Drug interactions
Mesalamine + Sulfasalazine
Severity: Moderate
Mesalamine and Sulfasalazine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Sulfasalazine is cleaved to mesalamine and sulfapyridine, so combining the two duplicates 5-aminosalicylate exposure. This may add to the rare risk of interstitial nephritis and other adverse effects of mesalamine.
What this interaction means in plain words
Mesalamine and Sulfasalazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Therapeutic duplication, since sulfasalazine releases mesalamine in the colon, giving additive 5-ASA nephrotoxicity.
What to do
Avoid unnecessary duplication of 5-ASA therapy. If both are used, monitor serum creatinine and urinalysis regularly.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Mesalamine
Frequently asked questions
Can I take Mesalamine with Sulfasalazine?
MediHelp rates the interaction as moderate. Mesalamine and Sulfasalazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Sulfasalazine is cleaved to mesalamine and sulfapyridine, so combining the two duplicates 5-aminosalicylate exposure. This may add to the rare risk of interstitial nephritis and other adverse effects of mesalamine.
How serious is the interaction between Mesalamine and Sulfasalazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid unnecessary duplication of 5-ASA therapy. If both are used, monitor serum creatinine and urinalysis regularly.
What other medicines interact with Mesalamine?
MediHelp also lists interactions of Mesalamine with, for example, Measles mumps rubella and varicella vaccine live, Varicella virus vaccine live, Aceclofenac. The full list is on the Mesalamine page.
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