mesalamine enemas (UK patients)

Hello,

I'm new here! Any of you guys from the UK, can you let me know which mesalamine enemas you are prescribed? I went to my GP because my consultant had written to them asking them to prescribe me mesalamine enemas. Asacol enemas were not prescribable, they were blocked off on his computer. Asacol was the only one I knew of from the top of my head, so that's the one he checked. In the end he told me I could have steroid enemas instead, but I would prefer not to use them. Can't currently get through to my IBD nurse. I'm sure there must be others out there...

Thanks in advance!

They're often known by other names in Europe, all of these would be equivalent: Salofalk enema, Pentasa enema, Mesalamine enema, or Mesalazine enema. On the other side of the pond here, we usually get the 4.0g/60 mL ones. I see a lot more 1.0 gram and 2.0 gram ones there. If given a choice, pick the highest total grams you can get, as they have more of the active ingredient Mesalamine/Mesalazine which has an anti-inflammatory affect, and the more you have the better they work!

Hi,

I live in the uk and I use Salofalk 2g enemas. I am not entirely certain but I think Pentasa may also do one here. I had a bad reaction to Pentasa suppositories and the granules so won't touch any Pentasa products again.

Post Edited (Mad Martha) : 9/1/2016 12:07:19 PM (GMT-6)

It's a good question for the doctor or pharmacist on the actual things they can prescribe within your area.

The foams are easier to retain but may not go as far as the liquid enemas. Some foams are rectum only coverage, others can go to the sigmoid colon, but there is some variation product-to-product. The amount of liquid within the enema can impact how far it goes, as well. A 4 gram 60/ml liquid can cover the rectum, sigmoid colon and as far as the splenic flexure (the bend where your large intestine turns from your left side to horizontally across your stomach).

Hi icanttrustmygut, just seen this thread. I've just replied to your question in the "Asacol 1g foam enema" thread, good luck.

I've used the 1g pentasa enemas in the past but I much prefer the salofalk 2g/59ml ones. They are available on the NHS and your GP should be able to find it on his system. Any pharmacy can order in. The mechanism is a concertina which is much easier to use. And more drug for less liquid suits a lot of people.

PS sorry I should have added I am in uk. See my user name!!! Persevere with obtaining the Salofalk I truly believe they are worth it.

What an awful GP! I was first prescribed Pentasa enemas but my wrists and hands were too weak to squeeze it and so they then prescribed Salofalk 2g which is very easy to administer. Yes they are relatively expensive but nothing compared to being hospitalised for instance with a bad flare! They helped me a lot for a while.

It's disgusting that they tried to substitute with steroid enema. Potential damaging side effects much worse with steroid enema.

Your GP is out of touch. NICE guidelines clearly state that treating with rectals and oral is recommended so long as the patient agrees (UK in general are pretty squeamish about bum meds, living in France everything seemed to go up that end!)

You don't have to wait for your next appointment to get the consultant to write a severe letter to your GP reminding them that research demonstrates that under medication is the main trigger for relapse or exacerbation. They can list the type and strength of med you should have. If you get in touch with your consultant's secretary or IBD nurse they can arrange a letter. The last thing you need with a disease that can be worsened by stress is to have to beg for your meds.

/www.nice.org.uk/guidance/cg166/chapter/1-recommendations?unlid=14526102820167282281#maintaining-remission-in-people-with-ulcerative-colitis

Maintaining remission in people with ulcerative colitis
Proctitis and proctosigmoiditis

1.4.1 To maintain remission after a mild to moderate inflammatory exacerbation of proctitis or proctosigmoiditis, consider the following options, taking into account the person's preferences:

a topical aminosalicylate[9] alone (daily or intermittent) or

an oral aminosalicylate[10] plus a topical aminosalicylate[9] (daily or intermittent) or

an oral aminosalicylate[10] alone, explaining that this may not be as effective as combined treatment or an intermittent topical aminosalicylate alone.

Good luck!