Patient Medication Information: uses, side effects, how to take - ZDS-Mesalamine Suppositories
What is ZDS–Mesalamine Suppositories used for?
ZDS–Mesalamine Suppositories is used:
- to manage a condition called ulcerative proctitis, in which the rectum is inflamed.
- as a combination therapy for severe inflammation of the lining of the large bowel and rectum (distal ulcerative colitis).
How does ZDS–Mesalamine Suppositories work?
ZDS–Mesalamine Suppositories is believed to reduce the activity of certain chemicals in your body that cause inflammation (e.g., prostaglandins). This helps to reduce the swelling and pain in your rectum and lower part of your large bowel.
What are the ingredients in ZDS–Mesalamine Suppositories?
Medicinal ingredients: mesalamine (me-SAL-a-meen), also known as 5-aminosalicylic acid, 5-ASA or mesalazine.
Non-medicinal ingredients: Hard Fat.
ZDS–Mesalamine Suppositories comes in the following dosage forms:
Suppositories: 1000 mg.
Do not use ZDS–Mesalamine Suppositories if:
- you have severe kidney problems
- you have severe liver problems
- you are allergic to mesalamine or to any of the non-medicinal ingredients in ZDS–Mesalamine Suppositories, or component of the container (see What are the ingredients in ZDS–Mesalamine Suppositories?)
- you have a sensitivity to a family of drugs known as salicylates, which includes acetylsalicylic acid (ASA)
- you have stomach or small intestinal ulcers
- you have a blockage in your urinary tract
- the patient is an infant under two years of age
To help avoid side effects and ensure proper use, talk to your healthcare professional before you use ZDS–Mesalamine Suppositories. Talk about any health conditions or problems you may have, including if you:
- have any kidney or liver problems
- have heart problems, including a history of heart inflammation (which may be the result of an infection of the heart)
- have stomach pain
- have had an unusual or allergic reaction to sulfasalazine (SAS), an ingredient in medicines used to treat ulcerative colitis
- have bleeding or clotting problems
Other warnings you should know about:
Serious Side Effects: ZDS–Mesalamine Suppositories can cause serious side effects:
- Serious skin reactions: Severe cutaneous adverse reactions (SCAR), including Stevens-Johnson syndrome (SJS), Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) and toxic epidermal necrolysis (TEN) have happened in people taking ZDS–Mesalamine Suppositories. These skin reactions are serious. Stop taking ZDS–Mesalamine Suppositories and get immediate medical help if you experience any signs of a severe skin reaction, such as mouth sores, a severe skin rash, or any other signs of an allergic reaction.
- Kidney problems, including kidney stones: People taking ZDS–Mesalamine Suppositories can develop kidney stones or other kidney problems. Symptoms may include blood in the urine, urinating more often and pain in your back, side, belly or groin. Be sure to drink enough liquids while you are using ZDS–Mesalamine Suppositories. Talk to your healthcare professional about how much water or other liquids you should be drinking.
- Acute Intolerance Syndrome: Symptoms of acute intolerance syndrome can be similar to a flare of your condition. If you think you are experiencing a flare, talk to your healthcare professional immediately.
- Heart problems: These include inflammation of the heart muscle (myocarditis) and inflammation of the tissue around the heart (pericarditis).
- Blood problems: This includes low numbers of all types of blood cells (myelosuppression).
- Liver problems: This included liver failure.
For more information on these and other serious side effects see the Serious side effects and what to do about them table, below.
Pregnancy and Breastfeeding:
- Talk to your healthcare professional if you are pregnant or thinking of becoming pregnant.
- You should not breastfeed while you are taking ZDS–Mesalamine Suppositories. Mesalamine passes into breastmilk.
- If you breastfeed your baby while taking ZDS–Mesalamine Suppositories, your baby could develop / start to have diarrhea. It is important to monitor your baby’s stool and contact your healthcare professional right away if they have diarrhea. Your healthcare professional may advise you to stop breastfeeding your baby.
Sensitivity to the sun: Tell your healthcare professional if you have eczema or atopic dermatitis. Your skin may be more sensitive to sunlight when taking ZDS–Mesalamine Suppositories. You should avoid the sun and wear protective clothing and a broad-spectrum sunscreen when you are outdoors.
Blood tests: ZDS–Mesalamine Suppositories can cause abnormal blood test results. Your healthcare professional will do blood tests before you start taking ZDS–Mesalamine Suppositories and periodically during treatment. They will check the health of your liver and kidneys as well as the levels of your red and white blood cells and monitor you for other side effects. Your healthcare professional will decide when to perform blood tests and will interpret the results.
Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
The following may interact with ZDS–Mesalamine Suppositories:
- other medicines used to treat ulcerative colitis, such as azathioprine, 6-mercaptopurine, aminosalicylates
- sulfonylureas, used to treat diabetes
- anti-inflammatory drugs (NSAIDS), used to treat pain and inflammation
- anticoagulants, used to thin the blood and prevent blood clots, such as coumarin
- methotrexate, used to treat cancer and severe inflammatory conditions
- medicines used to treat gout, such as probenecid, sulfinpyrazone
- medicines used to treat high blood pressure, such as spironolactone, furosemide
- rifampicin, an antibiotic used to treat bacterial infections
- the chicken pox vaccine (varicella virus vaccine)
How to use ZDS–Mesalamine Suppositories:
- Take ZDS–Mesalamine Suppositories exactly as your healthcare professional has told you. Your healthcare professional will tell you how many ZDS–Mesalamine Suppositories to use. They may adjust your dose as needed. Do not stop using ZDS–Mesalamine Suppositories without talking to your healthcare professional.
- Detach one suppository from the strip of suppositories.
- Hold the suppository upright and carefully remove the plastic wrapper.
- Avoid touching the suppository for too long. This is because the suppository can melt at body temperature.
- Insert the pointed end of the suppository completely into your rectum. Insert it with gentle pressure.
- You may use a small amount of lubricating gel on the tip of the suppository to help with the insertion. Keep the suppository in your rectum for one to three hours or longer, if possible.
Usual dose:
1000 mg ZDS–Mesalamine Suppositories: one suppository, once daily, at bedtime.
The usual adult dose is 1000 mg - 1500 mg per day. Therefore, to achieve 1500 mg per day, a 500 mg suppository may be needed to be sourced from another manufacturer.
Overdose:
If you think you, or a person you are caring for, have used too much ZDS–Mesalamine Suppositories, contact a healthcare professional, hospital emergency department, regional poison control centre or Health Canada's toll-free number, 1-844 POISON-X (1-844-764-7669) immediately, even if there are no signs or symptoms.
Missed Dose:
If you miss a dose of ZDS–Mesalamine Suppositories, use it as soon as possible, unless it is almost time for the next dose. Do not use two doses at the same time to make up for a missed dose.
What are possible side effects from using ZDS–Mesalamine Suppositories?
These are not all the possible side effects you may have when using ZDS–Mesalamine Suppositories. If you experience any side effects not listed here, tell your healthcare professional.
Side effects may include:
- anorectal pain, discomfort or discharge
- anal itching
- stomach pain, cramps or discomfort
- nausea, vomiting
- bloating, gas
- constipation
- diarrhea
- painful or incomplete bowel movements
- abnormal stool (frequent bowel movements, stools discoloured, mucous in stool)
- dizziness
- fever
- flu like symptoms
- hemorrhoids
- hair loss
- headache
- inflammation/swelling of the throat
- itching, rash, skin redness
- joint and lower back pain
- reaction at site of administration
- sleeplessness
- swollen hands or lower legs
- tiredness or weakness
- cough
- difficulty breathing
- eye swelling
- medication residue
- pain
Serious side effects and what to do about them
| Serious side effects and what to do about them | |||
|---|---|---|---|
| Serious side effects and what to do about them | |||
| Symptom / effect | Talk to your healthcare professional | Stop using drug and get immediate medical help | |
| Symptom / effect | Talk to your healthcare professional | Stop using drug and get immediate medical help | |
| Symptom / effect | Talk to your healthcare professional | Stop using drug and get immediate medical help | |
| Only if severe | In all cases | ||
| Only if severe | In all cases | ||
| Only if severe | In all cases | ||
| UNCOMMON | |||
| Kidney stones (hard little pebbles that form in your kidneys): blood in urine, urinating more often, pain in your back, side, belly or groin | ✓ | ||
| Urinary tract infection: strong, persistent urge to urinate, pain or burning when urinating, bloody, cloudy or strong smelling urine, passing frequent, small amounts of urine | ✓ | ||
| UNKNOWN | |||
| Pancreatitis (inflammation of the pancreas): abdominal pain, nausea, vomiting, fever, rapid heartbeat, feeling tired | ✓ | ||
| Allergic reaction: rash, hives, itching, fever, swelling of the mouth, lips, tongue or throat, difficulty in swallowing or breathing | ✓ | ||
| Heart problems (including myocarditis, pericarditis or heart inflammation): chest pain, fast or irregular heartbeat, fatigue, fever, difficulty in breathing, accumulation of fluid in the lung, cough | ✓ | ||
| Kidney problems (inflammation of the kidney or kidney failure): blood in the urine, fever, increased or decreased urine output, mental status changes | ✓ | ||
| (drowsiness, confusion, coma), rash, swelling of the body, weight gain (from retaining fluid) | |||
Liver problems (including liver failure): severe abdominal pain, nausea, vomiting, yellowing of the skin and eyes, loss of appetite, bloating and distension, dark urine, pale stool | ✓ | ||
Acute intolerance syndrome: cramping, stomach pain, bloody and excessive stools, fever, headache, rash | ✓ | ||
Lung problems: difficulty in breathing, dry cough, fever, chills, sweating, body aches, generally feeling unwell | ✓ | ||
| Blood problems (low levels of one or more types of blood cells): fatigue, difficulty in breathing with exertion, rapid or irregular heartbeat, pale skin, frequent or prolonged infections, unexplained or easy bruising, nosebleeds, bleeding gums, prolonged bleeding from cuts, skin rash, dizziness,headache | ✓ | ||
| Serious skin reactions (SCAR, DRESS, SJS, TEN): reddish, flat circular patches with blisters on the skin or inside the mouth, eyes, nose, or genitals, fever, severe rash, peeling skin, swollen lymph glands, flu-like feeling, yellow skin or eyes, shortness of breath, dry cough, chest pain or discomfort, feeling thirsty, urinating less often | ✓ | ||
Pleurisy (accumulation of fluid in the lungs): dry cough, chest pain, difficulty in breathing | ✓ | ||
| Increased pressure in brain: headache which may originate behind your eyes and worsen with eye movements, with blurred or dimmed vision, double vision, seeing light flashes, difficulty | ✓ | ||
| seeing to the side, and brief or permanent vision loss, dizziness, nausea, vomiting, ringing in ears | |||
| Worsening of ulcerative colitis: worsening of stomach cramps or pain or diarrhea | ✓ | ||
| Photosensitivity (sensitivity of the skin to the sun): rash, redness, blisters, itching and burning when the skin is exposed to the sun or UV light | ✓ | ||
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.
Reporting Side Effects
You can report any suspected side effects associated with the use of health products to Health Canada by:
- Visiting the Web page on Adverse Reaction Reporting (canada.ca/drug-device-reporting) for information on how to report online, by mail or by fax; or
- Calling toll-free at 1-866-234-2345.
NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.
Storage:
ZDS–Mesalamine Suppositories must be stored below 25°C. Can be refrigerated. Keep away from direct heat, light and humidity.
Keep out of reach and sight of children.
NOTE: ZDS–Mesalamine Suppositories will cause staining of direct contact surfaces, including but not limited to fabrics, flooring, painted surfaces, marble, granite, vinyl, and enamel.
If you want more information about ZDS–Mesalamine Suppositories:
- Talk to your healthcare professional.
Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website:
- (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); or by calling 1-877-716-5599.
Manufacturer :
Zydus Lifesciences Ltd.
Changodar, Ahmedabad-382210,
India.
Importer / Distributor:
Zydus Pharmaceuticals (Canada) Inc.
602-2425 Matheson Blvd E
Mississauga, ON L4W 5K4.