Mesalamine / 5-ASA (Lialda/Apriso/Pentasa)

DMARDprescriptionoral · inferred

5-Aminosalicylic acid (5-ASA) delivered via pH-dependent or time-delayed release systems to act topically on inflamed colonic mucosa; the active moiety liberated from sulfasalazine without the sulfapyridine AE burden. First-line for mild-to-moderate ulcerative colitis (induction and maintenance) and some Crohn's colitis. Typical dose 1.2-4.8 g/day PO. Systemic bioavailability ~30% (formulation-dependent); plasma t1/2 ~5h but therapeutic effect driven by colonic tissue concentrations, not plasma. Mechanisms include PPAR-gamma activation, COX/LOX inhibition, and scavenging of reactive oxygen species locally in colonic epithelium. Generally well tolerated; rare interstitial nephritis warrants baseline/periodic renal monitoring.

Projected serum levels — 2.4k mg, once daily

Maintenance schedule: 2.4k mg once daily (oral).

Modeled steady state after ~7 days: peak ≈ 0 mg, trough ≈ 0 mg body load. Population-based estimate over 15 days for a 2.4k mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category: DMARD
Route modeled: Oral
Model confidence: inferred
Common dose: 2.4k mg
Suggested maximum: 4.8k mg/day
Reference dose range: 1.2k–4.8k mg (single dose)
Suggested cadence: once daily

Documented interactions

danger
5-Aminosalicylic Acid (Mesalamine) + Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) Stacked effects
5-Aminosalicylic Acid (Mesalamine) and Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) both push the cox1, cox2, and ppar gamma in the same direction.
moderate
Aspirin (Acetylsalicylic Acid) + Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) Stacked effects
Aspirin (Acetylsalicylic Acid) and Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) both push the cox1 and cox2 in the same direction.
moderate
Celecoxib (Celebrex) + Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) Stacked effects
Celecoxib (Celebrex) and Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) both push the cox1 and cox2 in the same direction.
moderate
Diclofenac (Voltaren) + Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) Stacked effects
Diclofenac (Voltaren) and Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) both push the cox1 and cox2 in the same direction.
moderate
Meloxicam (Mobic) + Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) Stacked effects
Meloxicam (Mobic) and Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) both push the cox1 and cox2 in the same direction.
moderate
Naproxen (Aleve) + Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) Stacked effects
Mesalamine / 5-ASA (Lialda/Apriso/Pentasa) and Naproxen (Aleve) both push the cox1 and cox2 in the same direction.

Serum checks 17 modeled interaction pairings for mesalamine / 5-asa (lialda/apriso/pentasa) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

Oral 5-aminosalicylic acid therapy in the management of ulcerative colitis: a review of its clinical efficacy Ye B, van Langenberg DR · World Journal of Gastrointestinal Pharmacology and Therapeutics, 2015 DOI
Systematic review confirming oral 5-ASA 2.4-4.8 g/day as first-line for mild-moderate UC induction and maintenance, with dose-response favoring higher end of range for induction.
Once-daily dosing of delayed-release oral mesalamine (400-mg tablet) is as effective as twice-daily dosing for maintenance of remission of ulcerative colitis Sandborn WJ et al. · Gastroenterology, 2010 DOI
Phase 3 RCT demonstrating once-daily 2.4 g mesalamine non-inferior to divided dosing for UC remission maintenance - simplified dosing standard.

2 published studies referenced in the app, each with a plain-language summary.