Mesalamine (Rowasa)

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Mesalamine (Rowasa) works to stop the body from producing a certain substance that may cause pain or inflammation. Mesalamine is used to treat ulcerative colitis.

Delayed-release tablets and controlled-release capsules may be used to treat ulcerative colitis that affects any part of the colon. Suppositories and enemas should only be used to treat inflammation of the lower part of the colon.

How should it be used?

This medication is available in tablet, capsule, suppository and enema form.

Tablet and capsule form

  • Swallow the tablets whole
  • Do not split, chew or crush them.
  • Be careful not to break the protective coating on the tablets.
  • If you are unable to swallow the capsules, you may mix the contents of the capsules with water.
  • Open a capsule and sprinkle all of the beads in a small glass of water. Stir the beads into the water and drink the mixture right away. Do not store the mixture for later.

Enema (Rowasa) and suppositories form

  • If you use the enema form, follow these directions:
    • Try to have a bowel movement first. The medicine works best if your bowels are empty.
    • Look at the liquid inside the bottle. It should be off-white or tan color. The liquid may darken a little. If the liquid is dark brown, do not use.
    • Shake the bottle to mix well.
    • Remove the protective coating from applicator tip.
    • Lie on your left side with lower leg straight and upper leg bent toward the chest.
    • Gently insert the applicator tip into the rectum. Squeeze the bottle slowly to release the medicine.
    • Remain in the same position for about 30 minutes to allow the medicine to spread through your intestine. Try to keep the medicine inside your body for about 8 hours (while you sleep).
    • Throw away the empty bottle.

Suppository steps:

  • Try to have a bowel movement first. The medicine works best if your bowels are empty.
  • Hold suppository upright and peel off plastic wrapper. Handle as little as possible so it won’t melt.
  • Lie down on left side and, using your finger, insert completely into the rectum.
  • Try to keep in place 1-3 hours or longer if possible.
  • Wash hands.

Special Precautions/Instructions

Before you start taking this medicine tell your doctor about any of the following:

  • All of the medications (including over the counter), vitamins, herbal products, and supplements that you are taking.
  • Allergic or hypersensitive to mesalamine or any ingredient in the medicine:
    -mesalamine, carbomer 934P, edetate disodium, potassium acetate, potassium metabisulfate, purified water, xanthan gum, and sodium benzoate
  • Allergic to sulfites or sulfasalazine.
  • Have renal dysfunction or renal disease
  • Are pregnant, plan on becoming pregnant or breastfeeding.

Rowasa enema may cause dizziness. This effect may become worse if you take it with alcohol or certain medicines. Do not drive or perform other possibly unsafe tasks until you know how you will react to it.

Rowasa enema may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to it. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.

Some of these products contain sulfites. If you are allergic to sulfites, tell your doctor.

Rowasa enema may cause reactions such as bloody diarrhea, fever, headache, rash, or severe or persistent stomach pain or cramping. If you experience any of these reactions, contact your doctor.

Do not give Rowasa enema to a child or teenager who has the flu, chickenpox, or a viral infection. Contact your doctor with any questions.

Rowasa enema should be given with caution in the ELDERLY, and extreme caution in CHILDREN.

If you become pregnant, contact your doctor.

Side Effects

The most common side effects include:

  • fever
  • headache
  • nausea
  • abdominal cramps
  • gas
  • flu
  • fatigue
  • rash.

Contact your doctor immediately if you experience signs of an allergic reaction including:

  • Diarrhea
  • Feeling sick
  • Fever, shivering/chills, rash
  • Muscle and bone pain
  • Kidney problems (changes in the amount of urine or color of urine)
  • Tiredness, dizziness
  • Itching
  • Swelling
  • Trouble breathing

Storage Conditions

This medication should be stored at room temperature. Keep out of reach of children. Once the foilwrapped unit of seven bottles is opened, all enemas should be used promptly as directed by your doctor.


Call the national poison control center 1-800-222-1222 or 911 in the event of overdose. Symptoms of an overdose include vomiting, diarrhea, sore throat, fever, chills, and other signs of infection.