What is Pentasa?
Doctors have been using the drug, Azulfidine, for over 50 years to treat inflammatory bowel disease. In some ways the Azulfidine molecule is half aspirin-like and half like the antibiotic sulfa. Some patients have an adverse reaction to Azulfidine, mostly due to its similarity to sulfa compounds. Scientists were able to remove the sulfa-like portion of Azulfidine, while maintaining the full beneficial effect. The result was meslamine, an aspirin-like antiinflammatory drug. Approved by the FDA in 1987, mesalamine comes in different formulations and delivery systems - one of which is named Pentasa.
Pentasa is a man-made compound that is taken by mouth to treat inflammatory disorders of the colon such as Crohn's disease, and other inflammatory conditions. It is sometimes given in conjunction with other medications such as the steroid, prednisone. Another common name for mesalamine is 5-aminosalicylic acid, or 5-ASA. Each capsule of Pentasa contains about 250 mg of mesalamine. The shelf life is 3 years.
Targeted Delivery
One of the unique features of Pentasa is the fact that the pill does not release its medication until it reaches the diseased area. Each tablet has a special plastic coating which delays release of mesalamine until the tablets reach the end of the 20 feet of small intestine, or the ileum. This allows delivery of most of the medicine right where the problem lies - the ileum and right colon. How mesalamine works is unknown, but it appears to be topical rather than systemic. Once released in the colon, mesalamine is minimally absorbed. Most of it works directly on the lining of the ileum and colon - like putting a salve on a rash. Eventually most of it is excreted with the stool. Studies have shown that Pentasa can help bring a case of Crohn's under control and help maintain a remission over time. Realize that inflammatory bowel disease rarely goes into permanent remission, but the risk of flare-ups can be substantially reduced by continued use of Pentasa at the maintenance dose as directed by your doctor.
What Pentasa is not.
Pentasa is not a steroid like prednisone. It is not habit forming; it does not cause drowsiness. Since it lacks the sulfa-like properties of Azulfidine, most patients intolerant or allergic to Azulfidine and other sulfa drugs can be safely treated with Pentasa. In addition, Pentasa does not reduce a man's sperm count as does Azulfidine. There are no known interactions with other medications. As yet, there is no generic substitution available.
How does Pentasa differ from Asacol
Both Pentasa and Asacol are prescription forms of mesalamine. The difference between Asacol and Pentasa is in the outer chemical coating. Oral Pentasa has a unique formulation. The active ingredient is contained in coated microgranules, which enables a prolonged release of the active substance throughout the intestinal tract, from duodenum to the rectum. Therefore the Pentasa preparation is more useful for Crohn's patients who often have inflammation of the small intestine. The average small bowel transit time is approximately 3-4 hours in healthy volunteers.
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