Lialda (Mesalamine) - Oral

What Is Lialda?

Lialda (mesalamine) is a prescription tablet used to treat ulcerative colitis, a condition that causes symptoms like diarrhea, belly pain, and blood in the stool. The generic form is called mesalamine or sometimes mesalazine.

Lialda is a type of drug known as an amino-salicylate based on its chemical structure. Sometimes, it also is called by its chemical name: 5-aminosalicylic acid (5-ASA). Lialda is very similar in structure to the drug aspirin. It has anti-inflammatory properties that decrease inflammation and reduce symptoms associated with ulcerative colitis.

There are several different formulations of mesalamine. Lialda is a delayed-release formulation, designed not to release most of its medication until it reaches the latter parts of the digestive tract (where it can be most effective).

Drug Facts

Generic Name: Mesalamine

Brand Name(s): Lialda, Apriso, Asacol HD, Delzicol, Pentasa

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Ant-inflammatory, gastrointestinal agent

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Mesalamine

Dosage Form(s): Delayed-release tablet, delayed-release capsule, extended-release capsule, tablet

What Is Lialda Used For?

The Food and Drug Administration (FDA) approved Lialda to treat ulcerative colitis. Specifically, it is for people who have mild to moderate symptoms. People with severe disease will probably need to use other options.

Ulcerative colitis is a type of inflammatory bowel disease. Parts of the immune system become overactivated, leading to inflammation along the large intestine (the latter part of the digestive tract).

Lialda helps treat initial symptom flares of ulcerative colitis. It is also used long-term to prevent symptom flares from returning (usually using a lower dose).

Lialda is approved for adults and children weighing at least 53 pounds (24 kilograms).

How to Take Lialda

Take Lialda with food. Try to take it with a meal at roughly the same time every day. Do not crush or split the tablet before taking it. You need to swallow the tablets whole.

Depending on your situation, you may need to take two to four pills. These should be taken all at once—not spread out throughout the day.

Storage

Store the medication at room temperature (between 68 and 77 degrees F), safely away from pets and small children.

Off-Label Uses

Healthcare providers sometimes prescribe mesalamine to people with another related condition: Crohn’s disease. Technically, mesalamine was never FDA-approved for Crohn’s disease, although it has been prescribed for many years for this use.

Both Crohn’s disease and ulcerative colitis are types of inflammatory bowel disease that cause symptoms from inflammation in your digestive tract.

However, the two conditions aren’t exactly the same. Mesalamine doesn’t seem to work as well in Crohn’s disease compared with ulcerative colitis. Usually, other treatments are tried first for Crohn’s disease. However, it may still be the right choice for some people.

How Long Does Lialda Take to Work?

Lialda starts working right away to decrease inflammation in your large intestine. However, it takes a bit longer to relieve symptoms. You might notice improvement within a few days, but it can take up to a few weeks. Talk to your healthcare provider if your symptoms aren’t improving as expected.

What Are the Side Effects of Lialda?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Many people don’t notice side effects from using Lialda. However, some of the more commonly reported side effects are:

  • Worsened belly pain
  • Worsened diarrhea
  • Nausea
  • Headache
  • Flatulence

Severe Side Effects

Call your healthcare provider immediately if you think you might have a severe side effect from Lialda. Also, call 911 if you are experiencing potentially life-threatening symptoms, like sudden shortness of breath or chest pain.

Rarely, Lialda can cause problems from a type of severe allergic response. In extreme cases, this might cause organ damage, such as to your heart or other parts of your body.

Another potentially serious problem is mesalamine-induced intolerance syndrome. Paradoxically, this might actually increase your symptoms of ulcerative colitis. In other words, you can get a flare of your disease.

You would probably need to stop taking mesalamine for these or other severe symptoms but check with your healthcare provider first.

Long-Term Side Effects

Rarely, Lialda might damage your kidneys or liver. Most of the time, this would only result in temporary damage. However, kidney failure or significant liver damage might cause long-lasting problems.

Tell your healthcare provider immediately if you notice any issues like swollen limbs or yellow-colored skin.

You will probably need blood tests to check your kidney functioning to decrease the risk of kidney problems.

Report Side Effects

Lialda may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Lialda Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For the treatment of ulcerative colitis:
    • For long-acting oral dosage form (delayed-release capsules):
      • Adults—800 milligrams (mg) 3 times a day.
      • Children 5 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually not more than 2400 mg per day, divided in 2 doses.
      • Children younger than 5 years of age—Use and dose must be determined by your doctor.
    • For long-acting oral dosage form (delayed-release tablets):
      • Asacol®:
        • Adults—800 milligrams (mg) (two 400 mg tablets) 3 times a day for 6 weeks.
        • Children 5 years of age and older—Dose is based on body weight and must be determined by your doctor:
          • Weighing 54 to 90 kilograms (kg)—1200 mg (three 400 mg tablets) in the morning, then 1200 mg (three 400 mg tablets) in the afternoon for 6 weeks.
          • Weighing 33 to less than 54 kg—1200 mg (three 400 mg tablets) in the morning, then 800 mg (two 400 mg tablets) in the afternoon for 6 weeks.
          • Weighing 17 to less than 33 kg—800 mg (two 400 mg tablets) in the morning, then 400 mg (1 tablet) in the afternoon for 6 weeks.
        • Children younger than 5 years of age or weighing less than 17 kg—Use and dose must be determined by your doctor.
      • Asacol® HD:
        • Adults—1600 milligrams (mg) 3 times a day for 6 weeks.
        • Children—Use and dose must be determined by your doctor.
      • Lialda®:
        • Adults—2.4 to 4.8 grams (g) once a day.
        • Children 5 years of age and older—Dose is based on body weight and must be determined by your doctor:
          • Weighing more than 50 kilograms (kg)—4.8 grams (g) once a day for 8 weeks. Then 2.4 g once a day.
          • Weighing more than 35 to 50 kg—3.6 g once a day for 8 weeks. Then 2.4 g once a day.
          • Weighing 24 to 35 kg—2.4 g once a day for 8 weeks. Then 1.2 g once a day.
        • Children younger than 5 years of age or weighing less than 24 kg—Use and dose must be determined by your doctor.
    • For long-acting oral dosage form (extended-release capsules):
      • Adults—
        • For Apriso®: 1.5 grams (g) (four capsules) once a day as a single dose in the morning.
        • For Pentasa®: 1 g (four 250 milligrams [mg] capsules or two 500 mg capsules) 4 times a day.
      • Children—Use and dose must be determined by your doctor.
  • For prevention of ulcerative colitis:
    • For long-acting oral dosage form (delayed-release capsules):
      • Adults—1600 milligrams (mg) per day, taken in divided doses.
      • Children—Use and dose must be determined by your doctor.
    • For long-acting oral dosage form (Asacol® delayed-release tablets):
      • Adults—1600 milligrams (mg) (four 400 mg tablets) per day, taken in 2 to 4 divided doses.
      • Children—Use and dose must be determined by your doctor.
    • For long-acting oral dosage form (Lialda® delayed-release tablets):
      • Adults—2.4 grams (g) once a day.
      • Children—Use and dose must be determined by your doctor.

Modifications

If you have trouble swallowing tablets, you might want to talk to your healthcare provider about other mesalamine formulations.

Depending on the specifics of your disease, you might be able to use a formulation inserted into your anus. This may make sense if your disease affects the latter part of your large intestine and rectum. Mesalamine is available as an enema (Rowasa) or as a suppository (Canasa).

Missed Dose

If you miss a dose, take it as soon as you remember. However, if you are very close to your next dose, do not take the missed dose to double up.

It probably won’t be a big deal if you miss a single dose of mesalamine. However, you must take your medications exactly as prescribed.

If you keep missing doses, it will be harder to get your disease under control. It also makes it harder to determine if the drug works well for you. And, if your condition has been stable, stopping Lialda might trigger a flare of disease symptoms.

Overdose: What Happens If I Take Too Much Lialda?

If you accidentally take one extra pill, it is unlikely to be a big problem. However, it’s always worth checking in with the healthcare provider who prescribed it to you. Taking a lot more Lialda than prescribed could be dangerous and even life-threatening.

Overdose symptoms might include dizziness, vomiting, confusion, and seizures.

What Happens If I Overdose on Lialda?

If you think you or someone else might have overdosed on Lialda, call your healthcare provider or the Poison Control Center (800-222-1222) right away.

For potentially life-threatening symptoms like loss of consciousness after taking Lialda, call 911.

Precautions

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It is important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Asacol® delayed-release tablet and Pentasa® extended-release capsule may cause serious kidney problems, including kidney stones. Check with your doctor right away if you have lower back or side pain, decreased frequency or amount of urine, bloody urine, increased thirst, loss of appetite, nausea, vomiting, unusual tiredness or weakness, swelling of the face, fingers, or lower legs, weight gain, or trouble breathing.

Check with your doctor right away if you have stomach pain, bloody diarrhea, cramps, fever, headache, or a rash while you are using this medicine. These may be symptoms of a condition called mesalamine-induced acute intolerance syndrome.

Call your doctor right away if you have difficulty breathing or swallowing, a fast heartbeat, itching, rash, or skin redness, or swelling of the face, throat, or tongue. These may be symptoms of an allergic reaction to this medicine.

This medicine may cause serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). Check with your doctor right away if you have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, trouble breathing, unusual bleeding or bruising, or unusual tiredness or weakness.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may make you more sensitive to light and cause serious unwanted skin reaction. This is more likely if you have an existing skin problem (eg, atopic dermatitis, atopic eczema). Check with your doctor right away if you have increased sensitivity of the skin to sunlight, itching, redness or other discoloration of the skin, severe sunburn, or skin rash. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Do not take antacids (eg, Amphojel®, Maalox®, Mylanta®, Tums®) while you are using the Apriso® capsules. Using these medicines together may change the amount of medicine that is released in the body.

Make sure any doctor or dentist who treats you knows that you are using mesalamine. This medicine may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Lialda?

You should not take Lialda if you:

  • Are allergic to mesalamine or related drugs, like aspirin
  • Have an obstruction in your gastrointestinal tract

In other cases, taking Lialda may be a possibility, but you may be at higher risk of problems. You’ll need to weigh the pros and cons with your healthcare provider. This might apply to any of the following health issues:

  • Certain skin conditions
  • Kidney disease
  • Liver disease

If you are 65 or older or pregnant, you’ll also need to discuss the risk and benefits with your healthcare provider.

What Other Medications Interact With Lialda?

Taking mesalamine can change the way your body processes other medications you are taking and vice versa. So, it’s important to tell your healthcare provider about all your medications, including over-the-counter (OTC) and herbal products.

In particular, you might need to talk to your healthcare provider about medications that might damage your kidneys. This includes common pain reliever drugs called non-steroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen).

You may still be able to use such drugs, but you’ll need to consult with your healthcare provider first.

What Medications Are Similar?

One confusing thing about mesalamine is that many different formulations have the same active ingredient.

One of the biggest differences is between oral formulations of the drug and formulations that you apply directly into your anus. Canasa, for example, is a suppository formulation of mesalamine. Rowasa is an enema formulation of mesalamine that you flush through your anus.

These types of formulations are often recommended over an oral drug like Lialda for people with certain types of ulcerative colitis. For example, they may work more effectively in people who have active disease in the very last parts of the large intestine (the sigmoid colon or rectum).

However, many people don’t like these options for practical and personal reasons. Scientists have developed several oral options with almost identical active ingredients to Lialda. Some of these are:

These drugs differ slightly in terms of the part of the digestive tract where they are most effective so one might work better for you than the others. They may also differ slightly in side effects and cost. Unfortunately, scientists don’t have a clear understanding of the pros and cons of each.

If one form of mesalamine doesn’t work for you, you could try another formulation. Or your healthcare provider might recommend adding an additional treatment (like temporary prednisone). In some cases, you might need to switch to another type of treatment (like a TNF inhibitor such as infliximab or Remicade).

Frequently Asked Questions

  • What is Lialda used for?

    Lialda is FDA-approved to treat ulcerative colitis. Less commonly, it can be used off-label to treat a related condition called Crohn’s disease. In addition, Lialda can be used to treat disease flares, but it can also be taken long-term to keep flares from returning.

  • Can I stop taking Lialda if I feel better?

    Even if your symptoms have gone away, don’t stop taking Lialda without talking to your healthcare provider. Lialda works to prevent flares, so stopping it suddenly may trigger one.

  • Is Lialda better than other forms of mesalamine?

    You might find taking Lialda, an oral medication, more convenient than mesalamine in the form of a suppository or enema. On the other hand, other formulations might work better for people with certain kinds of ulcerative colitis.

    Scientists are still learning about some of the differences among the various oral formulations of mesalamine. You might find that one kind works better for you. Talk to your healthcare provider.

  • Could Lialda make my symptoms worse?

    Rarely, Lialda can make symptoms worse. Instead of helping, the drug might actually trigger a disease flare. If you think this is happening, talk to your prescribing healthcare provider right away. You will probably need to stop taking the drug.

  • Can I take NSAIDs while taking Lialda?

    If you are taking Lialda, you may need to avoid medications that might damage your kidneys. These can include pain reliever medications like Advil (ibuprofen) or Aleve (naproxen). You might need to use another pain reliever, like Tylenol (acetaminophen), if you have pain. Ask your healthcare provider if this applies to you.

How Can I Stay Healthy While Taking Lialda?

If you are starting Lialda, you are probably dealing with painful and bothersome symptoms from ulcerative colitis. Taking your medication every day exactly as prescribed is the most important thing you can do to reduce these symptoms.

Good nutrition can also play a role in reducing the number of flare-ups. Pay attention to how your body responds to certain foods, as this can help identify triggers. You may also find that eating in small amounts at a time helps, as opposed to large meals.

Keep taking your medicine, even if you think it isn’t working—it can take a few weeks or more to notice improvement. After a while, you can check in with your healthcare provider and get your treatment adjusted if needed.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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