Apriso Side Effects and Interactions

Apriso is a brand of mesalamine, or 5-aminosalicylic acid used to treat inflammation in the colon caused by ulcerative colitis. This helps patients stay in remission, which occurs when symptoms of a disease are reduced or go away.

Apriso is an extended-release medication, which means that it isn't released in the stomach. Rather, the medicine travels through the digestive tract and is released in the colon. Other brands of oral mesalamine include Pentasa, Asacol, Canasa, Delzicol, Rowasa, and Lialda.

This article outlines important information about Apriso, including who should not take the drug, and side effects to watch out for if it is prescribed for you.

How Apriso Is Used

The goal of ulcerative colitis treatment is to reduce symptoms and maintain remission. Anti-inflammatory drugs like Apriso are common and effective medications to help achieve this goal.

But even though mesalamine is a first-line treatment to achieve and maintain mild to moderate ulcerative colitis remission, it can also be used to treat flare-ups as of April 2022.

Who Should Not Take Apriso?

Some people shouldn't take Apriso. Tell your healthcare provider if you have ever had any of the following conditions before taking Apriso:

• Hypersensitivity to mesalamine or amino salicylic acid products or any component of the formulation
• Severe renal failure and severe hepatic impairment
• Underlying gastric or duodenal ulcers
  

Apriso is approved for patients ages 18 and up.

Using Apriso During Pregnancy

The FDA has classified Apriso as a category B drug, which means that the effects it could have on an unborn child have not been studied extensively. Apriso should only be used during pregnancy if clearly needed.

Let your healthcare provider know if you become pregnant while taking Apriso. This drug does pass into breast milk and could affect a nursing infant, so be sure to tell your healthcare provider if you are breastfeeding.

What Are the Side Effects of Apriso?

Like other forms of mesalamine, Apriso can have side effects. These range from minor side effects to more serious ones.

Minor Side Effects

Mesalamine can cause minor side effects that vary by person. These can include:

• Joint or muscle pain
• Nausea or vomiting
• Constipation
• Heartburn
• Dizziness or sweating
• Headache

Talk with your healthcare provider if these effects are bothersome or do not go away.

Serious Side Effects

Some side effects of Apriso are serious, and could even be life-threatening. Contact your healthcare provider right away if you experience any of the following symptoms after taking Apriso:

• Sudden or severe abdominal pain
• Bloody diarrhea
• Fever
• Chest pain
• Cough
• Extreme fatigue
• Difficulty swallowing or breathing
• Swelling of the eyes, throat, tongue, or lips
• Yellowing of the eyes or skin, or pain in the upper right part of the stomach

Mesalamine-Induced Acute Intolerance Syndrome can occur in up to 3% of patients taking mesalamine products including Apriso. This usually manifests with worsening GI symptoms like abdominal pain, diarrhea, and rectal bleeding—so it may be difficult to distinguish from the exacerbation of underlying active disease.

Apriso can be also associated with worsening kidney function due to development of interstitial nephritis, and cases of renal failure have been reported with mesalamine use. Increased risk of kidney stones can be seen in patients taking Apriso. Therefore it is recommended to closely monitor kidney function after starting Apriso and other mesalamine products.

Precaution should be taken in patients with underlying photosensitivity as a possible side effect of the medication. Apriso should be used in caution in patients with pre-existing eczema or atopic dermatitis. Precaution also should be taken in patients with underlying kidney and liver dysfunction and in patients with annual ketonuria.

Complications

Complications as a result of taking Apriso are rare, but may include:

• Heart conditions, including myocarditis (swelling of the heart muscle) or pericarditis
• Kidney disease or kidney stones
• Liver disease
• Pyloric stenosis (a type of stomach blockage)
• Eczema

Drug Interactions

As with all medications, it's important to talk to your doctor about whether any medicines you take could interfere with how Apriso works for you.

For instance, Apriso should not be taken with antacids, as Apriso requires a pH of 6 or more to be released in the colon. Taking an antacid can change the pH in the GI tract and therefore affect the ability of the drug to be released in the colon.

Tell your healthcare provider if you are taking:

• Imuran (azathioprine)
• Lanoxin (digoxin)
• Purinethol (mercaptopurine)
• The varicella virus vaccine or varicella, measles, mumps, and rubella vaccine

Apriso may interact with other drugs that are not on this list. It is always important to tell your healthcare provider about all the drugs and supplements you are taking, including over-the-counter medications.

Summary

If you have inflammation in your colon due to ulcerative colitis, Apriso may be an effective treatment to help you maintain a state of remission and limit active disease flare-ups. It's important, though, to talk with your healthcare provider about your other health conditions, and how any medications you take regularly could interact with Apriso. Be sure to also review potential side effects, both mild and serious.