Mesalazine Dosage Question

So my normal Pentasa dosage is 3g a day in remission. I take it all in one go which has worked well.

For a flare up (blood, mucus, BM’s increased to 3 times a day) I am taking an additional 1g suppository at night as it feels like recital inflammation.

Could I increase this to morning and night 1g? Is that a normal dosage on a flare up? I feel like they suppository is working well but not covering the whole day.

I’ve kept the oral meds the same. Should that change to 4.5g?

I agree with CC...but I would split your dosage to 2x daily.
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Hi!

Now I am on biologics (Amgevita, biosimilar to Ada), but during more than 10 years I managed my UC with mesalazine (Pentasa). During remission I took 3g daily, and 1 sup. every two nights to keep the end of the colon happy (as it seems oral Pentasa has trouble reaching so far). When flaring, I maxed up to 5g and 1 sup. each night.

Scientific evidence seems to document that 3g in a single dose is better than split in two or three 1g doses along the day. Having said this, half-life of mesalazine is 5 hours, so I would guess that it is better to keep a steady level of the drug by taking it at, say, 5 hours intervals, that is 3 doses during waking hours. As some patients may forget to take one or more doses, if split, doctors prefer to recommend a single dose daily (but if you forget that one then you skip the whole day). I would say that it is patient compliance (or lack of) rather than drug efficacy that leads to better results with a single dose, as literature seems to note.

By the way, even though I am taking Ada, the doctor still recomended 3g daily of Pentasa + 1 sup. at alternating days. Combination therapy.

Cheers!