Introduction
A drug that is used in the management of inflammatory bowel diseases. Its activity is generally considered to lie in its metabolic breakdown product, 5-aminosalicylic acid (see mesalamine) released in the colon. (From Martindale, The Extra Pharmacopoeia, 30th ed, p907)
Uses
Reumazin Tablet 500 mg is an anti-inflammatory drug used to treat Crohn's disease and rheumatoid arthritis.
For the treatment of Crohn's disease and rheumatoid arthritis as a second-line agent.
Associated Conditions
Pharmacodynamics
Reumazin Tablet 500 mg is an anti-inflammatory indicated for the treatment of ulcerative colitis and rheumatoid arthritis.
Mechanism of Action
The mode of action of Reumazin Tablet 500 mg or its metabolites, 5-aminosalicylic acid (5-ASA) and sulfapyridine (SP), is still under investigation, but may be related to the anti-inflammatory and/or immunomodulatory properties that have been observed in animal and in vitro models, to its affinity for connective tissue, and/or to the relatively high concentration it reaches in serous fluids, the liver and intestinal walls, as demonstrated in autoradiographic studies in animals. In ulcerative colitis, clinical studies utilizing rectal administration of Reumazin Tablet 500 mg, SP and 5-ASA have indicated that the major therapeutic action may reside in the 5-ASA moiety. The relative contribution of the parent drug and the major metabolites in rheumatoid arthritis is unknown.
Volume of Distribution
- 7.5 ± 1.6 L
Route of Elimination
The majority of 5-ASA stays within the colonic lumen and is excreted as 5-ASA and acetyl-5-ASA with the feces.
Half Life
5-10 hours
Clearance
- 1 L/h [IV administration]
Food Interactions
- Drink plenty of fluids. Inadequate fluid intake is associated with crystalluria and stone formation.
- Take with food.
Dosage
Adult dose for crohn’s disease: 500 mg orally 2 to 4 times a day with food.
Pediatric use (6 years or older) for Ulcerative Colitis: The initial dose 40 to 60 mg/kg/day orally divided into 3 to 6 doses.
Adult dose for rheumatoid arthritis: 2 g daily in two evenly divided doses. It is advisable to initiate therapy with a lower dosage e.g. 0.5 to 1.0 g daily, to reduce possible gastrointestinal intolerance. A suggested dosing schedule is given bellow:
- First week: One tablet in the evening
- Second week: One tablet in the morning & One tablet in the evening
- Third week: One tablet in the morning & two tablet in the evening
- Fourth week: Two tablet in the morning & two tablet in the evening
Juvenile rheumatoid arthritis-polyarticular course: Children 6 years of age and older: 30 to 50 mg/kg/day in two evenly divided doses. Typically the maximum dose is 2 g per day.
For other indications:
Initial therapy:
- Adults: 3 to 4 g daily in divided doses with dosage intervals not exceeding eight hours. It may be advisable to initiate therapy with a lower dosage e.g. 1 to 2 g daily to reduce possible gastrointestinal intolerance.
- Children 6 years of age and older: 40 to 60 mg/kg/day in to 3 to 6 divided doses.
- Adults: 2 g daily.
- Children 6 years of age and older: 30 mg/kg/day in 4 divided doses.
