Lialda side effects weight gain


Recent Weight Gain

Q1. I was diagnosed with Crohn’s in November and prescribed Asacol (800 mg three times a day). It has worked fabulously, almost immediately. However, I have gained almost 20 pounds since then. I have never had a weight problem. I am 39 years of age, 5 feet 5 inches, and the most I had ever weighed was 120. Could Asacol be the cause of the weight gain?

No, Asacol (mesalamine) is not the cause of your weight gain. Almost certainly, the Asacol is making you feel well enough to increase your food intake. Most weight reduction diets are well-tolerated in Crohn’s disease patients.

Q2. My sister has Crohn’s disease. What can be done to encourage her to eat rather than depending on TPN and lipids? She is supposed to hook up to her TPN and lipids daily. The last time that I was home, she only hooked up once. When she does eat, she only eats very low-calorie things like salads, celery and carrots. She walks five miles every day. Is that much exercise good for her while she isn’t eating and is on the TPN and lipids? I am afraid that she has developed anorexia on top of her Crohn’s disease. What can I do to help her? I am afraid that she is going to die from her actions. What upsets me is that she has an 11-year-old son, and she hasn’t even thought about what will happen to him if she dies. Any advice will be greatly appreciated.

Total parenteral nutrition (TPN) provides vitamins, minerals and hydration intravenously, avoiding the digestive system altogether. It is only given to Crohn’s disease patients who have intestinal failure and cannot absorb nutrients from food. Usually, people eat while on TPN to enjoy the taste of food, but the essential calories and nutrients are given through TPN and not food.

Your sister should be following her doctor’s prescription for how much and how often to take her TPN. She should not be changing the regimen without her doctor’s approval. If she refuses to follow her prescribed regimen, then it is reasonable to consider psychiatric counseling. Encourage her to talk to her doctor.

Finally, in answer to your question about her long walks, exercise is good for people with Crohn’s disease and five miles of walking daily does not seem excessive to me.

Q3. What do you suggest for an appropriate diet with those who have Crohn’s? Rumor has it that roughage is not a good thing.

Recommendations on diet vary from doctor to doctor. In general, you should not eat things that bother you (e.g., milk products, spicy foods, greasy foods). Roughage may be good or bad for you, depending on the nature of your IBD.

Q4. I am 59 and was diagnosed with Crohn’s in my mid-40s, after surgery for a blocked bowel and a resection. I have never had any problem with dairy products until now. I know some Crohn’s patients become lactose intolerant. What are the symptoms of lactose intolerance?

Lactose is the milk sugar that cannot be digested unless it is broken apart into its components – glucose and galactose – by an enzyme called lactase in the small bowel. Lactase deficiency is very common and is associated with certain ethnic groups and also with Crohn’s disease patients who have had surgery or extensive small bowel disease. Lactase deficiency can also happen as a normal part of the aging process – indeed, a majority of people in the world are lactase-deficient!

People with lactase deficiency will have symptoms of bloating, abdominal pain, abdominal gurgling and diarrhea when they eat foods that contain lactose. So the best therapy is to avoid foods that are high in lactose, such as milk, ice cream, cream cheese, sour cream and cottage cheese. However, yogurt and hard cheeses are usually fine for lactase-deficient people since the aging/fermentation process breaks down the lactose.

Q5. I have been on 150 milligrams of Imuran for several years for my Crohn’s. In the last year, I have been gaining weight while exercising and dieting. My internist thinks it may be my Imuran but my GI doctor does not. Is this a possible side effect after long-term use?

No, Imuran (azathioprine) itself is not causing your weight gain. Perhaps the drug is sufficiently controlling the disease to allow for more complete food absorption. If you’re concerned about your weight, note that most weight reduction diets are well-tolerated in Crohn’s disease patients.

Q6. I have had Crohn’s disease for over 24 years. I currently weigh more than 300 pounds and am considering weight loss surgery. I have found a surgeon who says that he can reduce the size of my stomach without hurting my intestines. Is this possible, or am I dealing with someone who does not know much about the effects of Crohn’s disease and surgery?

Yes, it is possible to do a bariatric procedure (weight loss surgery) that involves the stomach only. A typical gastric bypass involves closing off the top part of your stomach to create a small pouch, and then diverting the upper portion of the small intestine to connect to the pouch. This dramatically reduces the amount of food your stomach can hold (to about an ounce).

Before you go ahead with surgery, I recommend that you seek the opinion of a gastroenterologist experienced with Crohn’s disease therapy to evaluate the extent and severity of your disease. Only then can you know whether bariatric surgery is a safe, advisable option for you.

Q7. I had severe Crohn’s in 1996. I had surgery to remove all of the large intestine/rectum. I have been in remission up until just recently. I developed a peristomal wound about two and a half years ago that has yet to heal. After a scope and small bowel follow through it was determined that the Crohn’s has returned in a small area around the stoma, internally. The doctors are contemplating putting me on 6-MP (6-mercaptopurine). I am a little concerned because other than the annoyance of this wound, I really do not have much, if any, other symptoms. I am not sure the cost of taking the medicine (potential short-term and long-term side effects) will be worth whatever benefit may come from the medication. I definitely do not want to feel worse on the meds than I do off of them. I have had a hard time finding other people with an ileostomy who are also on 6-MP and how they have responded. Any advice would be greatly appreciated.

With medications to treat Crohn’s disease, there is always a trade-off between risk and benefit. The benefits of 6-mercaptopurine are its effectiveness in controlling the inflammation (in the bowel and the skin) and in preventing additional areas of involvement with Crohn’s disease. The principal adverse effects are pancreatitis (3 percent), allergy (1 percent), and leukopenia or decreased white blood cell count (10 percent). To be certain that you do not get leukopenic, you will need to have blood counts checked periodically.

In most patients – including you, I suspect – the benefits of 6-mercaptopurine far outweigh the risks.

Q8. How should I make up for the nutrients I lose because of inflammatory bowel disease (IBD)? I feel dehydrated all the time, and I want to make sure my body stays healthy.

You are right. Patients with Crohn’s disease and ulcerative colitis are often nutritionally deficient because of intestinal losses of nutrients, avoidance of fruits and vegetables that can exacerbate symptoms, and the use of certain drugs that block the absorption of nutrients. In general, Crohn’s patients and those with other inflammatory bowel conditions should pay careful attention to be certain they eat a balanced diet of carbohydrates, protein, and fat.

Fad diets are usually not helpful, but it’s reasonable to take a multivitamin on a daily basis. Also, when you do have diarrhea, you have to pay careful attention to your fluid status and drink liquids throughout the day even if you are not thirsty.

For more on how to get the proper nutrients, see Crohn’s Disease and Your Diet.

Q9. My 82-year-old mother-in-law was recently diagnosed with Crohn’s disease. I’ve read that raw vegetables will make any digestive symptoms worse, but she insists that raw is healthier. I’ve been trying to steam or boil our veggies thoroughly, but I can’t persuade her to eat them. What can I tell her?

Your instincts are correct. Although many patients with Crohn’s disease can handle raw fruits and vegetables, many cannot, and those who can’t may find that their symptoms of bloating, flatulence, and diarrhea increase. If your mother-in-law has been tolerating these foods well, she can continue to eat them. She can switch to cooked vegetables and fruits if she can better tolerate them, although cooking these foods results in the loss of many of their important vitamins and minerals. Also, eating a well-balanced diet and taking a vitamin supplement is very important for most patients with Crohn’s disease.

Learn more in the Everyday Health Crohn’s Disease Center.

Asacol Side Effects

Generic Name: mesalamine

Medically reviewed by Last updated on Dec 16, 2018.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

Note: This document contains side effect information about mesalamine. Some of the dosage forms listed on this page may not apply to the brand name Asacol.

For the Consumer

Applies to mesalamine: oral capsule delayed release, oral capsule extended release, oral tablet delayed release

Other dosage forms:

  • rectal enema, rectal suppository

Along with its needed effects, mesalamine (the active ingredient contained in Asacol) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking mesalamine:

More common

  • Bloody diarrhea
  • rectal bleeding
  • stomach pain (severe)

Less common

  • Blurred vision
  • dizziness
  • fever
  • full or bloated feeling
  • headache (severe)
  • itching, skin rash
  • nervousness
  • pounding in the ears
  • pressure in the stomach
  • slow or fast heartbeat
  • stomach cramps (severe)
  • swelling of the abdominal or stomach area
  • unusual tiredness or weakness


  • Anxiety
  • back pain (severe)
  • blue or pale skin
  • chest pain, possibly moving to the left arm, neck, or shoulder
  • chills
  • nausea
  • vomiting
  • yellow eyes or skin

Incidence not known

  • Blistering, peeling, or loosening of the skin
  • bloody urine
  • change in the ability to see colors, especially blue or yellow
  • clay- colored stools
  • cough
  • dark urine
  • decreased frequency or amount of urine
  • diarrhea
  • general feeling of discomfort or illness
  • greatly increased frequency of urination or amount of urine
  • hair loss
  • headache
  • hives
  • increased blood pressure
  • increased thirst
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • loss of appetite
  • lower back or side pain
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • stomach pain or tenderness
  • swelling of the feet or lower legs
  • swollen glands
  • thickening of bronchial secretions
  • troubled breathing
  • weight gain

Some side effects of mesalamine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Diarrhea (mild)
  • runny or stuffy nose
  • sneezing

Less common

  • Acne
  • back pain
  • belching
  • difficulty with moving
  • excess air or gas in the stomach or bowels
  • hair loss or thinning of the hair
  • heartburn
  • indigestion
  • muscle stiffness
  • passing gas
  • stomach discomfort or upset

For Healthcare Professionals

Applies to mesalamine: compounding powder, oral capsule extended release, oral delayed release capsule, oral delayed release tablet, rectal enema, rectal kit, rectal suppository


The most common adverse events were headache, eructation, and aggravation of ulcerative colitis.


Very common (10% or more): Eructation (up to 16%), ulcerative colitis aggravated (up to 15%)

Common (1% to 10%): Abdominal pain/cramps/discomfort, diarrhea, flatulence, nausea, gastroenteritis, gastrointestinal hemorrhage, rectal disorder, stool abnormalities (color or texture change), urinary frequency, dyspepsia, vomiting, bloating, rectal distension, pain on insertion of tip (enema formulation), hemorrhoids, rectal pain, colitis, constipation, abdominal distension

Rare (less than 0.1%): Increased amylase

Frequency not reported: Duodenal ulcer, dysphagia, esophageal ulcer, fecal incontinence, GI bleeding, mouth ulcer, oral candidiasis, rectal bleeding, rectal polyp, mild indigestion and cramping, bloody diarrhea, stomatitis, abdominal enlargement, lipase increase

Postmarketing reports: Frequent bowel movements, mucus stools, painful defecation, proctalgia, rectal discharge, stomach discomfort, gastritis, dry mouth, oral ulcers, perforated peptic ulcer, amylase increased

Nervous system

Very common (10% or more): Headache (up to 24%)

Common (1% to 10%): Dizziness

Uncommon (0.1% to 1%): Paresthesia, peripheral neuropathy, somnolence, tremor,

Very rare (less than 0.01%): Vertigo

Frequency not reported: Neuropathy, mild disorientation

Postmarketing reports: Guillain-Barre syndrome, hypertonia, transverse myelitis, hyperesthesia, taste perversion, tinnitus


Very common (10% or more): Pain (up to 14%)

Common (1% to 10%): Asthenia, fatigue, pyrexia, infection

Uncommon (0.1% to 1%): Ear pain, peripheral edema

Rare (less than 0.1%): Drug fever

Frequency not reported: Malaise, mesalamine-induced acute intolerance syndrome, plugged ears, adenovirus infection, aching, decreased body mass index,

Postmarketing reports: Medication residue, elevated alkaline phosphatase, elevated GGT, elevated LDH, ear congestion


Very common (10% or more): Nasopharyngitis (up to 15%)

Common (1% to 10%): Upper respiratory tract infection, influenza like symptoms, rhinitis, cold/sore throat

Uncommon (0.1% to 1%): Allergic and fibrotic lung reactions, dyspnea, cough, bronchospasm, pleural effusion, alveolitis, pulmonary eosinophilia, lung infiltration, pneumonitis, pharyngolaryngeal pain

Very rare (less than 0.01%): Eosinophilic pneumonia

Frequency not reported: Hypersensitivity pneumonitis (including interstitial pneumonitis, allergic alveolitis, eosinophilic pneumonitis, stuffy head, interstitial pulmonary fibrosis, bronchiolitis obliterans, sinusitis

Postmarketing reports: Fibrosing alveolitis, asthma exacerbation, pleuritis, bronchitis


Common (1% to 10%): Hypertension, vasodilation,

Uncommon (0.1% to 1%): Pericarditis, myocarditis, pericardial effusion, tachycardia, hypotension

Frequency not reported: Chest pain, T-wave abnormalities, Kawasaki-like syndrome


Common (1% to 10%): Rash, alopecia, urticaria, pruritus, acne

Very rare (less than 0.01%): Reversible alopecia, bullous skin reactions including erythema multiforme

Frequency not reported: Dry skin, eczema, erythema nodosum, nail disorder, photosensitivity, lichen planus, ecchymosis

Postmarketing reports: Prurigo, erythema, psoriasis, pyoderma gangrenosum


Common (1% to 10%): Back pain, arthralgia, leg/joint pain

Uncommon (0.1% to 1%): Myalgia, chills, myositis, arthritis

Frequency not reported: Leg cramps, lower back discomfort, muscle cramps, neck pain

Postmarketing reports: Joint disorder, rheumatoid arthritis


Common (1% to 10%): Hepatic function abnormal, increased alanine aminotransferase

Very rare (less than 0.01%): Hepatotoxicity (including cirrhosis, hepatic failure), changes in liver function parameters

Frequency not reported: GGTP increase, SGOT increase, SGPT increase, sclerosing cholangitis, increased alkaline phosphatase

Postmarketing reports: Jaundice, cholestatic jaundice, liver necrosis, cholecystitis


Common (1% to 10%): Anorexia

Frequency not reported: Thirst, edema

Postmarketing reports: Increased appetite, gout


Common (1% to 10%): Vision abnormalities

Uncommon (0.1% to 1%): Conjunctivitis

Postmarketing reports: Blurred vision, eye pain


Uncommon (0.1% to 1%): Acute or chronic interstitial nephritis, renal insufficiency, renal failure, nephrotoxicity

Very rare (less than 0.01%): Nephrotic syndrome, urine discoloration

Frequency not reported: Creatinine clearance decreased

Postmarketing reports: Minimal change nephropathy, elevated serum creatinine and BUN


Very rare (less than 0.01%): Eosinophilia (as part of an allergic reaction), anemia, bone marrow depression

Frequency not reported: Thrombocythemia

Postmarketing reports: Granulocytopenia, lymphadenopathy


Uncommon (0.1% to 1%): Allergic reaction, anaphylactic reaction, drug reaction with eosinophilia and systemic symptoms (DRESS)

Frequency not reported: Anaphylactic shock, angioedema


Uncommon (0.1% to 1%): Oligospermia (reversible), UTI/urinary burning

Frequency not reported: Albuminuria, amenorrhea, breast pain, hematuria, hypomenorrhea, menorrhagia, metrorrhagia, urinary frequency

Postmarketing reports: Dysuria, urinary urgency, epididymitis


Uncommon (0.1% to 1%): Insomnia

Frequency not reported: Depression, anxiety, decreased libido

Postmarketing reports: Nervousness, confusion, emotional lability, confusion

1. “Product Information. Rowasa product information (mesalamine).” Solvay Pharmaceuticals Inc, Marietta, GA.

2. “Product Information. Lialda (mesalamine (5-aminosalicylic acid)).” Shire US Inc, Florence, KY.

3. “Product Information. Pentasa Product Information (mesalamine).” Hoechst Marion-Roussel Inc, Kansas City, MO.

4. “Product Information. Asacol product information (mesalamine).” Procter and Gamble Pharmaceuticals, Cincinnati, OH.

5. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

6. “Product Information. Delzicol (mesalamine (5-aminosalicylic acid)).” Warner Chilcott Laboratories, Rockaway, NJ.

7. “Product Information. Apriso (mesalamine (5-aminosalicylic acid)).” Salix Pharmaceuticals, Raleigh, NC.

8. Cerner Multum, Inc. “Australian Product Information.” O 0

9. “Product Information. Canasa (mesalamine (5-aminosalicylic acid)).” Axcan Scandipharm Inc, Birmingham, AL.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

More about Asacol (mesalamine)

  • During Pregnancy or Breastfeeding
  • Dosage Information
  • Drug Images
  • Drug Interactions
  • Compare Alternatives
  • Support Group
  • 48 Reviews
  • Drug class: 5-aminosalicylates

Consumer resources

  • Asacol
  • Asacol 800 (Advanced Reading)

Other brands: Lialda, Apriso, Pentasa, Canasa, … +5 more

Professional resources

  • Asacol (FDA)
  • … +1 more

Other Formulations

  • Asacol HD

Related treatment guides

  • Ulcerative Colitis, Active
  • Crohn’s Disease, Maintenance
  • Inflammatory Bowel Disease
  • Ulcerative Colitis
  • Ulcerative Colitis, Maintenance
  • Ulcerative Proctitis

Being Judged for Gaining or Losing Weight as a Woman With IBD

Today is the fifth day of Crohn’s and Colitis Awareness Week. I’ve been browsing the boards and reading some posts of my favorite bloggers. The theme of the day? “But you don’t look sick.”

If only I could see all my fellow IBD’ers now! Eyes are rolling.

We live in such a superficial society – especially for women. One of the many effects IBD has on the body is weight loss or, yes, weight gain.

When I first got sick, I had emergency room nurses tell me I should thank my lucky stars I wasn’t 80 pounds. Basically they told me to suck it up because I “couldn’t be that sick if I wasn’t underweight.” I left feeling defeated, and from that point on, I compared myself to others with Crohn’s disease. Maybe she’s right, I thought. Maybe I’m not that sick since I’m not seriously underweight. This is a dangerous way of thinking for someone with IBD.

That experience played into my fear that I wouldn’t be taken seriously if I wasn’t a walking skeleton. When I did lose weight, I got so many compliments – even strangers told me how great I looked.

When I was put on steroids and started gaining weight, just like that… all the compliments stopped. They were replaced with, “It looks like you’re feeling better.”

No! No! Not even close.

But I was so embarrassed by the comments about my weight gain that I’d just nod my head and say, “Yup, feeling great.”

The medicine used to control the inflammation can make you gain weight so quickly, and you have no control over it.

Imagine: not only have you lost control of your bodily functions and energy levels, but now the medicine that is supposed to help you feel better is also changing your body and probably giving you mood swings that would give any teen a run for their money.

You may look OK on the outside but your insides are on fire. Every joint in your body hurts and it takes every ounce of energy you have just to get out of bed.

In the past year alone, I’ve watched my weight go up and down more times than I can count. I have three different sizes in my closet, not including the clothes for days I’m too distended to wear my normal wardrobe.

It’s hard to adjust to what you’re seeing in the mirror and everyone treats you differently because of outward appearances.

A few tips if you have a friend with IBD:

  • Don’t mention their weight. Trust me – we know if we’re losing or gaining.
  • Don’t assume they’re feeling better if they’ve gained a little weight.
  • Don’t ask how they could possibly be tired without having done anything.
  • Lastly, never tell them they don’t look sick.

Crohn’s and Colitis Awareness Week is December 1st – 7th. I am #IBDVisible.

We want to hear your story. Become a Mighty contributor here.

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Apriso; Asacol HD; Canasa; Delzicol; Lialda; Pentasa; Rowasa; SfRowasa

Brand Names: Canada

Asacol; Asacol 800; Mesasal ; Mezavant; Mezera; Pentasa; Salofalk; TEVA-5 ASA

What is this drug used for?

  • It is used to treat ulcerative colitis.
  • It is used to help keep ulcerative colitis flares from coming back.
  • It is used to treat mild to moderate disease at the far end of the colon.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

  • If you have an allergy to mesalamine, salicylates, sulfasalazine, or any other part of this drug.
  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.

This drug may interact with other drugs or health problems.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
  • If you are allergic to sulfites, talk with your doctor. Some products have sulfites.
  • If you have phenylketonuria (PKU), talk with your doctor. Some products have phenylalanine.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • Do not give to children and teenagers who have or are getting better from flu signs, chickenpox, or other viral infections due to the chance of Reye’s syndrome. Reye’s syndrome causes very bad problems to the brain and liver.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.


  • You may see parts of this drug in your stool. If this happens a lot, talk with your doctor.

Long-acting capsules (Delzicol):

  • You may see parts of this drug in your stool. If this happens a lot, talk with your doctor.

All rectal products:

  • This drug may stain fabric, flooring, painted surfaces, marble, granite, vinyl, and enamel.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
  • Chest pain or pressure.
  • Fast or abnormal heartbeat.
  • Fever, chills, or sore throat; any unexplained bruising or bleeding; or feeling very tired or weak.
  • Some people may have a reaction to this drug that looks like the signs of ulcerative colitis. Call your doctor right away if you have very bad belly pain or cramps, bloody stools, fever, headache, or rash.
  • Liver problems have rarely happened with this drug. Sometimes, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Some heart problems have rarely happened with this drug. Sometimes, this has been deadly. Call your doctor right away if you have shortness of breath, a big weight gain, or swelling in the arms or legs.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

  • Stomach pain or diarrhea.
  • Upset stomach or throwing up.
  • Heartburn.
  • Constipation.
  • Gas.
  • Burping.
  • Nose or throat irritation.
  • Headache.
  • Dizziness.
  • Back pain.
  • Cough.

All rectal products:

  • Rectal irritation.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.


  • Some drugs may need to be taken with food or on an empty stomach. For some drugs it does not matter. Check with your pharmacist about how to take this drug.
  • Take with a full glass of water.
  • Swallow whole. Do not chew, break, or crush.
  • If you have trouble swallowing, talk with your doctor.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.

Long-acting capsules (Pentasa):

  • Take with or without food.
  • Take with a full glass of water.
  • Swallow whole. Do not chew or crush.
  • If you cannot swallow this drug whole, you may sprinkle the contents on applesauce or yogurt. Swallow the mixture right away without chewing.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.

Long-acting capsules (Delzicol):

  • Take with or without food.
  • Take with a full glass of water.
  • Swallow whole. Do not chew or crush.
  • If you cannot swallow this drug whole, you may open the capsules and swallow the contents. Be sure to swallow the contents and that none stay in your mouth. Swallow the contents whole. Do not chew, break, or crush.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.

Long-acting capsules (Apriso):

  • Take with or without food.
  • Take with a full glass of water.
  • Swallow whole. Do not chew, open, or crush.
  • If you have trouble swallowing, talk with your doctor.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
  • Do not take antacids at the same time as this drug. Talk with your doctor.

All rectal products:

  • You could be on both a tablet or capsule and a rectal product at the same time.
  • Keep using this drug as you have been told by your doctor or other health care provider, even if you feel well.

Rectal enema:

  • Use enema rectally.
  • Shake suspension well before use.
  • Keep suspension in your rectum as long as you can.


  • Use suppository rectally.
  • Use at bedtime.
  • Wash your hands before and after use.
  • If suppository is soft, chill in a refrigerator or run cold water over it.
  • Take foil off the suppository and put in, pointed end first. Do not handle too much. Keep the suppository in for 1 to 3 hours or longer if you can. Do not cut or break the suppository.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

All oral products:

  • Store at room temperature.
  • Store in a dry place. Do not store in a bathroom.
  • Some products may come with a desiccant (protects the product from moisture) in the container, If the container comes with a desiccant, keep it in the bottle. Some brands may be stored without the desiccant for some time. Talk with the doctor or pharmacist if you are not sure.

Rectal enema:

  • Store at room temperature.
  • Store rectal suspension in foil until ready to use. Do not refrigerate.
  • Protect rectal suspension from heat.
  • Do not use if suspension changes color.


  • Store at room temperature or in a refrigerator. Do not freeze.
  • Protect from heat and light.
  • Store in a dry place. Do not store in a bathroom.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Last Reviewed Date



Lialda 1.2 g

Strengths available

  • 1.2 g

Brand name

Lialda (USA) (pronounced as Lee-al-dah)

Mezavant (Canada) (pronounced as Mez-ah-vant)

Generic name

Mesalazine or Mesalamine (pronounced as Mess-sal-la-meen)

Manufacturer Information

Shire Pharma

What is Lialda (Mezavant)?

Lialda 1.2 g delayed- and extended-release tablets are reddish brown, film coated, oval-shaped tablets, stamped with ‘S476’ on one side.

LIALDA contains mesalamine, a 5-aminosalicylic acid (5ASA) drug that acts locally and is used in the treatment of active disease of adults with ulcerative colitis (UC). It is also used in the maintenance of remission of ulcerative colitis. Mesalamine the active ingredient in Lialda is an anti-inflammatory drug which is effective in flare up attacks of ulcerative colitis and maintenance of its remission.

How does Lialda work?

Lialda is thought to work by blocking the action and the production of substances that cause inflammation in the intestine. Substances such as prostaglandins and cyclooxygenase are some of these affected substances. Lialda tablets are designed with MMX technology. This technology allows Lialda to delay and deliver the active ingredient (Mesalamine) in particular concentrations to needed areas of the of the colon and rectum to reduce inflammation effectively.

When should I take Lialda?

Take your Lialda dose exactly as prescribed by your Doctor. The most common dose for flare up of ulcerative colitis is 2 to 4 tablets (2.4g to 4.8g) ONCE daily. For maintenance of remission of UC to allow for healing of the mucosal membrane is 2 tables (2.4g) ONCE daily. Take your Lialda tablets with food. Swallow your Lialda tablets whole with a glass of water. Do not cut or crush Lialda tablets.

If you miss a dose of your Lialda tablets take as normal the next day. Do not double your dose to account for the missed dose. Keep a record of all missed doses and tell your Doctor at your next checkup.

What are the alternatives of Lialda and how to they differ from Lialda?

Some alternatives to Lialda include but are not limited to Lialda, Apriso and Delzichol.

LIALDA VS APRISO Lialda and Apriso are both extended release formulations of an anti-inflammatory, mesalamine, used to treat and prevent flare-ups of ulcerative colitis. from recurring. The side-effects and interactions of Apriso and Lialda are similar.

LIALDA VS DELZICOL Lialda and Delzichol are two mesalamine extended release formulations used in the treatment of ulcerative colitis and the prevention of flare ups. Many of the side-effects and drug-drug interactions between Lialda and Delzichol are similar as they are effectively the same active ingredient.

Neither Apriso or Delzichol are available in Canada.

What are the side effects of taking Lialda?

The most common side-effects reported with use of Lialda are gastro-intestinal. Side effects of Lialda include but are not limited to inflamed colon, abdominal pain, headache, abnormal liver function tests, diarrhea or loose and frequent stools and nausea.

Less commonly reported side-effects include bloated stomach, indigestion, vomiting, gas, joint pain, back pain and allergic reactions.

This list is not complete. If you are worried that you may be suffering from a side effect of Lialda always contact your Doctor or Pharmacist for advice.

Should I take Lialda with or without food?

Take Lialda with food. Swallow the tablets whole with a full glass of water. Do not chew or crush Lialda tablets.

Can I drink alcohol while taking Lialda?

Although there may not be a drug – drug interaction between alcohol and Lialda, alcohol can irritate your stomach and intestines and worsen the condition you are treating with Lialda. If you are not abstaining from alcohol, try to limit your alcohol intake.

Speak with your Doctor if you are concerned with your alcohol intake.

What drugs interact with Lialda?

Drugs that interact with Lialda include drugs that affect the kidney such as NSAIDs, azathioprine. A combination of these drugs may increase the risk of kidney issues. Mercaptopurine and azathioprine taken with Lialda may result in blood components.

Other drugs that interact with Lialda include but are not limited to digoxin, furosemide, cimetidine, ranitidine, low molecular weight heparins such as dalteparin, enoxaparin and methotrexate. Some drugs should be avoided while others require monitoring when used together with Lialda.

This is not a complete list. Always inform your Doctor and Pharmacist of all drugs you are currently taking including herbal and elicit substances.

How to order Lialda from Canada?

Lialda in Canada is marketed under a different name, Mezavant. If you have a US prescription and are struggling to afford the cost of Lialda you have a number of options. Firstly you could look for an alternative to Lialda. The issue with that is that many patients specifically require Lialda in terms of how and where in the body it works. If you specifically need Lialda then you could check to see if there are any Lialda manufacturer coupon available or if there is a patient assistance program for Lialda to help with the cost of the medication.

Another common way Americans can afford the cost of Lialda is to go to a Canadian Pharmacy such as Canada Cloud Pharmacy, where they can buy Lialda online direct from Canada. Of course the name-brand Lialda in Canada is known as Mezavant. Mezavant is made by the same company that makes Lialda, and is effectively the same medication.


Is Lialda called Mezavant in Canada?
Yes. The Canadian name for Lialda is Mezavant. Does Lialda cause weight gain?
Weight gain is not one of the listed side-effects on the Lialda monograph. However on the Lialda monograph it does mention that Lialda may cause Kidney problems which might result in weight gain. Always talk to your Doctor or Pharmacist if you are concerned with side-effects of Lialda. Where can I find Lialda reviews?
Reviews on Lialda can be found at the following . Has Lialda got a generic available?
Unfortunately there is currently no generic for Lialda available. Although there has been generic approvals for Lialda it is yet to hit the market. When will there be a generic of Lialda available?
There is no time line given for exactly when the generic for Lialda will be available but there is some speculation that it may be available in 2021. Does Lialda cause hair loss?
Hair loss is considered a less common side effect of Lialda with less than 1% of patients using Lialda suffering from some form of alopecia.

Buy Lialda 1.2 g from Canada

Information contained here on this page is for informational purpose only. Always speak with your Doctor about the usage of your medication.


How does this medication work? What will it do for me?

5-aminosalicylic acid (5-ASA or mesalamine) belongs to the group of medications known as anti-inflammatories. It is used to treat mild-to-moderate ulcerative colitis and mild-to-moderate Crohn’s disease. 5-ASA acts by reducing inflammation in the bowel.

Different brands of 5-ASA are designed to act on different places in the gastrointestinal tract (the digestion tube that runs from the mouth to the anus). Ulcerative colitis affects the colon and rectum only, while Crohn’s disease affects the whole gastrointestinal tract. For this reason, some brands and forms of this medication are used to treat only ulcerative colitis, while others can be used to treat both Crohn’s disease and ulcerative colitis.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?


Extended-release Tablets

500 mg
Each round, flat, white-grey-to-pale brown, speckled, extended-release tablet, marked “PENTASA” on one side and marked “500” above and “mg” below a score line on the other, contains 500 mg of 5-ASA. Nonmedicinal ingredients: cellulose, ethylcellulose, magnesium stearate, povidone, and talc. This medication does not contain gluten.

1 g
Each oblong, white-grey-to-pale brown, speckled, extended-release tablet, embossed “PENTASA” on both sides contains 1g of 5-ASA. Nonmedicinal ingredients: cellulose, ethylcellulose, magnesium stearate, povidone, and talc. This medication does not contain gluten.

Rectal Suspension
Each unit dose (100 mL) of rectal suspension enema contains 1 g or 4 g of 5-ASA. Nonmedicinal ingredients: hydrochloric acid (to adjust the pH to 4.8), purified water, sodium acetate, sodium edetate, and sodium metabisulfite.

Each suppository contains 1 g of 5-ASA. Nonmedicinal ingredients: magnesium stearate, polyethylene glycol, povidone, and talc.

How should I use this medication?

Tablet: The recommended adult dose of this medication depends on the product selected. Swallow the tablets whole, ensuring that you do not break the outer coating. Take the tablets only as directed by your doctor. Do not change the number or frequency of tablets taken without first consulting your doctor.

Suppository, rectal suspension, and enema: The usual dose for suppositories, rectal suspension, and enema is 1 g to 4 g daily, usually at bedtime, or as prescribed by your doctor.

For the proper administration of these dosage forms, check with your pharmacist.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. Ulcerative colitis and Crohn’s disease never completely go away. Once a flare-up of the illness has been controlled, your doctor will recommend a smaller dose to be taken daily to reduce the chance of the symptoms from flaring up again. It is important to not stop the medication suddenly, even when you are feeling well. Doing so may cause the illness to flare up again.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store all forms of this medication at room temperature, protect them from light and moisture, and keep them out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to 5-aminosalicylic acid or any ingredients of the medication
  • are allergic to other salicylates (e.g., ASA)
  • are not able to swallow tablets whole
  • have a gastric (stomach) or duodenal (intestinal) ulcer
  • have a urinary tract obstruction
  • have severely decreased kidney function
  • have severely decreased liver function

Do not give this medication to children under 2 years of age.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal or stomach cramps or pain (mild)
  • acne
  • back pain
  • blood pressure changes
  • diarrhea (mild)
  • dizziness
  • fatigue
  • hair loss
  • headache (mild)
  • gas
  • increased urge to have a bowel movement
  • irritation of the rectal area
  • nausea
  • tiredness
  • vomiting

Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • fever
  • fast or pounding heartbeat
  • sensation of numbness or tingling
  • severe headache
  • severe stomach pain
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine)
  • signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • skin rash and itching
  • unusual bruising or bleeding

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
  • signs of acute intolerance syndrome (e.g., abdominal or stomach cramps or pain , bloody diarrhea, chills, fever)
  • signs of inflammation around the heart (e.g., fatigue, fever, difficulty breathing, cough)
  • signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
  • signs of a serious skin reaction (such as skin rash; red skin; blistering of the lips, eyes, or mouth; skin peeling; fever; or joint pain)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Acute intolerance syndrome: This medication has been known to cause symptoms similar to those of worsening Crohn’s disease or ulcerative colitis. If you experience the sudden onset of symptoms such as cramping, acute abdominal pain and bloody diarrhea, headache, rash, and possibly fever, contact your doctor immediately.

Allergy: Some people who are allergic to sulfasalazine or acetylsalicylic acid (ASA) also experience allergic reactions to mesalamine (5-ASA). Before you take 5-ASA, inform your doctor about any previous adverse reactions you have had to medications, especially sulfasalazine or ASA.

Contact your doctor at once if you experience signs of an allergic reaction such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Breathing Problems: 5-ASA may increase the risk of allergic or hypersensitivity reactions for people who have conditions that affect their breathing. If you have asthma or chronic obstructive pulmonary disease (COPD) discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Fertility: This medication may cause a decrease in sperm production for men. If this is a concern, talk to your doctor.

Heart problems: People with heart problems may be at an increased risk of side effects of 5-ASA. If you have heart problems or a history of heart problems, including heart infections, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: This medication is removed from the body by the kidneys. 5-ASA may not be removed from the body as quickly as expected if your kidneys are not working properly. This increases the likelihood of experiencing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

5-ASA may also cause decreased kidney function and possibly kidney failure. If you notice a decrease in your amount of urine, swelling in your hands and lower legs, or unusual tiredness contact your doctor as soon as possible.

Liver function: The use of this medication by people with reduced liver function has not been well studied. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor as soon as possible.

Slow stomach emptying: The tablet form of 5-ASA may not work as well for people with a condition known as pyloric stenosis. If you have pyloric stenosis or have a history of slow emptying of the stomach, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Tablets in stool: Infrequently, what looks to be intact or partially intact tablets may appear in the stool. If this occurs repeatedly, consult your doctor.

Pregnancy: 5-aminosalicylic acid crosses the placenta and may affect the developing baby if taken by the mother during pregnancy. It should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking 5-aminosalicylic acid, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication for use by children have not been established.

What other drugs could interact with this medication?

There may be an interaction between 5-aminosalicylic acid and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source:

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