Interaction with other drugs
Mesalazine shows a variety of interactions with other drugs. Patients should inform their treating physician about taking mesalazine when prescribing a drug. Interactions may decrease the effectiveness or increase the risk of side effects.
Mesalazine interacts with anticoagulants, which may be more potent. The risk of gastrointestinal bleeding is increased. Mesalazine also interacts with sulfonyureas, blood sugar lowering agents.
This also applies to uricosurics, agents that promote uric acid excretion. Diuretic agents such as spironolactone and furosemide also interact with mesalazine. Glucocorticoids, which are used as anti-inflammatory agents, increase the risk of undesirable side effects.
In addition, mesalazine reduces the effect of rifampicin, an agent against tuberculosis. In combination with mercaptopurine, a cytotoxic and immunosuppressive agent, it can cause pancytopenia, a severe reduction in all blood cell groups. Patients with inflammatory bowel diseases suffer repeatedly from diarrhea.
As a result, the effectiveness of the pill may be diminished and is not the first choice of contraception in the acute phase of the disease. Mesalazine has no influence on the effectiveness of the pill. Nevertheless, patients should discuss the possibilities of contraception with their gynaecologist with regard to their illness and medication and, depending on the severity of the condition, also use an alternative method.
Alternatives to the Pill could include hormone implants or hormone coils. Effective contraception as long as there is no desire to have children is important, as particularly high-dose long-term medication carries a certain risk of damaging the fertility in severe cases. Alcohol has a negative influence on the course of chronic inflammatory bowel diseases and can promote an acute flare-up, which is why patients are generally advised against alcohol consumption. The interaction of alcohol and mesalazine has not been sufficiently researched.Those affected should enjoy alcohol in small quantities and responsibly and, in the best case, avoid taking it. This applies in particular to patients in the acute thrust, which are treated additionally with Kortison.
