WHAT IS THIS MEDICINE AND WHAT IS IT USED FOR?
Pentasa SR contains mesalazine in a unique sustained-release (SR) granule
formulation within the tablet. Unlike other mesalazine preparations that are
pH-dependent and only release the medicine in the more alkaline parts of the
bowel, Pentasa's special ethylcellulose-coated granules begin releasing
mesalazine from as early as the duodenum (the start of the small bowel) and
continue releasing it throughout the entire length of the bowel — including the
small intestine and the large bowel (colon).
This makes Pentasa SR particularly suited to treating inflammatory bowel
disease (IBD) that affects the small intestine, as well as the colon. It is
used for: ulcerative colitis (UC) — both active flares and long-term
maintenance of remission; Crohn's disease — particularly affecting the small
bowel or ileocolon, where the continuous release profile along the entire bowel
is advantageous.
3. HOW TO TAKE THIS MEDICINE
For treating an active flare: 2 to 4 tablets (1000 to 2000mg) three to
four times daily — up to a maximum of 4000mg per day. For maintaining
remission: 2 tablets (1000mg) three times daily, or as directed by your
gastroenterologist.
Tablets can be swallowed whole or dispersed in a glass of water if
swallowing is difficult — the granules inside are active and should be
swallowed, not chewed. Take with or without food. Take consistently at regular
intervals throughout the day.
Pentasa SR tablets can be broken or dispersed in water — the granules
inside remain active and effective. However, do not chew the granules
themselves. For patients who have difficulty swallowing, emptying the contents
of the tablet into water is an acceptable option.
⚠ PATIENT TIP: Unlike the once-daily Mezavant XL
formulation, Pentasa SR is taken multiple times a day. Using a pill organiser
or setting reminders on your phone can help you stay consistent — especially
for the higher-frequency dosing during a flare. Consistent daily dosing, even
when you feel completely well, is what keeps ulcerative colitis and Crohn's
disease in remission.
4. POSSIBLE SIDE EFFECTS
|
How Common? |
Side Effects |
|
Common |
Headache, nausea,
abdominal pain or cramping, diarrhoea — these are usually mild and often
settle after the first few weeks of treatment |
|
Less Common |
Skin rash, joint pain,
raised liver enzymes on blood tests |
|
Rare — Tell Your
Doctor |
Kidney problems
(periodic kidney function monitoring recommended during long-term use).
Paradoxical worsening of IBD shortly after starting. Severe allergic
reaction. Mesalazine-related blood disorders (very rare — unexplained
bruising or fatigue). Pancreatitis (very rare — severe tummy pain). |
5. WHO SHOULD NOT TAKE THIS MEDICINE
Do not use if you are allergic to mesalazine, other aminosalicylates, or
aspirin. Use with caution in kidney or liver disease — kidney function should
be checked before starting and at least once a year during long-term treatment.
Generally considered safe in pregnancy but always discuss with your
gastroenterologist.
⚠ KIDNEY MONITORING: Long-term mesalazine use
requires periodic kidney function blood tests (eGFR and creatinine) — at least
annually. Report any reduction in urine output, ankle swelling, or persistent
tiredness to your doctor.
⚠ ADHERENCE IN REMISSION: Stopping Pentasa SR
when you feel well is one of the most common triggers for a flare. Even without
symptoms, the medicine is actively maintaining the remission. Never stop
without discussing it with your gastroenterologist.
⚠ ASPIRIN SENSITIVITY: If you have ever reacted
to aspirin, tell your doctor before starting mesalazine.
6. MEDICINES THAT INTERACT WITH THIS TREATMENT
Azathioprine and 6-mercaptopurine: mesalazine may increase toxicity of
these medicines — FBC monitoring recommended. Warfarin: mesalazine may alter
anticoagulant effect — INR monitoring if both are taken. NSAIDs worsen IBD and
should generally be avoided. Digoxin absorption may be slightly reduced.
7. HOW TO STORE THIS MEDICINE
Store below 30°C. Keep in the original packaging, away from moisture.
Keep out of reach of children.
8. PRESCRIPTION REQUIREMENT
|
Field |
Details |
|
Status |
Prescription Only
Medicine (POM) — typically prescribed and monitored by a gastroenterologist |
9. GUIDANCE FOR PATIENTS & CAREGIVERS
Take your tablets at regular intervals throughout the day — spreading the
doses evenly helps maintain a consistent level of medicine in your bowel. You
can take them with or without food. If you find tablets hard to swallow, you
can disperse the tablet in a small glass of water and swallow the granule
suspension — but do not chew the granules.
Keep taking the tablets even when you feel completely well — this is what
prevents your IBD from flaring. Attend annual kidney function blood tests. Tell
your gastroenterologist if your symptoms worsen after starting, or if you
notice any unexplained tiredness or reduced urine output.
10. PHARMACIST & PRESCRIBER NOTES
|
Field |
Details |
|
Clinical Dispensing
Notes |
Pentasa SR
(ethylcellulose-coated granule) formulation releases mesalazine throughout
the entire GI tract from duodenum onward — advantageous for small bowel
Crohn's disease and pancolitis. Tablets may be dispersed in water (granules
must not be chewed). Dosing frequency is higher than once-daily formulations
(Mezavant XL) — adherence counselling essential. Annual renal function
monitoring (eGFR and creatinine) for long-term users. Aspirin
cross-reactivity screening. Azathioprine/6-MP co-therapy: FBC monitoring.
Warfarin INR monitoring if co-prescribed. Counsel on continued use in
remission — stopping is a primary relapse trigger. NSAIDs contraindicated in
IBD. Dispense with patient information leaflet. |
11. FREQUENTLY ASKED QUESTIONS
Q: Can I swallow the tablet whole or does it need to be dissolved?
Swallowing the tablet whole is the standard method. But if you have
difficulty swallowing, you can place the tablet in a glass of water and let it
disperse — the granules inside will separate into the water and can be
swallowed as a suspension. Do not chew the granules themselves.
Q: Is this the same as the Pentasa enema?
Mesalazine is the active ingredient in both, but they are different forms
for different purposes. The Pentasa enema delivers medicine directly to the
lower bowel for localised left-sided disease. The Pentasa SR tablets treat the
entire bowel — from the small intestine through to the colon. Some patients use
both simultaneously.
Q: Will I need to take this medicine indefinitely?
For many patients with ulcerative colitis or Crohn's disease, mesalazine
is a long-term maintenance medicine. Your gastroenterologist will review
whether treatment is still needed and at what dose at regular intervals.
Q: What should I do if my symptoms get worse after starting?
A small number of patients experience a temporary worsening of bowel
symptoms in the first few days of starting mesalazine — this is rare and is
called a paradoxical reaction. If your symptoms worsen after starting Pentasa
SR, stop taking it and contact your gastroenterologist promptly.