and conditions of storage. Keep out of reach of children at or above 25 ° C. Shelf life – 3 years.
