Comparative Pharmacology
Head-to-head clinical analysis: ASACOL versus CANASA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ASACOL versus CANASA.
ASACOL vs CANASA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Asacol (mesalamine) is an aminosalicylate that exerts anti-inflammatory effects in the colon via inhibition of prostaglandin and leukotriene synthesis, particularly by blocking cyclooxygenase and lipoxygenase pathways, and by scavenging reactive oxygen species. It also inhibits cytokine production and reduces mucosal inflammation.
Mesalamine (5-aminosalicylic acid) is an anti-inflammatory agent that inhibits prostaglandin and leukotriene synthesis, scavenges reactive oxygen species, and inhibits cytokine production and nuclear factor-kappa B (NF-κB) activation in colonic mucosa.
800 mg orally three times daily or 1600 mg three times daily for 6 weeks; maintenance: 1.6 g daily in divided doses.
Mesalamine 1000 mg rectally once daily at bedtime, or 500 mg rectally twice daily (morning and evening). Administered as suppository for ulcerative colitis.
None Documented
None Documented
Terminal half-life: 0.6-1.4 hours for 5-ASA; 6-12 hours for N-acetyl-5-ASA. Clinical context: short t1/2 necessitates multiple daily dosing for sustained colonic exposure.
Terminal elimination half-life of mesalamine is approximately 0.5-2 hours; however, the N-acetyl metabolite has a half-life of 5-10 hours. Due to the sustained-release formulation, clinical effects persist beyond the plasma half-life.
Renal (80% as 5-ASA and N-acetyl-5-ASA), fecal (20%)
Renal (approximately 20-30% as unchanged drug and metabolites, primarily N-acetyl-5-aminosalicylic acid); biliary/fecal (the remainder, with extensive enterohepatic circulation).
Category C
Category C
Aminosalicylate
Aminosalicylate