The human body is struggling with a variety of diseases, simple and complex, throughout its life. Far from the last place in a series of health problems is inflammatory bowel disease. To combat them, many different medicines with different principles of action have been developed.
Mesalazine is the main active ingredient in a fairly large group of drugs (Salofalk, analogues) to combat specific inflammatory bowel diseases.
Composition "Salofalk", pharmacodynamics
As mentioned earlier, the main active ingredient of the drug is mesalazine. A number of components act as auxiliary components, in particular, such as: sodium carbonate, glycine, povidone, microcrystalline cellulose, silicon dioxide and titanium dioxide, calcium stearate, croscarmellose sodium, hypromellose, the main butyl methacrylate copolymer.
Salofalk (granules, tablets, suppositories, suspension) inhibits (inhibits) the processes of neutrophilic lipoxygenase and the synthesis of prostaglandins and leukotrienes in the human body. The active substance reduces the rate of migration, degranulation and phagocytosis of neutrophils, reduces the secretion of lymphocytes. In addition, the drug has the ability to bind to free radicals and subsequently destroys them, that is, exhibits an antioxidant effect. Mesalazine is also able to bind to free radicals formed from reactive oxygen compounds.
Indications for appointment
The main area in which Salofalk has found application is the treatment of ulcerative colitis and Crohn's disease.
The first disease is a chronic inflammatory process of an as yet unknown nature. Its development is due to the interaction of genetic factors and environmental conditions.
Crohn's disease can be described as chronic granulomatous inflammation of the gastrointestinal tract. This process can capture all parts of the digestive system, affecting all layers of the digestive tube. The consequence may be the development of lymphadenitis, the formation of scars and ulceration on the walls of the intestine.
Forms of drug release
Manufacturers offer their consumers the drug Salofalk (analogues in this regard may vary) in several forms of release.
In tablet form may contain 250 and 500 mg of the main active ingredient - mesalazine. One sachet may contain 500 mg or 1 g of the basic substance. The medication in the form of suppositories (suppositories for rectal administration) is also presented in two dosages - 250 and 500 mg of the main component. Also in pharmacies you can buy a suspension and foam for rectal administration. The most effective form of release for each patient will help the doctor in charge.
Tablet dosage regimen
The standard dosage for adult patients is 500 mg three times a day. If a severe degree of the disease is diagnosed, the treating doctor has the right to increase the dose to 3-4 g per day. The course of therapy can last from 2 to 3 months. If the medication is taken for preventive purposes, then this is done according to the standard scheme (1.5 g in three divided doses throughout the day).
For small patients, “Salofalk” recommends giving instructions for use (analogues may vary in dosage regimen) in accordance with the weight of the child. For children with a body weight not exceeding 40 kg, the doctor prescribes 250 mg of the drug three times a day. If the child's weight exceeds 40 kg, the same dosage is shown as for adults: 500 mg three times a day.
Tablets are best taken after completing a meal, do not chew and drink plenty of fluids (preferably water).
Pellet application chart
This form of release of the Salofalk drug (granules) is prescribed by the attending physician purely individually, based on the general clinical picture of the patient’s health status. Most often, during an exacerbation of ulcerative colitis, the patient is prescribed to receive a dose of 500 mg or 1 g three times a day (i.e., the daily volume of the drug is from 1.5 to 3.0 g). You can take once 3 bags at once. If the patient is in remission, Salofalk is taken in a dose of 1.5 g per day: you can break it into 3 doses or take all the medicine at once.
If it is an exacerbation of ulcerative colitis in children (from 6 years of age and older), the attending physician prescribes a drug at a rate of 30-50 mg of mesalazine per 1 kg of weight. The entire dose can be taken at one time or distributed in 3 doses throughout the day.
The granules must be put on the tongue and swallowed without chewing. The drug should be washed down with plenty of fluids. In order for the therapeutic effect to be persistent, granules should be taken regularly and sequentially. The acute stage of ulcerative colitis usually fades after 2-3 months, then the daily dose can be reduced to 1.5 g per day.
Purpose and mode of application of suppositories
"Salofalk" (suppository); instructions for use recommends using at a dosage of 500 mg (1 rectal suppository 500 mg or 2 - 250 mg) three times a day. If the disease is in the acute stage, the daily dose can be doubled. If the patient is prescribed a long course of therapy or the purpose of admission is purely prophylactic (relapse prevention), the usual dose in this case is 250 mg (1 suppository) three times a day.
For young patients, the dosage regimen depends on body weight. For children weighing less than 40 kg “Salofalk” (candles), the instructions for use are prescribed for ½ dosage for an adult, that is, 250 mg three times a day. If the child's weight exceeds 40 kg, he is prescribed a medication in a dosage, as for an adult patient (three times 500 mg per day).
Rectal suspension
The drug "Salofalk" - the suspension is available in bottles intended for rectal administration. The procedure is carried out once, in the evening before bedtime. Before administering the drug, the patient is advised to empty the intestines. The daily volume of the drug is selected based on the weight of the patient (based on 30-50 mg / kg). If the disease is severe or in the acute stage, the maximum dose during the day can reach 3 g. To prevent relapse, specialists usually recommend taking Salofalk orally (in tablets). In this case, the dose (daily) is also prescribed depending on the weight - 15-30 mg / kg of weight. It is recommended to divide the entire daily amount of medication during the day into two doses.
Contraindications to taking Salofalk
The use of the drug Salofalk (analogues is no exception) is contraindicated in people with hypersensitivity to the main and auxiliary components of the drug. It is unacceptable to prescribe tablets to children under 3 years of age, granules - up to 6 years. Patients suffering from severe forms of renal and liver failure should not take the drug.
Salofalk is not prescribed for people who have a tendency to develop bleeding, various diseases of the hematopoiesis system. Those suffering from hemorrhagic diathesis, peptic ulcers of any gastrointestinal tract should also not take medications based on mesalazine.
In granules, the drug should not be prescribed to patients suffering from phenylketonuria (a hereditary disease associated with a violation of the metabolism of phenylalanine, leading to severe damage to the central nervous system in the form of mental disorders).
As for pregnant and lactating women, the use of the drug in the first 3 months of pregnancy should be justified by strict indications. Within 2-3 trimesters, the appointment of Salofalk is possible only in cases where the expected positive effect on the woman’s health dominates the possible risk for the baby. According to the same indications, it is permissible to use Salofalk granules during lactation. However, if the child has diarrhea, breastfeeding should be abandoned. In general, it is optimal to cancel the intake of Salofalk before the onset of the planned pregnancy or, at least, to reduce the dose taken.
Feasible side effects
Side effects are present in almost any medication. Salofalk was not an exception (Russian analogues as well). From the side of the central nervous system, manifestations such as headaches, dizziness, tremors, tinnitus, depression, cramps, paresthesias are possible. The gastrointestinal tract may respond to the use of Salofalk by pain in the abdomen, flatulence, diarrhea, nausea, and vomiting. Perhaps the development of hepatitis, a change in the values ​​of hepatic transaminases. From the side of the cardiovascular system, a rapid heartbeat, fluctuations in blood pressure (hyper- or hypotension), chest pain, shortness of breath may appear.
In some cases, patients can be heard about the development of myalgia, arthralgia. In addition, the medication can provoke the development of anemia, leukopenia, thrombocytopenia, anuria, oliguria, hematuria, crystalluria.
From a number of allergic reactions, itching, skin rash, erythema, bronchospasm, pericarditis and myocarditis are possible. In patients with hypersensitivity to mesalazine, the development of diseases such as interstitial nephritis, nephrotic syndrome, acute stage of pancreatitis is possible. In a separate group of patients, Salofalk (including analogues) caused symptoms similar to systemic lupus erythematosus syndrome.
Analog medicines
Salofalk has a sufficient number of analog medicines for the main active ingredient. How can, for example, replace "Salofalk" - candles? The analogs that are most often of interest to consumers and appointed by health workers are the Pentas and Samesil suppositories. In these medicines, the main active ingredient is mesalazine, so they have a similar pharmacological effect on the human body.
Mesacol is another fairly widely used analogue of Salofalk (in granules, tablets).
In addition to analogues in the active ingredient, there is a fairly large group of drugs similar in therapeutic effect. These medications can be safely attributed to “Azathioprine” and “Alginatol”, “Hydrocortisone” and “Dexamethasone”, “Diprospan” and “Irmalax”, “Prednisolone” and “Sulfasalazin”. This list goes on.
Special recommendations
Before starting treatment, as well as during the treatment process and upon its completion, healthcare providers recommend taking general blood and urine tests. Also, before treatment and in the process, it is necessary to monitor the parameters of the functional state of the liver. Monitoring is best done 14 days after the start of therapy, and then another 2-3 times with a frequency of 4 weeks. If the test results are within normal limits, monitoring studies are carried out every 3 months. If suddenly any deviations are observed in the analyzes, then control tests should be carried out immediately.
When prescribing any form of the Salofalk medication (suppositories, analogues in tablets, granules, suspensions) to patients suffering from bronchial asthma, the attending physician needs to carefully monitor the condition of patients during therapy. If the patient has a history of the possibility of side effects when taking Sulfasalazine, the health status of such people should be carefully monitored at the initial stage of Salofalk treatment. If they manifest acute intolerance reactions (cramps, abdominal pain, rash, fever), the use of the drug should be stopped immediately.
When driving or performing work requiring an increased rate of psychomotor reactions, patients taking Salofalk should be extremely careful.