NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Oral Mesalazine – Preferred Brands

Changes have been made to the recommendations on interchangeability of oral mesalazine preparations. The BNF now states that there is no evidence to show that any one oral preparation of mesalazine is more effective than another for ulcerative colitis.

The West of Scotland (WoS) Gastroenterology Prescribing Subgroup, a multi-disciplinary group supporting effective prescribing of gastro-intestinal (GI) medicines, has developed a regional recommendation on the preferred solid oral mesalazine agents for treatment and maintenance of remission of ulcerative colitis. The NHSGGC Adult Formulary has been updated here to reflect these recommendations.

All solid oral mesalazine preparations should continue to be prescribed by brand.

New Patients

  • Salofalk® is the preferred brand when a patient is being initiated on mesalazine.
  • Salofalk® is available in a range of different formulations with different dosing schedules. Please refer to the BNF for details. 
  • Should Salofalk® not be suitable, Pentasa® and Octasa® are alternative brands that should be considered.


Existing Asacol® prescribing

  • Patients prescribed Asacol® in primary and secondary care can be safely switched to Octasa® at the same dose and frequency as there is no clinical difference between the two brands and they are considered therapeutically equivalent. 
  • Despite Salofalk® being the lowest cost oral mesalazine, specialists are currently only advocating the switch from Asacol® to Octasa® due to the close similarity of the products and experience from other Health Boards of this switch being well tolerated.
  • Patient information should be supplied to patients switched from Asacol ® to Octasa®. The Medicines Cost Effectiveness Group supports the use of Tillotts Pharma switch literature which is being made available through hospital pharmacy department dispensaries, community pharmacists and prescribing support teams in primary care. A copy of the PIL can be found here. Patients should be advised to report any change in symptoms if switching brands.
  • If an alternative brand is required due to individual patient circumstances and/or specialist request, this should be specifically stated on the prescription. 


Secondary care prescribers have been informed of this change in practice via a memo.
In primary care, Scriptswitch messages will be deployed and prescribing support teams will also support active switching. Community pharmacists have been notified of a likely reduction in prescribing of Asacol® and to monitor demand and adjust stock levels of products accordingly.

Please note, at present, the GGC Formulary website does not enable search by brand name. To see entry for Salofalk® or Octasa® – search for mesalazine and refer to the prescribing notes.

 

Published 25/10/17