Drug & supplement interaction

Colocynth + Mesalamine

Mesalamine brand names: Pentasa, Asacol, Canasa, Rowasa, Lialda, and others.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Colocynth and Mesalamine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Mesalamine states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Colocynth and Mesalamine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Mesalamine and Colocynth in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Colocynth safety at a glance

Colocynth overall Avoid Colocynth is a strong irritant and poison that can cause severe gut damage and death.
Pregnancy Avoid It may stimulate the uterus and is considered unsafe in pregnancy.
Breastfeeding Unsafe When used orally due to severe gastrointestinal toxicity; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Mesalamine and Colocynth? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Mesalamine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Mesalamine is filed under a single classification — oral drugs. Colocynth has documented interactions with 5 drug classes — the most serious being antidiabetes drugs (moderate), digoxin (lanoxin) (moderate) and diuretic drugs (moderate) — and none of Mesalamine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Colocynth Does Interact With Other Medications

Colocynth has 185 moderate known drug interactions in our database — Mesalamine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 185 No known interaction 2,645 (incl. Mesalamine)
Taking anything else?

Check Another of Your Medications Against Colocynth

Covers the 2,830 medications we’ve checked against Colocynth. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Colocynth and Mesalamine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Kidney problems Worth acting on Additional detail

    Colocynth

    “Orally, colocynth is generally regarded as unsafe. Topically, colocynth seems to be well tolerated when used short-term.

    Most Common Adverse Effects:

    Orally: Diarrhea.

    Serious Adverse Effects (Rare):

    Orally: Bloody diarrhea, hemorrhagic cystitis, kidney damage, convulsions, paralysis, death.”

    Colocynth · Natural Medicines adverse-effect record, reported in diarrhea.

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

  • Diarrhea Additional detail

    Colocynth

    “Orally, ingestion of colocynth 0.6-1 grams can cause severe irritation of the gastric mucosa and bloody diarrhea (2,18). Cases of bloody diarrhea and intestinal cramps have been reported in case reports of individuals consuming the fresh fruit, the 'size of an orange' or unknown amounts of the extract. Colocynth ingestion can also cause acute toxic colitis.”

    Colocynth · Natural Medicines adverse-effect record, reported in diarrhea.

    5 sources cited
    1. 2. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
    2. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    3. 98601. Khan SA, Shelleh HH, Bhat AR, Bhat KS. Colocynth toxicity. A possible cause of bloody diarrhea. Saudi Med J. 2003;24(8):904-6. DOI
    4. 10653. Goldfain D, Lavergne A, Galian A, et al. Peculiar acute toxic colitis after ingestion of colocynth: a clinicopathological study of three cases. Gut 1989;30:1412-18.. PubMed
    5. 98604. Huseini HF, Darvishzadeh F, Heshmat R, Jafariazar Z, Raza M, Larijani B. The clinical investigation of Citrullus colocynthis (L.) schrad fruit in treatment of Type II diabetic patients: a randomized, double blind, placebo-controlled clinical trial. Phytot

    Mesalamine

    Listed in the ADVERSE REACTIONS section of the FDA label for Mesalamine. Read the label on DailyMed ›

Reported for Colocynth but not commonly for Mesalamine: seizures and itching.

Effects for Mesalamine come from the ADVERSE REACTIONS section of its FDA label; effects for Colocynth come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Colocynth in Pregnancy & Breastfeeding

Lactation Unsafe

When used orally due to severe gastrointestinal toxicity; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Mesalamine Products Have a Food Rule — Colocynth Should Not Break It

At least one FDA label for a product containing Mesalamine says to take it with food. If you take Colocynth on an empty stomach out of habit, keep them separate — and take Mesalamine with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Mesalamine products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

( 2 ) Administer mesalamine delayed-release tablets with food.

From the Dosage and Administration section of the FDA label we read for Mesalamine — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Colocynth or Mesalamine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Colocynth or Mesalamine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Mesalamine

This page covers Colocynth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Mesalamine page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Mesalamine page

“Activated charcoal is the one entry here I would treat as a genuine problem for anyone taking mesalamine (Asacol, Lialda, Pentasa, and others). It is the lone major-rated interaction among the 17 on file, because charcoal soaks up drugs in the gut and can pull mesalamine out of the picture before it does its job.”

Reviewed by 2 · Jul 18, 2026

Open the Mesalamine interaction page

One more smart check

Taking Colocynth as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2 real supplement products containing Colocynth, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Colocynth. Even though Colocynth itself has no known interaction with Mesalamine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Colocynth and Mesalamine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Colocynth
Steady interest

#853 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Mesalamine
Top 25%

#453 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Colocynth reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Colocynth and Mesalamine records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Colocynth

What is Colocynth?

  • Constipation
  • Digestive complaints
  • Diabetes (traditional use)
  • Joint and nerve pain
  • Skin conditions

Colocynth is a bitter desert gourd used in traditional medicine mainly as a powerful laxative, but it is highly toxic and can cause severe, sometimes deadly poisoning even at small doses. There is not enough good human evidence to support its use, and most pharmacists would advise against taking it. If you are curious about it, talk to a doctor or pharmacist before using any product that contains it.

Citrullus colocynthis · Cucurbitaceae · Fruit (pulp), seeds, and root · Dried fruit pulp, powder, capsules, traditional and homeopathic preparations

An interaction check asks whether these two react with each other — it does not ask whether Colocynth is a good idea for someone in your situation. Here is what our Colocynth record says about it on its own.

Colocynth: dosing

There is no established safe dose of colocynth for general use, and most health authorities and pharmacists do not recommend taking it at all because of its toxicity. Never take raw colocynth fruit, pulp, or seeds.

From our Colocynth monograph — the full record covers uses, side effects and every documented interaction.

Read the full Colocynth monograph & all interactions
Medication

About Mesalamine

What Is Mesalamine Used For?

Brand names: Pentasa, Asacol, Canasa, Rowasa, Lialda, Delzicol

Mesalamine is used to treat mildly to moderately active ulcerative colitis — a condition where the lining of the large intestine becomes inflamed and ulcerated. Depending on the product and formulation, it can be used to bring the disease under control (induction of remission) and/or to keep it from coming back (maintenance of remission).

Different products target different parts of the lower digestive tract. Oral forms (tablets and capsules) treat the colon more broadly. Rectal forms — including enemas (ROWASA, sfROWASA, mesalamine rectal suspension) — are used for distal ulcerative colitis, proctosigmoiditis, or proctitis (inflammation limited to the lower end of the colon or rectum). Rectal suppositories (CANASA, mesalamine rectal suppositories) are specifically for ulcerative proctitis (inflammation of the rectum only).

See full Mesalamine drug information
Keep checking

Other Drugs & Colocynth

Browse every other medication we’ve checked against Colocynth — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
185Moderate
0Minor
2,644No known interaction
185 Moderate 2,644 No interaction
Moderate

185 interactions

Showing 60 of 185 moderate interactions — see all 185 on the Colocynth page.

No interaction 2,644 drugs checked — show the list

We also checked Colocynth against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,644 medications checked with no known interaction — see the full Colocynth list.

See the full Colocynth interactions page
See every supplement checked against Mesalamine, ranked by severity
Evidence & sources

Colocynth References

The 9 references that drive our Colocynth monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. Osol and Farar. The Dispensatory of the United States of America. 25th ed. JB Lippincott Co., 1955.
  5. Goldfain D, Lavergne A, Galian A, et al. Peculiar acute toxic colitis after ingestion of colocynth: a clinicopathological study of three cases. Gut 1989;30:1412-18.. PubMed
  6. Li Y, Zheng M, Zhai X, et al. Effect of Gymnema Sylvester, Citrullus colocynthis and Artemisa absinthum on blood glucose and lipid profile in diabetic human. Acta Pol Pharm. 2015;72(5):981-5.
  7. Khan SA, Shelleh HH, Bhat AR, Bhat KS. Colocynth toxicity. A possible cause of bloody diarrhea. Saudi Med J. 2003;24(8):904-6. DOI
  8. Heydari M, Homayouni K, Hashempur MH, Shams M. Topical Citrullus colocynthis (bitter apple) extract oil in painful diabetic neuropathy: A double-blind randomized placebo-controlled clinical trial. J Diabetes. 2016;8(2):246-52. DOI
  9. Huseini HF, Darvishzadeh F, Heshmat R, Jafariazar Z, Raza M, Larijani B. The clinical investigation of Citrullus colocynthis (L.) schrad fruit in treatment of Type II diabetic patients: a randomized, double blind, placebo-controlled clinical trial. Phytot

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Colocynth and Mesalamine Together: Common Questions

Is it safe to take Colocynth with Mesalamine?
We do not list a known interaction between Colocynth and Mesalamine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Colocynth and Mesalamine have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Colocynth and Mesalamine at the same time of day?
At least one FDA label for a product containing Mesalamine says to take it with food. If you take Colocynth on an empty stomach out of habit, keep them separate and take Mesalamine with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Mesalamine products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Colocynth and Mesalamine combination checked?
Interactions in our licensed database are recorded against drug classes. Mesalamine is filed under 1 classification, and Colocynth has documented interactions with 5 drug classes — none of Mesalamine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Colocynth interact with any other medications?
Yes. Colocynth has 185 documented drug interactions in our database — Mesalamine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Mesalamine interact with any supplements?
Yes. Mesalamine has documented interactions with 17 supplements in our database — Colocynth is not one of them. The Mesalamine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Colocynth monograph Uses, safety profile, and every drug interaction in one place Mesalamine drug information The full plain-English guide to this medication Mesalamine supplement interactions Every supplement checked against Mesalamine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 9 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Mesalamine and Colocynth?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.