Mesalamine with Tamarind Interaction Details
Brand Names Associated with Mesalamine
- 5-ASA
- Apriso®
- Asacol HD®
- Asacol®
- Delzicol®
- Lialda®
- Mesalamine
- mesalazine
- Pentasa®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 25, 2023
Interaction Effect
Increased salicylate toxicity
Interaction Summary
It has been proposed that tamarind decreases the gastrointestinal tract pH, favoring the production of unionized lipid-soluble acetylsalicylic acid molecules. These molecules are more readily absorbed across the gastrointestinal tract and result in increased plasma levels. Patients taking both compounds together may be more prone to salicylate-mediated adverse effects and/or toxicity including tinnitus, increased risk of bleeding, nausea, vomiting, and anorexia .
Severity
Moderate
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Concomitant use of tamarind and salicylates is not recommended. Patients should be advised that tamarind may increase the bioavailability of the salicylate leading to increased salicylate blood levels and incidence of adverse effects and/or salicylate toxicity including tinnitus, increased risk of bleeding, nausea, vomiting, and anorexia. Patients taking high doses of salicylates are at an increased risk for these effects.
Mechanism Of Interaction
Increased plasma salicylate levels
Literature Reports
A) Bioavailability of aspirin 600 milligrams (mg) was significantly increased when taken with Tamarindus indica fruit extract in 6 healthy volunteers. Tamarind extract was prepared from dried tamarind fruit and incorporated into millet porridge; the exact amount of tamarind extract in each portion given to subjects was not determined. Aspirin Cmax increased from 10.04 +/- 0.11 micrograms (mcg)/ mL to 28.62 +/- 0.21 mcg/mL (p less than 0.05), area under the curve (AUC) (from zero to six hours) increased from 14.05 +/- 0.11 mcg/mL/hour to 86.57 +/- 0.12 mcg/mL/hour (p less than 0.05), and half-life increased from 1.04 +/- 0.12 hours to 1.5 +/- 0.44 hours (p less than 0.05) .
Mesalamine Overview
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Mesalamine is used to treat ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum) and also to maintain improvement of ulcerative colitis symptoms. Mesalamine is in a class of medications called anti-inflammatory agents. It works by stopping the body from producing a certain substance that may cause inflammation.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.