Evemesa
Generic Name
Mesalazine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| evemesa 1 gm microgranules | ৳ 50.00 | N/A |
Description
Overview of the medicine
Evemesa 1 gm Microgranules contains Mesalazine, an anti-inflammatory drug used to treat and prevent relapse of mild to moderate ulcerative colitis and Crohn's disease. The microgranule formulation ensures targeted release in the colon.
Uses & Indications
Dosage
Adults
For active ulcerative colitis, 1 gm to 4 gm daily, usually divided into 1 or 2 doses. For maintenance, 1 gm daily.
Elderly
Use with caution and monitor renal function. Dosage adjustment may be required based on renal status.
Renal_impairment
Contraindicated in severe renal impairment. Use with caution in mild to moderate impairment; regular monitoring of renal function is essential.
How to Take
Take orally, preferably with meals. Do not chew or crush the microgranules; swallow them whole or sprinkle them on soft food (e.g., yogurt, applesauce) and swallow immediately without chewing.
Mechanism of Action
Mesalazine acts topically on the intestinal mucosa, primarily in the colon, to reduce inflammation. Its exact mechanism is not fully understood, but it is believed to inhibit prostaglandin and leukotriene synthesis, scavenge free radicals, and modulate local immune response, thereby reducing inflammation and tissue damage.
Pharmacokinetics
Onset
Symptomatic relief typically begins within a few days to a few weeks, with full therapeutic effect often seen after 3-12 weeks of continuous treatment.
Excretion
Unabsorbed mesalazine is excreted in the feces. Absorbed mesalazine and its metabolite (N-Ac-5-ASA) are excreted via the kidneys in the urine.
Half life
The systemic half-life of mesalazine is short (approximately 0.5-1.5 hours), while its primary metabolite, N-acetyl-5-aminosalicylic acid (N-Ac-5-ASA), has a longer half-life (5-10 hours).
Absorption
Low systemic absorption; primarily acts locally. Microgranules are designed for pH-dependent or time-dependent release in the lower gastrointestinal tract, ensuring high local concentration in the colon.
Metabolism
Primarily metabolized in the intestinal mucosa and liver by N-acetyltransferase to N-Ac-5-ASA, which is largely inactive.
Side Effects
Contraindications
- Hypersensitivity to mesalazine, salicylates, or any component of the formulation
- Severe renal impairment (e.g., GFR <30 mL/min)
- Severe hepatic impairment
Drug Interactions
Antacids
May prematurely dissolve the coating of some mesalazine formulations, affecting release.
Azathioprine or 6-Mercaptopurine
May increase the risk of myelosuppression.
Lactulose or other agents altering stool pH
May alter the release and effectiveness of mesalazine.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
May increase the risk of renal adverse effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose symptoms may include headache, nausea, vomiting, abdominal pain, fever, and hyperventilation, similar to salicylate toxicity. Treatment is supportive and symptomatic; gastric lavage or activated charcoal may be considered in acute overdose.
Pregnancy & Lactation
Pregnancy Category B/C (depending on formulation and source). Use only if clearly needed and benefits outweigh risks. Small amounts are excreted in breast milk; use with caution during lactation and monitor the infant for diarrhea.
Side Effects
Contraindications
- Hypersensitivity to mesalazine, salicylates, or any component of the formulation
- Severe renal impairment (e.g., GFR <30 mL/min)
- Severe hepatic impairment
Drug Interactions
Antacids
May prematurely dissolve the coating of some mesalazine formulations, affecting release.
Azathioprine or 6-Mercaptopurine
May increase the risk of myelosuppression.
Lactulose or other agents altering stool pH
May alter the release and effectiveness of mesalazine.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
May increase the risk of renal adverse effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose symptoms may include headache, nausea, vomiting, abdominal pain, fever, and hyperventilation, similar to salicylate toxicity. Treatment is supportive and symptomatic; gastric lavage or activated charcoal may be considered in acute overdose.
Pregnancy & Lactation
Pregnancy Category B/C (depending on formulation and source). Use only if clearly needed and benefits outweigh risks. Small amounts are excreted in breast milk; use with caution during lactation and monitor the infant for diarrhea.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture.
Availability
Available in pharmacies and hospitals nationwide
Approval Status
DGDA approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Mesalazine has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in the induction and maintenance of remission in ulcerative colitis. Specific microgranule formulations like Evemesa are designed to optimize drug delivery to the colon.
Lab Monitoring
- Renal function (serum creatinine, BUN) before starting treatment and periodically thereafter (e.g., every 3-6 months)
- Liver function tests (ALT, AST) periodically
- Complete blood count (CBC) periodically
Doctor Notes
- Emphasize the importance of patient adherence for optimal outcomes in IBD.
- Monitor renal function (creatinine, GFR) at baseline and every 3-6 months, or more frequently if clinically indicated.
- Advise patients to report any new or worsening symptoms, especially fever, rash, chest pain, or changes in urine output, as these could indicate a serious adverse reaction.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not chew, crush, or break the microgranules.
- If you sprinkle on food, consume immediately without chewing.
- Report any severe abdominal pain, chest pain, fever, rash, or changes in urine output to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Evemesa generally does not affect the ability to drive or operate machinery. However, if you experience side effects like dizziness or headache, avoid driving or operating machinery until you feel well.
Lifestyle Advice
- Maintain adequate hydration by drinking plenty of fluids.
- Follow a balanced diet that supports digestive health.
- Avoid smoking, as it can worsen IBD symptoms and reduce treatment effectiveness.
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