DAGRAVIT TOTAL 8 Price

Overview

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This medicine contains an important and useful components, as it consists of
Vitamin - A / B1 / B2 / B6 / C / D / d-panthenol / Nicotinamide / Eis available in the market in concentration

Name

5 Aminosalicylic Acid (Mesalamine)

Precaution

Information not available

Indication

Information not available

Contra indication

- **Hypersensitivity to Mesalamine**: Contraindicated in patients with known hypersensitivity to mesalamine or any of its components. - **Severe Renal Impairment**: Mesalamine is contraindicated in patients with severe renal impairment, as it can exacerbate kidney dysfunction. - **Gastrointestinal Perforation**: Contraindicated in patients with a history of gastrointestinal perforation or active gastrointestinal ulcers. - **Sulfasalazine Allergy**: Mesalamine should be avoided in patients who have experienced a hypersensitivity reaction to sulfasalazine, as cross-reactivity can occur. - **Severe Hepatic Impairment**: Mesalamine should be used cautiously or avoided in patients with severe liver dysfunction, as it can worsen liver conditions. - **Pregnancy Category C (First Trimester)**: Although mesalamine is generally safe in pregnancy, it is contraindicated during the first trimester unless the benefits outweigh the risks. - **Breastfeeding**: While mesalamine is considered safe for use during breastfeeding, it is contraindicated if the infant shows signs of sensitivity or if there are concerns about infant health.

Side Effect

- **Common Side Effects**: - Nausea, vomiting, diarrhea, abdominal pain, and bloating. - Headaches and dizziness. - Mild rash or pruritus (itching). - Fatigue and malaise. - **Serious Side Effects**: - Severe allergic reactions (e.g., skin rash, fever, eosinophilia, and anaphylaxis). - Blood disorders: leukopenia, thrombocytopenia, and anemia. - Renal toxicity: Acute interstitial nephritis or worsening renal function, particularly in patients with pre-existing kidney disease. - Hepatitis or elevated liver enzymes (transaminases). - Severe gastrointestinal reactions such as colitis or intestinal perforation (rare but serious). - Pulmonary reactions: eosinophilic pneumonia or lung inflammation (though rare, these may occur). - **Long-term Use**: Prolonged use can sometimes lead to chronic side effects such as renal and hepatic damage, and patients should be monitored regularly.

Pregnancy Category ID

2

Mode of Action

- **Anti-inflammatory Action**: Mesalamine is a 5-aminosalicylic acid derivative that works by directly inhibiting the production of inflammatory mediators in the gut, such as prostaglandins and leukotrienes. - **Localized Effect**: The drug is locally acting, meaning it primarily affects the colonic mucosa and does not significantly enter systemic circulation. This localized effect makes it particularly useful for treating conditions like ulcerative colitis and proctosigmoiditis. - **Immune Modulation**: Mesalamine also suppresses T-cell activation and reduces the levels of pro-inflammatory cytokines, helping reduce inflammation in the gastrointestinal tract. - **Reduced Inflammatory Enzyme Activity**: Mesalamine inhibits cyclooxygenase (COX) and lipoxygenase pathways, which are involved in the inflammatory process within the intestines. - **Prevention of Flare-ups**: By controlling inflammation, mesalamine can help maintain remission in patients with chronic inflammatory bowel diseases, preventing relapse of symptoms.

Interaction

- **Azathioprine and Mercaptopurine**: Concomitant use with mesalamine can increase the risk of blood dyscrasias such as leukopenia. - **Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)**: NSAIDs may reduce the effectiveness of mesalamine and increase the risk of renal toxicity when used together. - **Warfarin**: Mesalamine may alter the anticoagulant effects of warfarin, increasing the risk of bleeding. Close monitoring of INR levels is advised. - **Other Aminosalicylates**: Concurrent use with other drugs of the same class (e.g., sulfasalazine) should be avoided as this could lead to additive toxicity. - **Antacids and H2 Blockers**: Use of antacids or H2 blockers may alter the dissolution of mesalamine in the intestines, potentially reducing its effectiveness. - **Methotrexate**: Caution is needed when mesalamine is used with methotrexate, as both drugs may increase the risk of liver toxicity. - **Probenecid**: Co-administration with probenecid may increase mesalamine plasma levels, raising the risk of toxicity. - **Immunosuppressants**: Use of immunosuppressive agents with mesalamine requires careful monitoring for increased risk of infections and blood dyscrasias.

Pregnancy Category Note

Information not available

Adult Dose

- **Ulcerative Colitis**: - **Induction of Remission**: 4.8 g per day divided into 2–3 doses. - **Maintenance of Remission**: 2.4–4.8 g per day in divided doses. - **Crohn’s Disease**: - **Induction of Remission**: Typically 4.8 g per day in divided doses, though efficacy is variable. - **Maintenance**: 2.4–4.8 g per day, adjusted based on patient response. - **Proctosigmoiditis**: - **Rectal Administration**: 4 g per day for up to 8 weeks, or as directed by a healthcare provider. - **Maximal Dose**: The maximum recommended dose for adults is 4.8 g per day for active disease; higher doses are generally not advised due to increased risk of side effects. - **Administration Tips**: Mesalamine should be taken with food to minimize gastrointestinal irritation. If taken in delayed-release form, ensure that the capsule or tablet is not crushed or chewed.

Child Dose

- **Ulcerative Colitis (Mild to Moderate)**: - For children aged 5 years and older, the usual dose is 50–70 mg/kg per day, divided into 2–3 doses. - For maintenance, the typical dose is 20–40 mg/kg per day, again in divided doses. - **Age Consideration**: Mesalamine should be used cautiously in children under 5 years of age, and its use in this population should be evaluated by a pediatric gastroenterologist. - **Maximum Dose**: The maximum recommended dose for pediatric patients is 2.4 g per day. - **Rectal Formulation**: In cases of proctosigmoiditis, mesalamine rectal formulation (enemas or suppositories) may be used as a treatment option for children over 6 years of age.

Renal Dose

- **Renal Impairment**: - For mild to moderate renal impairment (creatinine clearance 30-50 mL/min), reduce the dose or use with caution. - For severe renal impairment (creatinine clearance <30 mL/min), mesalamine should be avoided or used only under strict medical supervision due to the risk of further renal deterioration. - **Monitoring**: Patients with impaired renal function should be monitored frequently for signs of renal toxicity, including changes in creatinine levels and urine output. - **Adjustment**: Dosage adjustments are made based on the severity of the renal dysfunction and should be managed by a healthcare provider.

Administration

Information not available