Mesalazine monitoring

Published Last updated
Topics: MesalazineMonitoring
Using this page · Individualise medicines monitoring

This medicines monitoring page has been written using publications and expert opinion. It is designed to save clinician time, but not replace professional responsibility. When using this page you should: ensure an individualised monitoring plan is developed in partnership with the patient and take account of any locally agreed advice and guidance.

Before starting

Required

  • Baseline
    • Serum creatinine (for creatinine clearance) or Estimated glomerular filtration rate
    • Urea and electrolytes

Consider

  • Baseline
    • Full blood count
    • Liver function tests

Continued until stable

Required

  • At 3 months; then annually. More frequently in renal impairment
    • Serum creatinine (for creatinine clearance) or Estimated glomerular filtration rate
    • Urea and electrolytes

Consider

  • At 3 months; then annually
    • Full blood count
    • Liver function tests

Some manufacturers recommend more frequent monitoring, such as 14 days after starting, then every 4 weeks for 2 to 3 months, then 3 monthly thereafter.

Ongoing once stable

Required

  • Annually, more frequently in renal impairment
    • Serum creatinine (for creatinine clearance) or Estimated glomerular filtration rate
    • Urea and electrolytes

Consider

  • Annually (depending on risk factors)
    • Full blood count
    • Liver function tests

Some manufacturers recommend monitoring 3 monthly.

Abnormal results

Be aware of trends in results in addition to absolute values. A downward trend in liver transaminases could be sign of toxicity, even if the absolute results are within the normal range.

Respond to absolute values

Renal function

Stop if deteriorates

Liver function

If AST or ALT are greater than twice the upper limit of the reference range, stop and discuss with specialist.

Notes

Advice to patients

Advise patients to report any of the following:

  • unexplained bleeding
  • bruising
  • rash
  • sore throat
  • fever
  • malaise

Beware of blood dyscrasia or toxicity

Perform full blood count and stop treatment immediately if a blood dyscrasia or toxicity is suspected.

Bibliography

Update history

  1. Full update and review complete. Clarity added to which tests are required and those to be considered. Requirement to perform a urine dipstick has been removed.
  1. Published

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