Лечение обострений и профилактика рецидивов при язвенном колите и болезни Крона.
Противопоказания
Гиперчувствительность к компонентам препарата и другим производным салициловой кислоты заболевания крови язвенная болезнь желудка и двенадцатиперстной кишки дефицит глюкозо-6-фосфатдегидрогеназы геморрагический диатез тяжелая почечная/печеночная недостаточность детский возраст (до 6 лет).
Круглые, двояковыпуклые таблетки, покрытые пленочной оболочкой от светло-желтого до желто-коричневого цвета.
Фармакотерапевтическая группа
Противовоспалительное кишечное средство
Фармакологические свойства
Фармакодинамика:
Обладает противовоспалительным действием. Ингибирует синтез метаболитов арахидоновой кислоты (простагландинов) активность нейтрофильной липооксигеназы тормозит миграцию дегрануляцию и фагоцитоз нейтрофилов секрецию иммуноглобулинов лимфоцитами; связывает и разрушает свободные радикалы кислорода.
Фармакокинетика:
Биотрансформация
Месалазин метаболизируется как пресистемным путем в слизистой оболочке кишечника так и системным путем в печени превращаясь в фармакологически неактивную М-ацетил-5-аминосалициловую кислоту (N-Ац-5-ACK). Характер ацетилирования не зависит от ацетилирующего фенотипа больного. В небольшой степени ацетилирование может осуществляться за счет действия бактериальной микрофлоры толстой кишки. Связь с белками плазмы месалазина и N-Ац-б-АСК составляет соответственно 43% и 78%.
Распределение
Комбинированное фармакосцинтиграфическое / фармакокинетическое исследование продемонстрировало что при приеме с пищей таблетки Салофальк 250 мг покрытые кишечнорастворимой оболочкой растворяются приблизительно через 3-4 часа в подвздошной кишке. Среднее время эвакуации желудочного содержимого составило приблизительно 3 часа. После приблизительно 7 часов таблетки достигли толстой кишки. Приблизительно 75% дозы месалазина достигают толстого кишечника в неметаболизированном виде.
Абсорбция
Абсорбция месалазина максимальна в проксимальных отделах кишечника и минимальна в дистальных отделах. Наивысшая концентрация в плазме крови достигается после приблизительно 5 часов (в области подвздошной кишки) и при введении 500 мг месалазина три раза в день при условии установившегося равновесия составляет 21 ± 17 мкг/мл для месалазина и 28 ± 17 мкг/мл для его метаболита N-Ац-5-ACK.
Выведение
Месалазин и его метаболит N-Ац-5-ACK выводятся с калом (основная часть) через почки (от 20% до 50% в зависимости от способа применения фармакологического препарата и пути высвобождения месалазина) а также с желчью. N-Ац-5-ACK преимущественно выделяется с почками. Около 1% принятой внутрь дозы месалазина выводится с грудным молоком преимущественно в виде N-Ац-5-ACK. При длительном лечении с использованием таблеток Салофальк 250 мг при дневной дозе 500 мг месалазина (при условии установившегося равновесия) суммарная скорость выведения почками месалазина и N-Ац-5-ACK составила приблизительно 55% (значение полученное в течение 24 часов после введения последней дозы). Доля неметаболизированного месалазина составляла приблизительно 5%. Время полувыведения составляет 07-24 часа (в среднем 14 ±06 ч) при введении 500 мг месалазина три раза в день.
Показания к применению
Лечение обострений и профилактика рецидивов при язвенном колите и болезни Крона.
Противопоказания
Гиперчувствительность к компонентам препарата и другим производным салициловой кислоты заболевания крови язвенная болезнь желудка и двенадцатиперстной кишки дефицит глюкозо-6-фосфатдегидрогеназы геморрагический диатез тяжелая почечная/печеночная недостаточность детский возраст (до 6 лет).
С осторожностью
Нарушение функции печени и почек легкой и средней степени тяжести заболевания легких (особенно бронхиальная астма) больным с повышенной чувствительностью к сульфасалазину.
Применение при беременности и в период грудного вскармливания
Достаточных данных о применении таблеток Салофальк 250 мг у беременных не существует. Однако данные о применение месалазина у нескольких беременных женщин свидетельствует об отсутствии нежелательного влияния месалазина на беременность или на здоровье плода/новорожденного.
Исследования на животных которым месалазин назначался внутрь не указывают на наличие прямого или непрямого отрицательного влияния на беременность развитие эмбриона/плода роды и послеродовое развитие.
Салофальк таблетки следует применять во время беременности только в тех случаях когда потенциальная польза от его применения для матери превышает возможный риск для плода.
Салофальк таблетки может применяться у женщин в период кормления грудью только в тех случаях если потенциальный эффект от его применения для матери превышает возможный риск неблагоприятного действия для ребенка. Если у новорожденного вскармливаемого грудью появляется диарея грудное вскармливание необходимо прекратить.
Способ применения и дозы
Прием препарата строго по назначению врача.
Взрослые. При язвенном колите для лечения обострения в зависимости от тяжести заболевания внутрь по 2-4 таблетки 250 мг 3 раза в сутки (суточная доза от 15 до 30 грамм месалазина). При болезни Крона для лечения обострения в зависимости от тяжести заболевания по 2-6 таблетки 250 мг 3 раза в сутки (суточная доза от 15 до 45 грамм месалазина).
Для профилактики рецидивов при язвенном колите и болезни Крона препарат назначают по 2x250 мг 3 раза в сутки при необходимости в течение нескольких лет.
Дети (6 лет и старше). Для лечения обострения при язвенном колите и болезни Крона доза подбирается индивидуально. Начальная доза составляет 15-30 мг/кг/сутки разделенная не несколько приемов; максимальная доза - 75 мг/кг/сутки. Суммарная суточная доза не должна превышать максимальную суточную дозу для взрослых.
Для профилактики рецидивов используется доза 15-30 мг/кг/сутки разделенная на несколько приемов. Суммарная суточная доза не должна превышать рекомендованную суточную дозу для взрослых.
Общая рекомендация состоит в том что до 40 кг массы тела применяется 1/2 суточной дозы для взрослых (необходимо использовать таблетки по 250 мг 3 раза в сутки) более 40 кг массы тела - суточная доза для взрослых - 500 мг 3 раза в сутки.
Таблетки следует принимать целиком не разжевывая утром днем и вечером за 1 час до еды и запивать большим количеством воды. При дистальных формах язвенного колита предпочтительно одновременное ректальное введение препарата в виде свечей или клизм пены.
Побочное действие
Со стороны ЖКТ: диарея, тошнота, боли в животе, метеоризм, потеря аппетита, рвота, повышение уровня печеночных ферментов в крови, гепатит.
Со стороны ЦНС: головная боль, депрессия, головокружение, нарушение сна, недомогание, парестезии, судороги, тремор, шум в ушах.
Реакции, связанные с повышенной чувствительностью: кожная сыпь, зуд, эритема, лихорадка, бронхоспазм, перикардит и миокардит, острый панкреатит, интерстициальный нефрит, нефротический синдром.
Наблюдались отдельные случаи аллергического альвеолита и панколита. При определенных условиях месалазин и препараты, имеющие аналогичную химическую структуру, могут привести к развитию синдрома, сходного с синдромом системной красной волчанки.
Другие побочные эффекты: редко — тахикардия, артериальная гипертензия или гипотензия, боли за грудиной, одышка; миалгии, артралгии. В отдельных случаях наблюдались протеинурия, гематурия, кристаллурия, олигурия, анурия; анемия, лейкопения, агранулоцитоз, тромбоцитопения, гипопротромбинемия; уменьшение продукции слезной жидкости, алопеция.
Передозировка
Случаев передозировки не выявлено. В случае передозировки проводят симптоматическое лечение.
Взаимодействие с другими лекарственными средствами
Исследований взаимодействия препарата Салофальк с другими лекарствами не проводилось.
У пациентов которые одновременно получают лечение азатиоприном 6-меркаптопурином либо тиогуанином следует помнить о возможном усилении миелосупрессивного эффекта азатиоприна и 6-меркаптопурина либо тиогуанина. Применение месалазина вместе с антикоагулянтами например варфарином может снижать антикоагулянтный эффект последнего.
Особые указания
Перед началом лечения и в процессе его проведения по усмотрению лечащего врача необходимо определять параметры функционального состояния печени (такие как активность АЛТ или ACT) и контролировать анализы мочи (с помощью погружения тест - полосок). Проведение контроля рекомендуется обычно через 14 дней после начала лечения затем еще 2-3 раза с интервалом в 4 недели.
Если результаты анализов оказываются нормальными контрольные исследования следует проводить каждые 3 месяца. Если отмечается появление дополнительных симптомов контрольные исследования необходимо выполнять немедленно.
Если нарушение функции почек развилось во время лечения следует думать о нефротоксичном действии месалазина.
При назначении Салофалька таблетки больным с заболеваниями легких в частности бронхиальной астмой необходимо осуществлять тщательный контроль в процессе лечения.
Больные у которых отмечались анамнестические указания на побочные реакции при назначении препаратов содержащих сульфасалазин подлежат тщательному наблюдению в начальный период лечения Салофальком таблетки. Если на фоне лечения Салофальком возникают реакции острой непереносимости такие как судороги острые боли в животе лихорадка выраженная головная боль и сыпь применение препарата необходимо немедленно прекратить Примечание:
В редких случаях у пациентов перенесших резекцию толстой кишки/операцию на толстой кишке в области илеоцекального угла с удалением илеоцекальной заслонки наблюдалось выделение таблеток Салофальк в нерастворенном виде с калом ввиду чрезмерно быстрого прохождения через кишечник.
1 таблетка Салофальк 250 мг содержит 21 ммоль (48 мг) натрия. Если пациент находится на диете с контролем содержания солей натрия следует принять это во внимание.
Влияние на способность управлять автомобилем и движущимися механизмами
Препарат не оказывает влияние на управление транспортными средствами и обслуживание движущихся механизмов. При появлении описанных нежелательных явлений (таких как головокружение и др.) следует воздержаться от выполнения указанных видов деятельности.
В защищенном от света месте при температуре не выше 25°С. Хранить в недоступном для детей месте.
Срок годности
3 года. Не применять после истечения срока годности.
Условия отпуска
По рецепту
Производитель
Д-р Фальк Фарма ГмбХ, Leinenweberstrasse 5, 79108 Freiburg, Germany, Германия
Организация, принимающая претензии потребителей
Д-р Фальк Фарма ГмбХ
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от светло-желтого до желто-коричневого цвета."}}]},{"id":6,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"Противовоспалительное кишечное средство"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"header","data":{"text":"Фармакодинамика:","level":3}},{"type":"paragraph","data":{"text":"Обладает противовоспалительным действием. Ингибирует синтез метаболитов арахидоновой кислоты (простагландинов) активность нейтрофильной липооксигеназы тормозит миграцию дегрануляцию и фагоцитоз нейтрофилов секрецию иммуноглобулинов лимфоцитами; связывает и разрушает свободные радикалы кислорода."}},{"type":"header","data":{"text":"Фармакокинетика:","level":3}},{"type":"paragraph","data":{"text":"Биотрансформация"}},{"type":"paragraph","data":{"text":"Месалазин метаболизируется как пресистемным путем в слизистой оболочке кишечника так и системным путем в печени превращаясь в фармакологически неактивную М-ацетил-5-аминосалициловую кислоту (N-Ац-5-ACK). Характер ацетилирования не зависит от ацетилирующего фенотипа больного. В небольшой степени ацетилирование может осуществляться за счет действия бактериальной микрофлоры толстой кишки. Связь с белками плазмы месалазина и N-Ац-б-АСК составляет соответственно 43% и 78%."}},{"type":"paragraph","data":{"text":"Распределение"}},{"type":"paragraph","data":{"text":"Комбинированное фармакосцинтиграфическое / фармакокинетическое исследование продемонстрировало что при приеме с пищей таблетки Салофальк 250 мг покрытые кишечнорастворимой оболочкой растворяются приблизительно через 3-4 часа в подвздошной кишке. Среднее время эвакуации желудочного содержимого составило приблизительно 3 часа. После приблизительно 7 часов таблетки достигли толстой кишки. Приблизительно 75% дозы месалазина достигают толстого кишечника в неметаболизированном виде."}},{"type":"paragraph","data":{"text":"Абсорбция"}},{"type":"paragraph","data":{"text":"Абсорбция месалазина максимальна в проксимальных отделах кишечника и минимальна в дистальных отделах. Наивысшая концентрация в плазме крови достигается после приблизительно 5 часов (в области подвздошной кишки) и при введении 500 мг месалазина три раза в день при условии установившегося равновесия составляет 21 ± 17 мкг/мл для месалазина и 28 ± 17 мкг/мл для его метаболита N-Ац-5-ACK."}},{"type":"paragraph","data":{"text":"Выведение"}},{"type":"paragraph","data":{"text":"Месалазин и его метаболит N-Ац-5-ACK выводятся с калом (основная часть) через почки (от 20% до 50% в зависимости от способа применения фармакологического препарата и пути высвобождения месалазина) а также с желчью. N-Ац-5-ACK преимущественно выделяется с почками. Около 1% принятой внутрь дозы месалазина выводится с грудным молоком преимущественно в виде N-Ац-5-ACK. При длительном лечении с использованием таблеток Салофальк 250 мг при дневной дозе 500 мг месалазина (при условии установившегося равновесия) суммарная скорость выведения почками месалазина и N-Ац-5-ACK составила приблизительно 55% (значение полученное в течение 24 часов после введения последней дозы). Доля неметаболизированного месалазина составляла приблизительно 5%. Время полувыведения составляет 07-24 часа (в среднем 14 ±06 ч) при введении 500 мг месалазина три раза в день.\n\n"}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Лечение обострений и профилактика рецидивов при язвенном колите и болезни Крона."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к компонентам препарата и другим производным салициловой кислоты заболевания крови язвенная болезнь желудка и двенадцатиперстной кишки дефицит глюкозо-6-фосфатдегидрогеназы геморрагический диатез тяжелая почечная/печеночная недостаточность детский возраст (до 6 лет)."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Нарушение функции печени и почек легкой и средней степени тяжести заболевания легких (особенно бронхиальная астма) больным с повышенной чувствительностью к сульфасалазину."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"\n\nДостаточных данных о применении таблеток Салофальк 250 мг у беременных не существует. Однако данные о применение месалазина у нескольких беременных женщин свидетельствует об отсутствии нежелательного влияния месалазина на беременность или на здоровье плода/новорожденного."}},{"type":"paragraph","data":{"text":"Исследования на животных которым месалазин назначался внутрь не указывают на наличие прямого или непрямого отрицательного влияния на беременность развитие эмбриона/плода роды и послеродовое развитие."}},{"type":"paragraph","data":{"text":"Салофальк таблетки следует применять во время беременности только в тех случаях когда потенциальная польза от его применения для матери превышает возможный риск для плода."}},{"type":"paragraph","data":{"text":"Салофальк таблетки может применяться у женщин в период кормления грудью только в тех случаях если потенциальный эффект от его применения для матери превышает возможный риск неблагоприятного действия для ребенка. Если у новорожденного вскармливаемого грудью появляется диарея грудное вскармливание необходимо прекратить.\n\n"}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nПрием препарата строго по назначению врача."}},{"type":"paragraph","data":{"text":"Взрослые. При язвенном колите для лечения обострения в зависимости от тяжести заболевания внутрь по 2-4 таблетки 250 мг 3 раза в сутки (суточная доза от 15 до 30 грамм месалазина). При болезни Крона для лечения обострения в зависимости от тяжести заболевания по 2-6 таблетки 250 мг 3 раза в сутки (суточная доза от 15 до 45 грамм месалазина)."}},{"type":"paragraph","data":{"text":"Для профилактики рецидивов при язвенном колите и болезни Крона препарат назначают по 2x250 мг 3 раза в сутки при необходимости в течение нескольких лет."}},{"type":"paragraph","data":{"text":"Дети (6 лет и старше). Для лечения обострения при язвенном колите и болезни Крона доза подбирается индивидуально. Начальная доза составляет 15-30 мг/кг/сутки разделенная не несколько приемов; максимальная доза - 75 мг/кг/сутки. Суммарная суточная доза не должна превышать максимальную суточную дозу для взрослых."}},{"type":"paragraph","data":{"text":"Для профилактики рецидивов используется доза 15-30 мг/кг/сутки разделенная на несколько приемов. Суммарная суточная доза не должна превышать рекомендованную суточную дозу для взрослых."}},{"type":"paragraph","data":{"text":"Общая рекомендация состоит в том что до 40 кг массы тела применяется 1/2 суточной дозы для взрослых (необходимо использовать таблетки по 250 мг 3 раза в сутки) более 40 кг массы тела - суточная доза для взрослых - 500 мг 3 раза в сутки."}},{"type":"paragraph","data":{"text":"Таблетки следует принимать целиком не разжевывая утром днем и вечером за 1 час до еды и запивать большим количеством воды. При дистальных формах язвенного колита предпочтительно одновременное ректальное введение препарата в виде свечей или клизм пены.\n\n"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны ЖКТ: диарея, тошнота, боли в животе, метеоризм, потеря аппетита, рвота, повышение уровня печеночных ферментов в крови, гепатит."}},{"type":"paragraph","data":{"text":"Со стороны ЦНС: головная боль, депрессия, головокружение, нарушение сна, недомогание, парестезии, судороги, тремор, шум в ушах."}},{"type":"paragraph","data":{"text":"Реакции, связанные с повышенной чувствительностью: кожная сыпь, зуд, эритема, лихорадка, бронхоспазм, перикардит и миокардит, острый панкреатит, интерстициальный нефрит, нефротический синдром."}},{"type":"paragraph","data":{"text":"Наблюдались отдельные случаи аллергического альвеолита и панколита. При определенных условиях месалазин и препараты, имеющие аналогичную химическую структуру, могут привести к развитию синдрома, сходного с синдромом системной красной волчанки."}},{"type":"paragraph","data":{"text":"Другие побочные эффекты: редко — тахикардия, артериальная гипертензия или гипотензия, боли за грудиной, одышка; миалгии, артралгии. В отдельных случаях наблюдались протеинурия, гематурия, кристаллурия, олигурия, анурия; анемия, лейкопения, агранулоцитоз, тромбоцитопения, гипопротромбинемия; уменьшение продукции слезной жидкости, алопеция."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Случаев передозировки не выявлено. В случае передозировки проводят симптоматическое лечение."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\n\nИсследований взаимодействия препарата Салофальк с другими лекарствами не проводилось."}},{"type":"paragraph","data":{"text":"У пациентов которые одновременно получают лечение азатиоприном 6-меркаптопурином либо тиогуанином следует помнить о возможном усилении миелосупрессивного эффекта азатиоприна и 6-меркаптопурина либо тиогуанина. Применение месалазина вместе с антикоагулянтами например варфарином может снижать антикоагулянтный эффект последнего.\n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nПеред началом лечения и в процессе его проведения по усмотрению лечащего врача необходимо определять параметры функционального состояния печени (такие как активность АЛТ или ACT) и контролировать анализы мочи (с помощью погружения тест - полосок). Проведение контроля рекомендуется обычно через 14 дней после начала лечения затем еще 2-3 раза с интервалом в 4 недели."}},{"type":"paragraph","data":{"text":"Если результаты анализов оказываются нормальными контрольные исследования следует проводить каждые 3 месяца. Если отмечается появление дополнительных симптомов контрольные исследования необходимо выполнять немедленно."}},{"type":"paragraph","data":{"text":"Если нарушение функции почек развилось во время лечения следует думать о нефротоксичном действии месалазина."}},{"type":"paragraph","data":{"text":"При назначении Салофалька таблетки больным с заболеваниями легких в частности бронхиальной астмой необходимо осуществлять тщательный контроль в процессе лечения."}},{"type":"paragraph","data":{"text":"Больные у которых отмечались анамнестические указания на побочные реакции при назначении препаратов содержащих сульфасалазин подлежат тщательному наблюдению в начальный период лечения Салофальком таблетки. Если на фоне лечения Салофальком возникают реакции острой непереносимости такие как судороги острые боли в животе лихорадка выраженная головная боль и сыпь применение препарата необходимо немедленно прекратить Примечание:"}},{"type":"paragraph","data":{"text":"В редких случаях у пациентов перенесших резекцию толстой кишки/операцию на толстой кишке в области илеоцекального угла с удалением илеоцекальной заслонки наблюдалось выделение таблеток Салофальк в нерастворенном виде с калом ввиду чрезмерно быстрого прохождения через кишечник."}},{"type":"paragraph","data":{"text":"1 таблетка Салофальк 250 мг содержит 21 ммоль (48 мг) натрия. Если пациент находится на диете с контролем содержания солей натрия следует принять это во внимание.\n\n"}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат не оказывает влияние на управление транспортными средствами и обслуживание движущихся механизмов. При появлении описанных нежелательных явлений (таких как головокружение и др.) следует воздержаться от выполнения указанных видов деятельности."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки покрытые кишечнорастворимой пленочной оболочкой."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В защищенном от света месте при температуре не выше 25°С. Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года. Не применять после истечения срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Д-р Фальк Фарма ГмбХ, Leinenweberstrasse 5, 79108 Freiburg, Germany, Германия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Д-р Фальк Фарма ГмбХ"}}]}],"source":null},"description_toggle":false,"short_description":"Обладает противовоспалительным действием. Ингибирует синтез метаболитов арахидоновой кислоты (простагландинов) активность нейтрофильной липооксигеназы тормозит миграцию дегрануляцию и фагоцитоз нейтрофилов секрецию иммуноглобулинов лимфоцитами; связывает и разрушает свободные радикалы кислорода. Биотрансформация Месалазин метаболизируется как пресистемным путем в слизистой оболочке кишечника так и системным путем в печени превращаясь в фармакологически неактивную М-ацетил-5-аминосалициловую кислоту (N-Ац-5-ACK). Характер ацетилирования не зависит от ацетилирующего фенотипа больного. В небольшой степени ацетилирование может осуществляться за счет действия бактериальной микрофлоры толстой кишки. Связь с белками плазмы месалазина и N-Ац-б-АСК составляет соответственно 43% и 78%. Распределение Комбинированное фармакосцинтиграфическое / фармакокинетическое исследование продемонстрировало что при приеме с пищей таблетки Салофальк 250 мг покрытые кишечнорастворимой оболочкой растворяются приблизительно через 3-4 часа в подвздошной кишке. Среднее время эвакуации желудочного содержимого составило приблизительно 3 часа. После приблизительно 7 часов таблетки достигли толстой кишки. Приблизительно 75% дозы месалазина достигают толстого кишечника в неметаболизированном виде. Абсорбция Абсорбция месалазина максимальна в проксимальных отделах кишечника и минимальна в дистальных отделах. Наивысшая концентрация в плазме крови достигается после приблизительно 5 часов (в области подвздошной кишки) и при введении 500 мг месалазина три раза в день при условии установившегося равновесия составляет 21 ± 17 мкг/мл для месалазина и 28 ± 17 мкг/мл для его метаболита N-Ац-5-ACK. Выведение Месалазин и его метаболит N-Ац-5-ACK выводятся с калом (основная часть) через почки (от 20% до 50% в зависимости от способа применения фармакологического препарата и пути высвобождения месалазина) а также с желчью. N-Ац-5-ACK преимущественно выделяется с почками. Около 1% принятой внутрь дозы месалазина выводится с грудным молоком преимущественно в виде N-Ац-5-ACK. При длительном лечении с использованием таблеток Салофальк 250 мг при дневной дозе 500 мг месалазина (при условии установившегося равновесия) суммарная скорость выведения почками месалазина и N-Ац-5-ACK составила приблизительно 55% (значение полученное в течение 24 часов после введения последней дозы). Доля неметаболизированного месалазина составляла приблизительно 5%. Время полувыведения составляет 07-24 часа (в среднем 14 ±06 ч) при введении 500 мг месалазина три раза в день.","substance":[{"id":745,"title":"Месалазин","title_latin":"Mesalazinum","slug":"mesalazin_745"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Салофальк - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/9800/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/9800/share_default/"}},"diseases":[{"id":"872","title":"Болезнь Крона [регионарный энтерит]","slug":"872-bolezn_krona_regionarnyy_enterit"},{"id":"873","title":"Язвенный колит","slug":"873-yazvennyy_kolit"}],"other_packages":[{"id":93180,"title":"Салофальк","subtitle":{"full":"Таблетки, 50 шт, 250 мг","short":"Таблетки, 50 шт, 250 мг","package":"50 шт, 250 мг"},"prescription":true,"catalog_section_id":100329,"manufacturer":{"id":2250,"title":"Dr. Falk 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