Delzicol
Generic name: mesalamine
Brand name: Delzicol
Dosage form: oral delayed-release capsule
Drug class: 5-aminosalicylates
Inflammatory Bowel Disease (IBD) is a chronic condition that affects millions of people worldwide, often causing significant discomfort and impacting daily life. Among the various medications available to manage IBD, Delzicol stands out as an effective treatment option for those suffering from ulcerative colitis, one of the most common types of IBD.
Overview of Delzicol
Delzicol, containing the active ingredient mesalamine, is a delayed-release medication specifically designed to treat colon inflammation. Mesalamine belongs to a class of drugs known as aminosalicylates, which reduce the production of substances in the body that cause inflammation.
The delayed-release capsules are engineered to bypass the stomach and release mesalamine directly into the colon. This targeted approach ensures that the medication acts where it's most needed, maximizing its effectiveness and minimizing potential side effects in other body parts. Delzicol is typically prescribed as a long-term treatment to help manage symptoms, maintain remission, and prevent flare-ups in patients with ulcerative colitis.
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Uses of Delzicol
Ulcerative Colitis
Delzicol is primarily used to treat active mild to moderate ulcerative colitis. By reducing inflammation in the colon, it helps alleviate symptoms such as diarrhea, rectal bleeding, and abdominal pain.
Remission in Ulcerative Colitis
Delzicol is also used to maintain remission in patients whose ulcerative colitis is under control. Continuous use of the medication can help prevent flare-ups and maintain patients' quality of life.
Proctosigmoiditis Management
Proctosigmoiditis is a form of ulcerative colitis that affects the rectum and sigmoid colon. Delzicol's targeted action in the colon makes it an effective treatment option for managing this condition.
Pancolitis
Pancolitis is a severe form of ulcerative colitis that affects the entire colon. Delzicol can be part of a treatment regimen for patients suffering from this extensive form of IBD, helping to reduce inflammation and control symptoms.
Off-Label Use in Crohn’s Disease
Although primarily used for ulcerative colitis, Delzicol has also been used off-label to manage symptoms of Crohn’s disease, another form of IBD. While not its primary indication, some patients with Crohn’s disease have found relief with mesalamine.
Side Effects of Delzicol
Headache
One of the most common side effects of Delzicol is headaches. These can range from mild to moderate and may occur more frequently when starting the medication. Staying hydrated and taking the medication with food may help reduce the severity of headaches.
Nausea and Vomiting
Some patients may experience nausea or vomiting when taking Delzicol. This side effect is often temporary and may improve as the body adjusts to the medication. Taking Delzicol with meals can help minimize these symptoms.
Abdominal Pain and Cramps
Abdominal discomfort is another common side effect. While Delzicol is intended to reduce inflammation in the colon, it can sometimes cause or worsen abdominal pain, particularly in the early stages of treatment.
Diarrhea
Ironically, a medication designed to treat ulcerative colitis, which often causes diarrhea, can also cause this side effect. Patients experiencing severe or persistent diarrhea, as this may indicate a need for dosage adjustment or a different treatment approach.
Dizziness
Some patients may feel dizzy or lightheaded, especially when taking Delzicol. This side effect is usually temporary, but patients should seek medical advice if it persists or worsens.
Warnings for Delzicol
Kidney Impairment
Delzicol can affect kidney function, so monitoring kidney health regularly while on this medication is essential. Patients with pre-existing kidney conditions should use Delzicol cautiously, and regular blood tests may be necessary to monitor kidney function.
Severe Allergic Reactions
Although rare, some patients may experience severe allergic reactions to mesalamine, including anaphylaxis. Symptoms include rash, itching, swelling, dizziness, and difficulty breathing. If any of these symptoms occur, seek immediate medical attention.
Liver Dysfunction
Delzicol can cause or exacerbate liver problems, particularly in patients with existing liver conditions. Liver function tests may be required periodically to monitor for any adverse effects.
Cardiac Concerns
Mesalamine has been associated with myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining surrounding the heart). Patients with a history of heart disease should be monitored closely while taking Delzicol.
Pyloric Stenosis
Patients with pyloric stenosis, which causes the stomach opening to narrow into the small intestine, should use Delzicol with caution. The delayed-release capsules may not dissolve appropriately in these patients, potentially reducing the medication's effectiveness.
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Interactions with Delzicol
Azathioprine
Azathioprine is an immunosuppressant often used in IBD treatment. Combining it with Delzicol can increase the risk of blood disorders, including leukopenia and anemia. Close monitoring of blood counts is essential if these drugs are used together.
Non-Steroidal Anti-Inflammatory Drugs
NSAIDs like ibuprofen and aspirin can increase the risk of kidney damage when taken with Delzicol. Patients should avoid NSAIDs unless expressly advised.
Methotrexate
Methotrexate is another immunosuppressant that, when combined with Delzicol, can lead to increased toxicity, particularly affecting the liver and bone marrow. Regular monitoring is necessary when these drugs are co-administered.
Warfarin
Warfarin is a blood thinner, and Delzicol may enhance its effects, increasing the risk of bleeding. Patients on warfarin should have their INR (International Normalized Ratio) monitored more frequently to adjust the warfarin dosage as needed.
Digoxin
Delzicol may reduce the absorption of digoxin, a medication used to treat heart conditions. Patients taking both drugs should be monitored for any changes in digoxin effectiveness.
Before Taking Delzicol
Before starting Delzicol, it is essential to have a thorough discussion with your healthcare provider. Provide a complete medical history, including any known allergies, pre-existing conditions (especially kidney or liver disease), and a list of all medications and supplements you are currently taking.
It is also crucial to discuss any current or planned pregnancies. While mesalamine is generally considered safe during pregnancy, your healthcare provider may adjust your dosage or recommend close monitoring to ensure the safety of both you and your baby.
What to Avoid When Taking Delzicol
Avoid NSAIDs
As mentioned earlier, NSAIDs can increase the risk of kidney damage when taken with Delzicol. Stick to acetaminophen (Tylenol) for pain relief unless otherwise advised by your doctor.
Limit Sun Exposure
Mesalamine can make your skin more sensitive to sunlight, increasing the risk of sunburn. Wear protective clothing, use sunscreen with a high SPF, and avoid prolonged sun exposure.
Avoid Antacids
Antacids can interfere with Delzicol's delayed-release mechanism, potentially reducing its effectiveness. If you need to take antacids, discuss alternative options with your doctor.
Avoid Alcohol
While moderate alcohol consumption may be permissible for some patients, alcohol can irritate the gastrointestinal tract and may worsen symptoms of ulcerative colitis. It is advisable to limit or avoid alcohol altogether while taking Delzicol.
Dosage Information of Delzicol
The dosage of Delzicol varies depending on the condition being treated, the patient’s age, and other factors. The typical dosage for adults with active mild to moderate ulcerative colitis is two 400 mg capsules three times daily, totaling 2.4 grams daily. This dosage may be adjusted based on the patient’s response to the treatment.
The dosage is generally lower for maintaining remission, with many patients taking one 400 mg capsule three times daily (1.2 grams per day). Pediatric dosages are typically determined based on body weight and should be prescribed. It's important to follow your doctor’s instructions closely and not to adjust the dosage on your own, as doing so could impact the effectiveness of the treatment or increase the risk of side effects.
Delzicol capsules should be swallowed whole without chewing, crushing, or breaking. This ensures that the medication is correctly released in the colon. The capsules can be taken with or without food, but if you experience nausea, taking them with a meal might help reduce discomfort.
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Conclusion
Delzicol is a valuable medication for managing and maintaining remission in ulcerative colitis. However, like all medications, it comes with potential side effects and interactions. Always ensure Delzicol is the right choice for your condition and discuss any concerns about side effects, interactions, or dosage adjustments.
FAQs
How long does it take for mesalamine to work?
Mesalamine may start to reduce symptoms within 3 to 21 days, but it may take 6 to 8 weeks to see the full benefits.
When is the best time to take mesalamine?
Mesalamine is usually taken with or without food. However, taking it simultaneously each day can help maintain consistent levels in your body.
Why is mesalamine so expensive?
The cost of mesalamine is high due to the complex manufacturing process, the need for delayed-release formulations, and market exclusivity by brand-name drugs.
How long can you take mesalamine?
Mesalamine is often used as a long-term treatment to maintain remission in ulcerative colitis. Some patients may take it for years under the guidance.
Is mesalamine an immunosuppressant?
No, mesalamine is not classified as an immunosuppressant. It works by reducing inflammation directly in the colon.
What is the maximum dosage of mesalamine?
The maximum dosage for active ulcerative colitis is generally 4.8 grams daily, though this may vary based on individual circumstances.
Can I stop taking mesalamine?
Do not stop taking mesalamine without consulting as stopping abruptly may lead to a flare-up of your condition.
What are 7 mesalamine side effects to be aware of?
The 7 side effects are Headache, Nausea, Abdominal pain, Diarrhea, Rash, Increased liver enzymes and Dizziness.