Last update Aug. 17, 2019
Very Low Risk
A salicylic derivative with anti-inflammatory, immunosuppressive and bacteriostatic properties, used to treat ulcerative colitis.
Oral or rectal administration 1 to 3 times a day.
Mesalazine is poorly absorbed in the intestine, especially if administered rectally.
Plasma levels are very low and it transfers in very small amounts to breastmilk (Datta 2019), although a metabolite (inactive in order to treat the disease), N-acetyl-5-ASA (Na5ASA), transfers in higher concentrations to breastmilk but without exceeding 10% of the relative dose (Silverman 2005, Christensen 1994, Klotz 1993, Miller 1993, Jenss 1990).
No problems have been observed in more than 130 infants whose mothers were taking it (Datta 2019, Xu 2017, Moretti, 1989), except for some isolated cases of diarrhea (Ito 1993, Nelis 1989, Branski 1986).
Various medical associations, experts and expert consensus consider its use to be safe during breastfeeding (Huang 2016, Nguyen 2016, Damas 2015, Van der Woude 2015, Mahadevan 2015, Schulz 2014, Nielsen 2014, Yarur 2013, Salinger 2012, Habal 2012, Van Assche 2010, van der Woude 2010, Mottet 2009, Heetun 2007, Mahadevan 2006, Connell 1996).
It is very debatable (Sánchez 204) whether the thrombocytosis of a 4-month-old infant whose mother was in chronic treatment with mesalazine was due to mesalazine or to the sudden stopping of breastfeeding (Barriuso 2003).
We do not have alternatives for Mesalazine (5-ASA) since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.
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