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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Modified Release Mesalazine

Mesalazine is a commonly prescribed drug that provides a modified release (MR) delivery of a topical anti-inflammatory for the treatment of Crohn's Disease and Ulcerative Colitis.

Concerns have been raised that there are differences in the release characteristics of the different products. These concerns are based upon in vitro studies of Asacol® and Ipocol®. These differences are the basis of recommendations to prescribed MR mesalazine by brand. However, in vitro differences may not mean that there are clinically noticeable differences.

Both UK Medicines Information and the East Anglian Medicines Information Service have looked at the evidence used to support claims of a difference. They have both concluded that while there is evidence of in vitro differences there is also evidence of clinical similarity based on the available clinical data.

Action: Many MR products should be prescribed by brand but there is currently insufficient clinical data to support brand name prescribing of mesalazine. Generic prescribing should be used in the majority of cases unless individual patients show demonstrable benefit on one product in preference to another.

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