Pentasa Suppositories

📦 Every order is covered by our Reshipment Assurance Policy — if your parcel does not arrive within 20 business days, we reship it.

Why order from MedsBase

Our generic medications are sourced from WHO-GMP certified manufacturers and shipped worldwide in discreet, plain packaging — no medication name on the parcel exterior. Card payments are routed through a regulated processor (statement descriptors include a regulated card-payment processor — never “MedsBase” or any medication name). Crypto and SEPA bank transfer are also accepted. Every order is backed by our Reshipment Assurance Policy.

Why order from MedsBase

Pentasa Suppositories is supplied from a WHO-GMP certified manufacturer. Every order ships discreetly worldwide and is covered by our Reshipment Assurance Policy — if it does not arrive within 20 business days, we reship at no cost. Topical mesalazine delivers high local concentration to the rectum with negligible systemic absorption, which makes it the cornerstone of distal UC remission — safer than oral or systemic steroid courses.

Mechanism

Mesalazine (5-aminosalicylic acid, 5-ASA) is the active anti-inflammatory moiety of the older drug sulfasalazine (which is hydrolysed by colonic bacteria into 5-ASA + sulfapyridine; the sulfapyridine accounts for sulfasalazine’s side effects). 5-ASA acts on the colonic mucosa through several mechanisms: PPAR-γ agonism (anti-inflammatory transcription), inhibition of COX/LOX prostaglandin pathways, scavenging of reactive oxygen species, and inhibition of NF-κB activation. Suppository formulation delivers the drug directly to the rectum (15 cm reach) with very little systemic absorption.

Indications

• Mild-to-moderate ulcerative proctitis (induction and maintenance)
• Distal proctosigmoiditis (combine with oral 5-ASA)
• Crohn’s proctitis
• Post-surgical pouchitis (off-label)
• Radiation proctitis (off-label, second-line)

Dose

Induction: 1 suppository (1 g) once daily, ideally at bedtime, for 4–8 weeks. Maintenance: 1 suppository three times weekly or daily depending on disease pattern. Children > 12 years: same as adult. Severe hepatic or renal impairment: caution.

How to use

1. Empty the bowels and bladder if possible.
2. Wash hands; chill the suppository (5–10 minutes in fridge if it has softened).
3. Lie on your left side with the right knee drawn up.
4. Insert the rounded end first, push gently 2–3 cm into the rectum.
5. Stay lying down for 15–30 minutes to allow the suppository to retain in place.
6. Bedtime application maximises retention through the night.

Side effects

• Local: anal burning, leakage, mild itch
• Systemic (rare): headache, nausea, abdominal pain
• Idiosyncratic: hypersensitivity (rash, fever, eosinophilia), interstitial nephritis (rare; baseline + annual creatinine and urinalysis recommended for chronic oral mesalazine, optional for suppository-only)
• Acute mesalazine intolerance syndrome — paradoxical worsening of colitis (rare; stop drug and review)

Drug interactions

• Azathioprine, mercaptopurine: mesalazine inhibits TPMT and raises 6-MP levels — monitor FBC closely.
• Warfarin: rare INR rise reported.
• Live oral typhoid vaccine: avoid.

Frequently Asked Questions

How quickly will I improve?

Tenesmus and rectal bleeding often improve within 1–2 weeks. Full mucosal healing takes 4–8 weeks. Continue the full induction course even if symptoms resolve sooner.

Why bedtime?

A bedtime suppository remains in the rectum overnight while you sleep, maximising mucosal contact time. Daytime applications often leak after activity.

I had no improvement after 4 weeks. What now?

Step up to oral mesalazine (Asacol, Mesacol, or Pentasa) added to the suppository, or escalate to topical budesonide foam. If still no response after 8 weeks, gastroenterology review for systemic steroid, immunomodulator, or biologic.

Is it safe in pregnancy?

Yes. Topical mesalazine has minimal systemic absorption and is considered safe throughout pregnancy and breastfeeding. Active ulcerative colitis flares are themselves a risk to pregnancy; controlling the flare is the priority.

Will I need it long term?

Many people do for maintenance. Three-times-weekly dosing often suffices once remission is achieved. The aim is to prevent flares, which carry their own risk of complications and surgery.

Can I take other UC medication at the same time?

Yes, the typical regimen for moderate distal UC is oral mesalazine (Asacol/Mesacol) 2.4–4.8 g/day plus a topical mesalazine suppository or enema. Adding a topical 5-ASA accelerates remission compared to oral alone.

What about my kidneys?

Interstitial nephritis is rare with oral mesalazine and very rare with topical-only therapy. If you are on chronic oral mesalazine in addition, baseline and annual creatinine and urinalysis are recommended.

Can I cut it in half?

No — the suppository is designed to release mesalazine gradually as it dissolves. Cutting changes the surface area and release rate.

Storage

Below 30°C in the original sealed packet. Suppositories that have softened or fragmented should not be used.

What if I miss a dose?

Insert it as soon as you remember. If close to the next dose, skip and continue. Do not double up.

Other Gastro Health Medications

• Asacol — Oral mesalamine 400 mg DR
• Mesacol — Oral mesalamine 400 mg
• Saaz — Sulfasalazine 500 mg
• Budez CR — Budesonide CR (terminal-ileal Crohn’s)
• Rifagut — Rifaximin (gut-selective antibiotic)
• Browse all Gastro Health Medications

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