Mesalamine, Asacol, Delzicol, mesalazine, and 5-ASA – what’s the difference?!?

A belly man with a picture of Chrons and Colitis

Mesalamine is a first-line medication used to treat and prevent mild to moderately active inflammatory bowel disease, including ulcerative colitis and Crohn’s disease. It is an anti-inflammatory medication that works by direct contact with the intestines.  

Mesalamine is also known as mesalazine or 5-aminosalicylic acid (5-ASA). 

Mesalamine is available as a variety of formulations administered orally or rectally (suppositories and enemas).  Available forms of mesalamine differ in their route of administration (oral or rectal), strength and how often they are administered.  

According to studies performed to date, the available oral formulations have similar rates of efficacy when used in the treatment of ulcerative colitis. No significant differences were reported between once daily and multiple daily mesalamine regimens.  

US brand Delzicol 400 mg capsule (formerly Asacol 400 mg tablet) by Allergan – dosed orally 3 times daily 

Global Alternatives: brand Asacol MR 400 mg tablet (UK) by Allegan 

Brand Asacol 400 mg tablet (Canada) by Allergan 

Generic Octasa 400 mg tablet (UK) by Tillotts Pharma UK 

Generic Teva-5-ASA 400 mg tablet (Canada) by Teva 

US brand Asacol HD 800 mg tablet – dosed orally 3 times daily 

Global Alternatives: brand Asacol MR 800 mg tablets (UK) by Allergan 

Brand Asacol HD 800 mg tablets (Canada) by Allergan 

Generic Octasa 800 mg tablet (UK) by Tillotts Pharma UK 

US brand Lialda 1.2 g tablet by Shire US Inc. – dosed orally once daily with food 

Global Alternatives: brand Mezavant XL 1.2 g (UK) by Shire Pharma 

Brand Mezavant  1.2 g (Canada) by Shire Pharma  

US brand Pentasa 250 mg and 500 mg capsule – dosed orally 4 times daily  

Global Alternatives: brand Pentasa 500 mg and 1000 mg tablet (UK) by Ferring 

Brand Pentasa 500 mg and 1000 mg tablet (Canada) by Ferring 

US brand Apriso 375 mg capsule – dosed orally once daily (note: contains phenylalanine) 

Global Alternatives not available 

US brand Canasa 1000 mg suppository by Allergan (registered trademark of Aptalis Pharma)– dosed rectally at bedtime, retained for 1-3 hours or more if possible to achieve maximum benefit 

Global Alternatives: brand Salofalk 500 mg and 1000 mg suppositories (Canada) by Aptalis Pharma 

US brand Rowasa 4 g per 60 mL enema by Meda Pharmaceuticals – dosed rectally once daily at bedtime, retained for 8 hours 

Global Alternatives: brand Salofalk enema 4 g per 60 mL (Canada) by Aptalis Pharma 

Additional Information on this subject: 

10 Crohn’s Disease Symptoms, From Diarrhea to Beyond

Find a Gastroenterologist

Health Care Cost Assistance Guide

How Crohn’s Disease Is Treated

Complementary Medicine

How to Create a Healthy Home Environment that Will Soothe Autoimmune Disease Symptoms

Nutrition Tips for Inflammatory Bowel Disease

Complications of Crohn’s disease

This article contains medical information provided to help you better understand this particular medical condition or process, and may contain information about medication often used as part of a treatment plan prescribed by a doctor.  It is not intended to be used as either a diagnosis or recommendation for treatment of your particular medical situation.  If you are unwell, concerned about your physical or mental state, or are experiencing symptoms you should speak with your doctor or primary health care provider. If you are in medical distress please contact emergency services (such as 911). 

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