MEZAVANT XL 1200MG TABS 60`S

Mesalazine (5-ASA) is an anti-inflammatory medicine that acts locally in the colon. Mezavant XL uses the Multi-Matrix (MMX) technology — a hydrophilic matrix within a lipophilic matrix — to release mesalazine gradually throughout the entire colon, from the ascending to the sigmoid colon, after a single daily dose.

It is used for the induction and maintenance of remission of mild to moderate active ulcerative colitis (UC) in adults.

For active disease (induction): 2400–4800 mg once daily (2–4 tablets) with or after a meal. For maintenance of remission: 2400 mg once daily (2 tablets). Take at the same time each day. Swallow whole — do not crush, chew, or split (this would destroy the MMX release mechanism). Take with food for best tolerability.

Mesalazine is contraindicated in: known hypersensitivity to mesalazine, salicylates, or any excipient; severe renal impairment (eGFR < 30); severe hepatic impairment; and in patients with active gastric or duodenal ulcer.

Use with caution in: renal impairment; hepatic impairment; elderly patients; pulmonary disease (rare pulmonary toxicity); and in patients with known aspirin hypersensitivity (cross-reactivity).

•       Azathioprine / 6-mercaptopurine: mesalazine inhibits TPMT enzyme, increasing azathioprine/6-MP toxicity — monitor FBC closely and consider TPMT genotyping.

•       Warfarin: mesalazine may reduce anticoagulant effect — monitor INR.

•       Nephrotoxic agents (NSAIDs, ciclosporin): additive renal toxicity — monitor renal function.

Store below 30°C. Keep in original packaging. Keep out of reach of children.

Mezavant XL once-daily dosing significantly improves adherence compared to older mesalazine preparations requiring multiple doses. The MMX technology ensures mesalazine is released throughout the whole colon — important for complete control of inflammation in UC.

The tablet shell may appear in the stool intact or as a ghost — this is expected and means the medicine has already been released. Do not take an extra dose if you see this.

Maintenance therapy is as important as induction therapy — staying on mesalazine long-term reduces relapse rates by approximately 70% compared to stopping after remission is achieved.

The MMX system in Mezavant XL is proprietary — this formulation cannot be considered interchangeable with other modified-release mesalazine products at the same mg dose without re-titration.

The TPMT interaction with azathioprine/6-MP is clinically significant: mesalazine concentrations in the range achieved with Mezavant XL can inhibit TPMT by 15–30%, increasing the risk of azathioprine-induced myelosuppression.

Monitor FBC more frequently when combination therapy is used, and consider TPMT genotyping before starting. Annual renal function monitoring is the minimum recommendation; biannual if pre-existing renal disease.

What is an acute intolerance syndrome?

In a small number of patients, mesalazine paradoxically worsens UC symptoms shortly after starting, with increased diarrhoea, cramping, and sometimes fever. If your colitis symptoms acutely worsen within the first few days of starting Mezavant XL, contact your gastroenterologist.

Is mesalazine safe during pregnancy?

Mesalazine is generally considered safe in pregnancy — maintaining UC control during pregnancy is important as disease flares carry more risk than the medicine. Discuss your specific situation with your gastroenterologist and obstetrician.

Do I need regular blood tests?

Kidney function should be checked before starting, then annually. If you also take azathioprine, blood count monitoring is more frequent because of the interaction. Your gastroenterologist will set the monitoring schedule.

Why can't I crush or split the tablet?

The tablet's multi-matrix coating is essential for delivering mesalazine to the entire colon in a controlled way. Crushing or splitting destroys this mechanism, releasing the drug too early (in the small bowel), where it cannot work for colitis and would be absorbed systemically.