Mesalamine Side Effects & Alternatives Of Mesalamine In Ayurveda

Mesalamine Side Effects & Alternatives Of Mesalamine In Ayurveda
May 2023


Mesalamine is useful in treating bowel diseases such as Ulcerative Colitis. It commonly belongs to the class of drugs known as Aminosalicylates. Mesalazine or 5-aminosalicylic acid generally treats mild to moderately severe disease. It is taken orally and rectally. It is used to treat inflammatory bowel disease which includes ulcerative colitis and Crohn's disease. It works by inhibiting the production of certain substances such as prostaglandins which reduces inflammation. Inflammation is part of the body's defence mechanism which plays an important role in the process of healing. When the body detects it launches a biological response and removes it. In Ulcerative colitis or in inflammatory bowel disorder there is an abnormal reaction in the immune system which causes inflammation of the inner lining of the large intestines. In this article, we are going to discuss the pathophysiology of mesalamine and its various effects along with the Ayurvedic aspect in detail.


Mesalamine is a class of drugs which belongs to anti-inflammatory drugs. It treats the symptoms of ulcerative colitis such as irritations and ulcers in the large intestines. It is useful in preventing the flare-up of symptoms by decreasing the inflammation in the digestive tract. Belongs to a group of medications known as Salicylates. Common brand Names such as Asacol, Asacol HD, Delzicol and Pentasa. Its chemical formula is C7H7NO3. It is the active functional group of Sulfasalazine which is metabolized to sulfapyridine and mesalazine. It dampens the inflammatory process which inhibits prostaglandin synthesis and interferes with leukotriene synthesis, acting as a scavenger of the free radicals.

Mechanism Of Action

  • It is a topical anti-inflammatory which shows its result on colonic epithelial cells.
  • The mucosal production of arachidonic acid metabolites through prostanoids and through the lipoxygenase pathway is increased already in chronic inflammatory bowel disease.
  • But Mesalamine diminishes the inflammation by blocking and inhibiting the production of prostaglandins in the colon.
  • It has the potential to inhibit the activation of nuclear factor Kappa B which produces the pro-inflammatory cytokines.
  • Mesalazine produces the direct activation of PPAR gamma receptors in the rectal epithelium. But mesalazine inhibits enteropathy in inflammatory bowel disease.
  • The increased leukocyte migration, abnormal cytokine production and the increased production of arachidonic acid with the increased radical formation in the intestinal tissue are seen in all inflammatory bowel disorders. So therefore mesalazine has in-vitro and in-vivo effects which decrease cytokine and leukotriene production.

Route Of Elimination

  • It is eliminated via the renal route following the metabolism of N-acetyl 5- aminosalicylic acid. But limited excretion in the urine.
  • Can be excreted in the faeces and in urine which depends upon the formulation of drugs.


  • Ulcerative Colitis (can be used in the form of suppositories and enema for distal disease).
  • Remission of Crohn's disease and inflammatory bowel disease.


  • Renal impairment
  • Serious blood dyscrasias
  • Nephrolithiasis

Side Effects

  • Muscle pain, stiffness and tightness in the muscles
  • Nausea
  • Constipation
  • Dizziness
  • Heartburn
  • Rashes, hives and blistering of the skin
  • Swollen glands
  • Difficulty in breathing and swallowing
  • Bloody vomit
  • Worsening of cough
  • Peripheral neuropathy
  • Lupus erythematosus
  • Interstitial nephritis
  • Rarely there is an exacerbation of Stevens-Johnson syndrome and Erythema multiforme

Alternatives Of Mesalamine In Ayurveda

  1. BAEL - Bael (Aegle marmelos) has various healing properties, which improve the digestive functions of the body and relieve swelling and soothes the mucus membrane of the rectum. Has anti-diarrheal and Anti-microbial properties. Manages constipation as it has laxative properties. Lower the blood sugar level.
  2. VACHA - Vacha (Acorus calamus) has anti-inflammatory properties which are effective in soothing and reducing the inflammation of the mucosal ulcers of the intestine. Due to its antioxidant property, it protects the delicate mucosa from any oxidative damage. Controls various acidity and gastric acid secretion to protect the lining of the stomach.
  3. VAIVIDANGA - Vaividanga (Embelia ribes) treats various inflammatory disorders and reduces inflammation and ulceration. Has anti-cancer properties so it is useful in preventing rectum cancer. Due to its antioxidant property, it prevents the deterioration of the mucosal lining. Reduces fat so clears the toxins from the body. Helpful in the elimination of undigested food.
  4. MULETHI - Mulethi (Glycyrrhiza glabra) has anti-inflammatory properties, is helpful in boosting immunity and controls the cholesterol level. It reduces the testosterone level and increases the chance of fertility. Has antiviral and antibacterial properties. Soothes the rashes of the skin and maintains healthy skin.

Alternative Products For Mesalamine By Planet Ayurveda

Planet ayurveda is a renowned GMP- certified, ISO 900-2015 certified US-FDA registered ayurvedic company which adhered to the aim of manufacturing ayurvedic medications as described in the ancient Ayurvedic textbooks. These products are made up of pure herbs without any additions of preservatives and any chemicals which do not cause any side effects. Planet Ayurveda provides effective treatment for ulcerative colitis which is helpful in curing the disease without causing any side effects which we will discuss further in detail.


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  1. Arjuna Capsules - Arjuna Capsules are single herbal capsules which are made by planet ayurveda using a standardised extract of Arjuna (Terminalia Arjuna). Helpful in balancing pitta and Kapha doshas. Maintains a healthy cardiovascular system. Due to its Kshaya Rasa, it works as a Stambhana which stops the ati-rakta Pravriti. Arjuna possesses hydrolipidic properties.
  2. Dosage - 2 capsules twice daily with plain water after meals.

  3. Vatsakadi Churan - Vatsakadi Churan is a blend of powerful herbs which is formulated by planet ayurveda using Kutaj (Holarrhena antidysenterica), Saunf (Foeniculum vulgare), Jaiphal (Myristica fragrans), Anar (Punica granatum) and many more. It is helpful in maintaining a healthy digestive system. Act as Antibiotic and Anti-spasmodic in nature. Promotes the healthy functioning of the intestines.
  4. Dosage - 1 teaspoon twice daily with plain water after meals.

  5. Pitta Balance - Pitta balance is a polyherbal capsule formulation which is made by planet ayurveda using JaharMohra Pishti (Natural Calcium Compound), Giloy Satva (Tinospora cordifolia), Mukta Pishti (Natural calcium compound) and many more. Restores healthy skin and works as a blood cleanser and is helpful in improving bone marrow density. Maintains a healthy digestive system.
  6. Dosage - 1 capsule twice daily with plain water after meals.

  7. Kutajghan Vati - Kutajghan Vati are herbal tablet formulations by planet Ayurveda using Kutaja (Holarrhena antidysenterica) which is helpful in maintaining a healthy digestive system. Supports healthy intestines and provides relief from bleeding disorders and has antidysenteric, anti-amoebic actions. Fulfils the nutritional deficiency in the body.
  8. Dosage - 2 tablets twice daily with plain water after meals.

Depending upon the status of the patient Planet Ayurveda also provides a Double Strength Ulcerative Colitis Pack and an Ulcerative Colitis Care Pack For Advanced Stages [ID-199] which depends upon the severity of the ulcerative colitis and all the ingredients vary from pack to pack and these are made up of pure herbs without any preservatives and they provide a healthy and happy life to the patient!