Rectal mesalamine is used to treat proctitis (rectal swelling), proctosigmoiditis, and ulcerative colitis, conditions that cause swelling and ulcers in the lining of the colon (large intestine) and the rectum (swelling in the rectum and sigmoid colon [last section of the colon]). The drug rectal mesalamine belongs to the group of drugs known as anti-inflammatory agents. It functions by preventing the body from generating a certain chemical that could lead to inflammation.

Mesalamine for the rectum is available as a suppository and an enema. Both the suppository and the enema are typically administered at bedtime, once daily. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the rectal mesalamine directions exactly. Use it only as directed by your doctor, and never more or less regularly.

Within the first few days or weeks of your rectal mesalamine treatment, you should start to feel better. Even if you feel better at the start of your treatment, keep using rectal mesalamine until the end of your prescription. Without consulting your physician, do not stop using rectal mesalamine.

Mesalamine enemas and suppositories can leave stains on flooring, painted walls, marble, granite, enamel, vinyl, and other surfaces. When using these medications, take care to avoid stains.

While using mesalamine enemas and suppositories, be sure to stay hydrated.

To administer a mesalamine enema, do the following:

• Attempt to go to the bathroom. If your bowels are empty, the drug will work more effectively.
• Cut the protective foil pouch that is holding the seven bottles of medicine’s seal using scissors. Don’t cut or squeeze the bottles, please. From the pouch, take out one bottle.
• Look inside the bottle at the liquid. It should be brown or off-white in colour. If the bottles are removed from the foil pouch and left for a while, the liquid can somewhat discolour. Liquid that has somewhat darkened may be used, but dark brown liquid should not be used.
• To ensure that the drug is blended, shake the bottle vigorously.
• The applicator tip’s protective cover should be removed. To prevent medication from leaking out of the container, be sure to hold the bottle by the neck.
• For balance, lie on your right side with your right leg bowed towards your chest and your lower (left) leg straight. Moreover, you can kneel on a bed while supporting your upper chest and one arm there.
• The applicator tip should be gently inserted into your rectum and slightly pointed towards your navel (belly button).
• The nozzle should be pointed towards your back when you firmly grasp the bottle. To release the medication, slowly and steadily squeeze the bottle.
• Take the applicator away. To allow the medication to spread throughout your intestines, stay in the same posture for at least 30 minutes. Attempt to maintain the medication inside your body for approximately 8 hours (while you sleep).
• Put the bottle in a secure location where it is out of the reach of children and animals. There is just one dose in each bottle, thus they shouldn’t be used again.

Follow these steps if using a mesalamine suppository:

• As soon as possible before using the suppository, try to go to the bathroom. If your bowels are empty, the drug will work more effectively.
• One suppository should be removed from the strip of suppositories. With the suppository held upright, take the plastic wrapper off with your fingers. To prevent melting the suppository with the heat of your hands, try to handle it as little as possible.
• Raise your right knee to your chest while lying on your left side. (Lie on your right side with your left leg raised if you are a left-handed person.)
• Put the suppository in your rectum pointed end first using your finger. To fully insert the suppository, apply light pressure. If you can, try to leave it in place for a minimum of 1 to 3 hours.
• Before you get back to your regular activities, wash your hands thoroughly.

If you will be using mesalamine enemas or suppositories, ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient that comes with the medication.

Other prescriptions for this drug are possible. For more information, consult your physician or pharmacist.

Before using mesalamine,

• Inform your doctor and pharmacist if you have any allergies to mesalamine, sulfasalazine (Azulfidine), salicylate pain relievers like aspirin, diflunisal, or magnesium salicylate (Doan’s, among others), salicylate pain relievers like aspirin. Inform your doctor if you have an allergy to any foods, colours, preservatives, or sulfites, which are compounds that are used as food preservatives and are naturally present in some foods. Get a list of the components from your pharmacist.
• Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Your physician might need to adjust the dosage of your drugs or keep a closer eye on you for adverse effects.
• Inform your doctor if you have or have ever had asthma, allergies, liver or kidney problems, pericarditis (swelling of the sac around the heart), myocarditis (swelling of the heart muscle), or pericarditis.
• Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor if you become pregnant while using rectal mesalamine.
• Consider wearing protective clothes, sunglasses, and sunscreen as well as avoiding excessive or prolonged sun exposure. Your skin may become more sensitive to sunlight if you take mesalamine.
• You should be aware that mesalamine can result in a dangerous reaction. It may be challenging to distinguish between a reaction to the medicine and a flare (episode of symptoms) of your disease because many of the symptoms of this reaction are identical to the symptoms of ulcerative colitis. If you develop any, all, or any combination of the following symptoms, get medical attention right away: stomach cramps, bloody diarrhoea, fever, headache, weakness, or rash.

Keep eating normally unless your doctor instructs you otherwise.

The missed dose should be taken as soon as you remember. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

Side effects from rectal mesalamine are possible. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Joint, back, or leg pain
• Heartburn
• Gas
• Dizziness
• Hemorrhoids
• Acne
• Rectal discomfort
• Hair fall

Some adverse effects may be severe. Call your doctor right away if you suffer any of the symptoms described below or in the SPECIAL PRECAUTIONS section:

• Hives, a rash, irritation, or skin that is peeling or blistering
• Mouth blisters or sores
• Enlargement of the mouth, throat, lips, tongue, eyes, or other body parts
• Flu-like symptoms or a fever
• Enlarged glands
• Eyes that are runny, red, itching, or irritating
• Chest ache
• Breathing difficulty
• Back or side ache
• Swelling in the ankles, foot, or legs
• Pink or crimson urine, painful urination, or the presence of blood in the urine
• Extreme fatigue
• Eyes or skin that have a yellow tint
• Stomach ache in the right upper portion
• Light stools

Further negative effects of mesalamine might occur. If you experience any strange issues while taking this medicine, contact your doctor right away.

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from light, excessive heat, and moisture at room temperature (not in the bathroom). Suppositories containing mesalamine can be kept in the refrigerator. Use each bottle of the mesalamine enemas as soon as you have cracked open the foil container, according your doctor’s instructions.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include:

• Abdomen ache
• Shallow or rapid breathing
• Hearing ringing

Keep all of your appointments with your physician and the lab.

Inform the lab staff and your doctor that you are using mesalamine prior to any laboratory test.

Do not share your medication with anybody else. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.