All About Apriso

If you have ulcerative colitis (UC), your doctor may prescribe Apriso (mesalamine). It’s a prescription drug used in adults to keep UC in remission. When UC is in remission, you don’t have any active symptoms.

To learn more about how Apriso is used, see the “Is Apriso used for ulcerative colitis?” section below.

Apriso basics

Apriso contains the active drug mesalamine, which is also available as a generic drug. It’s part of the aminosalicylate group of medications.

Apriso comes as a capsule that you’ll take by mouth. Apriso capsules are extended-release (ER) and delayed-release (DR). ER means the drug is released into your body slowly over time, and DR means it’s released a certain amount of time after swallowing.

In this article, we describe Apriso’s uses, side effects, and more.

Like most drugs, Apriso may cause mild or serious side effects. The lists below describe some of the more common side effects that Apriso may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Apriso. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Apriso can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Apriso’s prescribing information.

Mild side effects of Apriso that have been reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information about this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Apriso can occur, but they aren’t common. If you have serious side effects from Apriso, call your doctor right away. If you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Apriso that have been reported include:

• kidney problems, such as kidney failure
• mesalamine-induced acute intolerance syndrome (a reaction to Apriso’s active drug that can cause symptoms similar to an ulcerative colitis flare-up)
• myocarditis and pericarditis (kinds of inflammation around the heart)
• severe skin reaction, such as Stevens-Johnson syndrome or toxic epidermal necrolysis
• liver problems
• allergic reaction*

* For more information about this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects Apriso may cause. It’s important to note that you should not stop taking Apriso without first talking with your doctor, even if you’re experiencing side effects.

In addition to the information below, you can refer to this article for more details about Apriso’s side effects.

Hair loss

It’s possible to have hair loss with Apriso. This side effect was rare in the drug’s studies, and more research is needed to confirm whether Apriso directly causes hair loss.

It is important to note that hair loss is common in people with inflammatory bowel disease (IBD), and ulcerative colitis (UC) is a kind of IBD.

Mesalamine has been shown to be less likely to cause hair loss than similar medications.

What might help

If you think Apriso might be causing hair loss, talk with your doctor. Together you can discuss possible causes and how to manage this.

With UC, you may lack certain nutrients, such as vitamin B12 and iron. Low levels of vitamin B12 and iron are thought to be associated with hair loss, though this hasn’t been confirmed by studies. Your doctor may recommend that you try to eat a balanced, nutritious diet while taking Apriso.

Fatigue

Fatigue is a possible side effect of Apriso, but it isn’t common. Fatigue means having low energy.

Fatigue can be a symptom of UC, especially if you’re not eating a nutritious diet or if you’re having trouble eating. Not having enough nutrients in your diet can make you feel tired.

What might help

Talk with your doctor if you think Apriso is making you feel more tired than usual. They might recommend that you have a blood test to check for anemia (low iron level in the blood). Anemia can be a symptom of UC and can cause fatigue.

Try to eat a nutritious diet while taking Apriso. This can help you get the nutrients you need, which can help you avoid fatigue.

Belly pain

Belly pain, usually in the upper part of your belly, can be a side effect of Apriso.

UC can also cause belly pain as a symptom, and it may occur with cramping or an urgent need to have a bowel movement.

What might help

If you have belly pain while taking Apriso, talk with your doctor. They can help determine if Apriso is the cause or if it could be a UC symptom.

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat, which can cause trouble breathing
• inflammation (swelling and damage) in certain body areas, such as your kidneys, liver, lungs, or the lining of your heart
• changes in your blood cells

Your doctor will recommend the dosage of Apriso that’s right for you. Below is the drug’s standard recommended dosage, but always take the dosage your doctor prescribes.

Form and strength

Apriso comes as a capsule that you’ll take by mouth. It comes in a strength of 0.375 grams (g).

Apriso capsules have an extended-release (ER) coating and a delayed-release (DR) coating. ER means the drug is released into your body slowly over a period of time. DR means the drug is released from the capsule a certain period of time after swallowing.

Recommended dosage

The recommended Apriso dosage for ulcerative colitis (UC) is 1.5 grams (g) once daily in the morning. For this dose, you’ll take four capsules at once.

Questions about Apriso’s dosage

• What if I miss a dose of Apriso? If you miss a dose of Apriso, take it as soon as you remember that day. But if you’re getting close to your next day’s dose, skip the missed dose. Take your next dose at your regularly scheduled time. If you’re unsure of what to do after missing a dose of Apriso, talk with your doctor or pharmacist. Do not take two doses at once.
• Will I need to take Apriso long term? UC is a long lasting medical condition. Apriso helps to manage your symptoms when your condition is in remission. When UC is in remission, you still have the condition, but you don’t have active symptoms. So you might need to take Apriso long term. To find out how long you might take Apriso, talk with your doctor.
• How long does it take for Apriso to start working? Apriso can start working in your body to reduce UC inflammation (swelling and damage) after your first dose. But you might need to take Apriso for several weeks before you notice a reduction in your symptoms.

You can refer to this article for more details about Apriso’s dosage.

Find answers to some commonly asked questions about Apriso.

How does Apriso compare with Asacol HD, Delzicol, generic mesalamine, or other alternatives?

Apriso, Asacol HD, Delzicol, and generic* mesalamine all contain mesalamine. Asacol HD is discontinued and no longer available. But all these drugs treat ulcerative colitis (UC) in slightly different situations.

To find out which form of mesalamine is best for your condition and learn more about a specific drug listed here, talk with your doctor.

* A generic drug is an exact copy of the active drug in a brand-name medication. A generic is considered as safe and effective as the original drug.

Why should I take Apriso in the morning?

Taking Apriso in the morning is recommended because of how the drug is released in your body after you take it.

Apriso capsules have extended-release and delayed-release coatings. This means the medication is released a certain time after you swallow it, and over a certain period of time.

Usually, people take Apriso in the morning so that the drug works throughout the day. But if taking your dose in the morning doesn’t work for you, talk with your doctor about whether you might be able to take it at a different time.

Is Apriso a steroid?

No, Apriso isn’t a steroid. It’s an aminosalicylate drug. It works to reduce inflammation (swelling and damage) in your large intestine.

Steroid drugs can also lower inflammation in your intestine, but they work differently than Apriso.

Your doctor or pharmacist can provide more information about how Apriso compares with steroids.

Will I have weight gain with Apriso?

No, changes in weight aren’t a known side effect of Apriso. But UC can cause weight loss as a symptom. So weight gain or weight loss could be a sign that Apriso isn’t working well to maintain your UC remission (a period of time without active symptoms).

If you notice that your weight is changing while taking Apriso, talk with your doctor or pharmacist. They can help determine the cause and recommend ways for you to maintain a moderate weight. And be sure to talk with your doctor if you think your UC symptoms may be returning.

How does Apriso work?

Apriso’s exact mechanism of action (the way the drug works in the body) isn’t known. It’s thought that Apriso may cause your body to produce fewer proteins and activate fewer cells that cause UC inflammation. This can help maintain UC remission.

Mesalamine, the active drug in Apriso, is considered an antioxidant (a substance that can slow down cell damage). But it isn’t clear whether antioxidants help with UC.

Does Apriso treat Crohn’s disease?

No, Apriso isn’t prescribed to treat Crohn’s disease. It’s only prescribed to treat UC.

Crohn’s disease and UC are both kinds of inflammatory bowel disease. But they have different treatments. Mesalamine, the active drug in Apriso, isn’t effective for treating Crohn’s disease.

To learn more about Crohn’s disease and its possible treatments, talk with your doctor or pharmacist.

Pentasa and Apriso contain the same active drug, mesalamine. Apriso is only prescribed to help keep ulcerative colitis (UC) in remission. With remission, you still have UC, but you don’t have active symptoms. Pentasa is prescribed to help get UC into remission.

Pentasa comes as an extended-release (ER) capsule. ER means the drug is released into your body slowly over a period of time.

Apriso capsules have both an ER coating and a delayed-release (DR) coating. DR means the drug is released from the capsule a certain period of time after swallowing.

Pentasa and Apriso tend to cause similar side effects but can also cause different ones. Diarrhea, headache, nausea, and belly pain were the more common side effects in studies of both drugs. You can refer to the details in the prescribing information for Apriso and Pentasa.

Your doctor or pharmacist can tell you more about how these drugs compare.

Lialda and Apriso both contain the active drug mesalamine. Apriso is only prescribed to help keep ulcerative colitis (UC) in remission. With remission, you still have UC, but you don’t have active symptoms. Lialda can be prescribed to help get UC into remission.

To learn about the similarities and differences between Apriso and Lialda, see this article. Also, talk with your doctor to find out which drug is right for you.

Yes, Apriso is prescribed for adults to keep ulcerative colitis (UC) in remission. With remission, you still have UC, but you don’t have active symptoms. A period of time when symptoms come back is called a flare-up or relapse.

UC causes inflammation (swelling and damage) in the lining of your large intestine. Symptoms may include:

• bloody diarrhea with or without mucus
• urgent need to have a bowel movement
• belly pain
• weight loss
• fever

If you have UC, you’ll have periods of active symptoms and periods of remission. There’s no cure for UC at this time, but medications can help manage symptoms and can lead to remission. Then medications such as Apriso are used to maintain remission.

If you have questions about Apriso’s use for UC, you can talk with your doctor or pharmacist.

Some important things to discuss with your doctor when considering treatment with Apriso include your overall health and any medical conditions you may have. Tell your doctor if you’re taking other medications. This is important because some drugs can interact with Apriso.

These and other considerations to discuss with your doctor are described below.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Apriso, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Apriso.

Interactions with drugs or supplements

Apriso can interact with several kinds of drugs. These drugs include:

• stomach acid-reducing medications, such as calcium carbonate (Tums)
• nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Naprosyn) and ibuprofen (Advil)
• drugs that reduce the activity of your immune system, such as azathioprine (Imuran) and 6-mercaptopurine (Purinethol)

This list does not contain all kinds of drugs that may interact with Apriso. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Apriso.

Other interactions

Taking Apriso may affect results from some lab tests, including urine tests. If you’re having lab tests done, make sure the healthcare professional knows that you’re taking Apriso.

Warnings

Apriso may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Apriso. Factors to consider include those in the list below.

• Liver problems. Some people who have liver disease and are taking Apriso may develop liver failure. If you have problems with your liver, talk with your doctor before taking Apriso. Together you can discuss the risks and benefits of taking Apriso for your condition.
• Kidney problems. Apriso can cause kidney problems, such as kidney failure and kidney stones. Some people with kidney problems can experience worsened kidney function while taking Apriso. If you have problems with your kidneys, tell your doctor before taking Apriso. They’ll tell you if Apriso is safe for you. If you take Apriso, your doctor will monitor your kidney function with tests before and during treatment. If your kidney function worsens, your doctor will likely have you stop Apriso treatment. Make sure you drink enough fluids when taking Apriso to help prevent kidney stones.
• Allergic reaction. If you’ve had an allergic reaction to Apriso or any of its ingredients, your doctor will likely not prescribe Apriso. Ask your doctor what other medications are better options for you.
• Mesalamine-induced acute intolerance syndrome. Some people may have an intolerance to mesalamine, the active drug in Apriso. Symptoms of an intolerance include cramping, belly pain, and bloody diarrhea. Sometimes you might also have a fever, headache, or rash. It can be hard to know if you’re having symptoms of ulcerative colitis (UC) or an intolerance to mesalamine. If you have any possible symptoms of this syndrome, tell your doctor. If they determine that you have this condition, they’ll have you stop taking Apriso.
• Phenylketonuria (PKU). Apriso contains small amounts of phenylalanine. If you have PKU, you’ll need to add up all sources of this amino acid from your diet while you’re taking Apriso. Your doctor can tell you if Apriso is safe for you to take, and can help you with this if you start taking Apriso.
• Skin conditions such as eczema. People who have eczema or a similar skin condition may have a higher risk of severe photosensitivity (sensitivity to sunlight) with Apriso. If you have such a skin condition, your doctor will likely recommend that you avoid exposure to the sun. They may also suggest wearing sun-protective clothing and wearing broad-spectrum sunscreen outside. Talk with your doctor about your condition before starting Apriso.

Apriso and alcohol

Apriso isn’t known to interact with alcohol. But if you drink alcohol, before starting Apriso, ask your doctor or pharmacist if it’s safe for you to drink alcohol during Apriso treatment.

It’s not exactly clear how alcohol affects UC. So it’s important to talk with your doctor about how alcohol can affect your UC.

Pregnancy and breastfeeding

Apriso might be safe to take during pregnancy, but more data is needed to confirm this. Studies haven’t shown any harmful effects of the drug when taken during pregnancy.

If you’re pregnant or considering pregnancy, talk with your doctor before starting Apriso. Your doctor can help find the safest treatment for your condition. It’s important to manage UC symptoms during pregnancy.

If taken while breastfeeding, small amounts of Apriso can pass into breast milk. This can cause a child who’s breastfed to have diarrhea.

If you’re breastfeeding or considering breastfeeding while taking Apriso, talk with your doctor first. They can discuss feeding options and help determine the risks and benefits of Apriso treatment.

Sulfasalazine is approved to get ulcerative colitis (UC) into remission and to keep it in remission. With remission, you don’t have any active symptoms. Sulfasalazine is also approved to treat certain chronic (long-term) inflammatory diseases, including rheumatoid arthritis. Apriso is prescribed to keep UC in remission.

If you’d like to see a side-by-side comparison of Apriso and sulfasalazine, check out this article. Ask your doctor which medication is best for you.

Your doctor will explain how you should take Apriso. They’ll also explain how much to take and how often. Be sure to follow their instructions.

Taking Apriso

You should take Apriso once each day. It’s recommended to take the drug in the morning.

You can take Apriso with or without food. But you should take it the same way every day. For example, if you decide to take Apriso with a meal, always take Apriso with a meal. This helps keep the amount of Apriso in your body consistent over time.

It’s also recommended that you drink lots of water when taking Apriso. This can help prevent kidney stones, which are a possible side effect.

Taking Apriso with other drugs

Before taking any other medications with Apriso, talk with your doctor. You might not need other medications with Apriso to keep your ulcerative colitis (UC) in remission (a period of having no active symptoms). But you and your doctor will determine the best treatment plan for you.

If your UC symptoms return, your doctor may tell you to stop taking Apriso. They might prescribe other medications to get your condition back into remission.

Questions about taking Apriso

• Can Apriso be chewed, crushed, or split? No, you should swallow Apriso capsules whole. Do not chew, crush, or split the capsules. If you’re having trouble swallowing the capsules, see this article or talk with your doctor or pharmacist.
• Should I take Apriso with food? You can take Apriso with or without food. Eating with your dose doesn’t affect how much of the drug your body absorbs. But you should take Apriso the same way every day. For example, if you decide to take Apriso with a meal, always take Apriso with a meal. This helps keep the amount of Apriso in your body consistent over time.

• Before your appointment, write down questions such as:
  • How will Apriso affect my body, mood, or lifestyle?

  Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

  Apriso is available as the generic drug mesalamine. Generics usually cost less than brand-name drugs. Talk with your doctor if you’d like to know about taking generic mesalamine.

  Financial assistance to help you pay for Apriso may be available. Medicine Assistance Tool and NeedyMeds are two websites that provide resources to help reduce the cost of Apriso capsules. These websites also offer tools to help you find low-cost healthcare and certain educational resources. To learn more, visit their websites.

  If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Apriso manufacturer’s website to see if they have support options. And, you can check out this article to learn more about saving money on prescriptions.

  Savings for Apriso

  Visit this page to access Optum Perks coupons and get price estimates for Apriso when you use the coupons. These coupons can provide significant savings on your prescription costs.

  Note: Optum Perks coupons cannot be used with insurance copays or benefits.

  Do not take more Apriso than your doctor prescribes. Taking more than this can lead to serious side effects.

  Symptoms of overdose

  Symptoms caused by an overdose can include:

  • nausea
  • vomiting
  • belly pain
  • fast breathing
  • taking deeper breaths than usual
  • ringing in your ears
  • headache
  • dizziness
  • confusion
  • seizure

  In very severe cases, an overdose of Apriso can cause some of your organs to stop working, such as your liver or kidneys.

  What to do in case you take too much Apriso

  Call your doctor if you think you’ve taken too much Apriso. You can also call 800-222-1222 to reach America’s Poison Centers, or use its online resource. However, if you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

  If you have questions about taking Apriso, talk with your doctor or pharmacist. Your doctor can tell you about other treatments you can use to maintain remission of your ulcerative colitis. Below are some articles that might be helpful for your discussion:

  • Ulcerative Colitis Treatment Options
  • 12 Things to Know About Ulcerative Colitis Treatment

  Some questions to ask your doctor about Apriso may include:

  • Is Apriso prescribed for longer than 6 months?
  • I’ve taken Apriso before. Can I take it again if I’m in remission after a relapse?
  • Will eating a certain diet help maintain remission while taking Apriso?
  • I’ve had kidney stones before. Can I still take Apriso?
  • Can smoking tobacco help maintain remission or make Apriso more effective?

  To learn more about Apriso, see these articles:

  • Apriso Dosage Information
  • Side Effects of Apriso: What You Need to Know

  To get information on different conditions and tips for improving your health, subscribe to any of Austra Health’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

  Q:

  Are probiotics helpful for maintaining remission with ulcerative colitis (UC)? Can I take probiotics while I’m taking Apriso?

  A:

  Research demonstrating the potential of probiotics for maintaining remission with UC is mixed. More studies are needed to find out whether probiotics might be beneficial for people with UC.

  If you’re interested in adding a probiotic to your UC treatment, discuss with your doctor the pros and cons of doing so and which probiotic might be best for you.

  The Austra Health Pharmacist Team Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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  Disclaimer: Austra Health has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.