What is Pentasa (Mesalamine)?
Pentasa, a brand name for the drug mesalamine, is an anti-inflammatory medication primarily used to treat and induce remission in adults with mild to moderate ulcerative colitis (UC) [1.4.2, 1.6.5]. UC is a type of inflammatory bowel disease (IBD) that causes inflammation and ulcers in the large intestine [1.3.4]. Pentasa belongs to a class of drugs called aminosalicylates (or 5-ASA) and works by reducing inflammation directly in the lining of the colon [1.6.5, 1.7.1]. Its controlled-release formulation allows the medication to be delivered throughout the gastrointestinal tract [1.7.4, 1.8.4]. The typical dosage is 1 gram, taken four times daily [1.10.2].
Do Common Pentasa Side Effects Go Away?
For many users, the answer is yes. Many mild side effects of Pentasa are temporary and may resolve on their own within a few days to a couple of weeks as your body gets used to the medication [1.2.1, 1.2.5]. These common, often transient, side effects include:
- Headache [1.2.1]
- Diarrhea [1.2.1]
- Abdominal pain [1.2.1]
- Nausea and vomiting [1.2.1]
- Gas or burping [1.3.3, 1.2.5]
- Rash [1.3.2]
- Joint pain [1.2.3]
If these side effects persist, become severe, or are bothersome, it is crucial to speak with your doctor or pharmacist [1.2.1].
Managing Mild Side Effects
Simple strategies can often help manage these initial side effects:
- For Stomach Issues: Taking Pentasa with food can sometimes help, as can eating smaller, more frequent meals and avoiding spicy or greasy foods [1.2.5].
- For Headaches: Ensure you are drinking plenty of fluids to stay hydrated, as dehydration can contribute to headaches. An over-the-counter painkiller like acetaminophen may be helpful, but you should consult your pharmacist first [1.5.1, 1.5.3].
- Hydration: Drinking an adequate amount of fluids is important during treatment to help prevent certain side effects, including kidney stones [1.10.2, 1.9.2].
Serious Side Effects: When to Contact a Doctor Immediately
While uncommon, Pentasa can cause serious side effects that require immediate medical attention. It is important to stop taking Pentasa and call your doctor right away if you experience any of the following [1.3.3, 1.4.2]:
- Mesalamine-Induced Acute Intolerance Syndrome: This condition can be difficult to distinguish from a UC flare-up. Symptoms include severe stomach cramping, acute abdominal pain, bloody diarrhea, fever, and headache [1.8.2].
- Kidney Problems: Although rare, Pentasa can cause kidney issues like interstitial nephritis or kidney stones. Symptoms to watch for include swelling in your feet or ankles, decreased urine output, severe back or side pain, or blood in the urine [1.2.2, 1.9.1]. Your doctor should evaluate your kidney function before and during therapy [1.10.2].
- Liver Problems: In patients with pre-existing liver disease, there have been reports of liver failure. Symptoms include yellowing of the skin or eyes (jaundice), dark urine, upper right abdominal pain, and unusual tiredness [1.2.2, 1.3.3].
- Severe Skin Reactions: Though very rare, conditions like Stevens-Johnson syndrome (SJS) can occur. These reactions may start with a rash, blisters, fever, or body aches and require immediate hospitalization [1.2.2, 1.3.5].
- Heart Inflammation (Myocarditis/Pericarditis): Symptoms can include chest pain, shortness of breath, and a fast or pounding heartbeat [1.3.5, 1.4.3].
- Blood Disorders: In older adults, particularly those 65 and over, there is a higher incidence of blood disorders like agranulocytosis or pancytopenia. Signs can include fever, chills, sore throat, and unusual bruising or bleeding [1.4.2].
Comparison Table: Pentasa vs. Other Mesalamine Formulations
Pentasa is one of several available mesalamine products. They share the same active ingredient but differ in their delivery mechanisms, which affects where they release the drug in the digestive tract [1.7.1, 1.7.3].
| Feature | Pentasa | Asacol HD (and generics) | Lialda (and generics) |
|---|---|---|---|
| Release Type | Time-dependent, controlled-release beads | pH-dependent, delayed-release tablet | pH-dependent, delayed-release tablet |
| Release Site | Stomach, small intestine, and colon [1.7.3] | Terminal ileum and colon [1.7.3] | Colon [1.6.1] |
| Active Drug | Mesalamine (5-ASA) [1.8.4] | Mesalamine (5-ASA) [1.6.1] | Mesalamine (5-ASA) [1.6.1] |
| Dosing Freq. | Typically four times per day [1.10.2] | Typically three times per day [1.6.5] | Typically once per day [1.6.5] |
| Form | Extended-release capsule (250mg, 500mg) [1.10.2] | Delayed-release tablet (800mg) [1.6.1] | Delayed-release tablet (1.2g) [1.6.1] |
Conclusion
For many patients starting Pentasa, common side effects like headache and nausea are mild and temporary, often resolving within a few weeks [1.2.1]. However, it is essential to monitor for any persistent or severe symptoms. While long-term side effects are rare, they can be serious and may involve the kidneys or liver [1.2.4, 1.9.3]. Maintaining open communication with your healthcare provider, attending regular check-ups for kidney and liver function monitoring, and reporting any new or worsening symptoms promptly are crucial steps for safely managing ulcerative colitis with Pentasa [1.9.2, 1.10.2].
For more detailed information, consult the official patient information provided by the FDA.
Official FDA Patient Information [1.10.2]
