Generic Name: mesalazine
Product Name: Salofalk Foam Enema
Indication: What Salofalk Foam Enema is used for
Salofalk foam enemas contain the active ingredient, mesalazine (5-aminosalicylic acid), which is used to treat and prevent relapses of mild to moderate attacks of ulcerative colitis (inflammation of the large bowel).
Ask your doctor if you have any questions about why Salofalk has been prescribed for you. Your doctor may have prescribed Salofalk for another reason.
Salofalk is not addictive.
Salofalk is only available on a doctor’s prescription.
Action: How Salofalk Foam Enema works
Mesalazine has been identified as the active component of sulfasalazine in inflammatory bowel disease and is thought to have a topical action. The mechanism of action by which mesalazine protects the mucosa in chronic inflammatory bowel disease is not yet fully known.
Mesalazine seems to act in multiple ways against several inflammatory mediators and principles. The results of in vitro investigations indicate that inhibition of lipoxygenase may play a role. Effects on prostaglandin concentrations in the intestinal mucosa have also been demonstrated, as has an influence on leukotriene production. Mesalazine may also function as a radical scavenger of reactive oxygen compounds.
Each application of Salofalk foam enema contains 1 g of the active ingredient, mesalazine.
Salofalk foam enemas also contain sodium metabisulfite, polysorbate 60, cetostearyl alcohol, disodium edetate, propylene glycol, propane, butane, isobutane.
Dose advice: How to use Salofalk Foam Enema
Before you use it
When you must not use it
Do not use Salofalk if:
- You are allergic to mesalazine or aspirin-like medicines, sulfites or any of the ingredients listed here. Signs of allergic reactions may include itchy skin rash, shortness of breath and swelling of the face or tongue;
- You suffer from a severe kidney or liver problem;
- The expiry date (EXP) printed on the pack has passed. If you use this medicine after the expiry date has passed, it may not work as well;
- The package is torn or shows signs of tampering.
Do not give Salofalk to a child 12 years old or under. The safety and effectiveness of Salofalk in this age group have not been established.
Talk to your doctor if you are not sure whether you should start to use this medicine.
Before you start to use it
Tell your doctor if:
- You have any allergies to any other medicines, foods, preservatives or dyes;
- You are pregnant or intend to become pregnant. Your doctor will discuss the risks and benefits of using Salofalk if you are pregnant;
- You are breastfeeding or wish to breastfeed. Salofalk should not be used during breastfeeding as there is no experience with Salofalk foam enemas in breastfeeding women. Women using Salofalk and who are breastfeeding or wish to breastfeed should discuss this with their doctor;
- You have or have had any medical conditions, especially lung or breathing problems such as asthma. Salofalk contains a sulfite which may cause an allergic reaction and propylene glycol which may cause skin irritation in some people. In addition, propylene glycol may cause drowsiness and confusion in people with kidney problems.
If you have not told your doctor about any of the above, tell them before you start to use Salofalk.
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.
Salofalk may interfere with the action of the following types of medicines:
- Anticoagulants, medicines used to stop blood clots, e.g. warfarin;
- Glucocorticoids, medicines used to treat inflammation or swelling (e.g. prednisolone);
- Sulphonylureas, medicines used to lower blood sugar;
- Methotrexate, medicine used to treat some types of cancer and arthritis;
- Probenecid/sulphinpyrazone, medicines used to treat gout;
- Spironolactone/frusemide, medicines which lower blood pressure or increase volume of urine;
- Rifampicin, a medicine used to treat tuberculosis;
- Azathioprine, a medicine used to suppress the immune system;
- Mercaptopurine or thioguanine, medicines used to treat leukaemia.
You may need to use different amounts of these medicines or you may need to take different medicines when you are using Salofalk. Your doctor or pharmacist will advise you.
How to use it
Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained here.
How much to use
The usual dose is two applications a day at bedtime, although your doctor or pharmacist will tell you exactly how much to use and where to check this information.
Two applications are equivalent to 2 g mesalazine.
How to use it
If possible, go to the toilet and empty your bowels before using your enema.
Store and use Salofalk foam enema at room temperature, 20–25°C.
- Wash your hands thoroughly with soap and water;
- Push the applicator firmly onto the spout of the aerosol can;
- Shake the can for 15 seconds;
- Remove the safety tab from under the pump dome;
- Twist the dome on top of the canister until the semicircular gap underneath it is in line with the nozzle;
- The aerosol can is now ready for use;
- Place your forefinger on top of the pump dome. Turn the aerosol can upside down and keep it upright with the pump dome pointing down;
- Stand with one foot on the floor and raise the other foot onto a chair or stool;
- Insert the applicator into the rectum as far as is comfortable. To administer one application of Salofalk foam (equivalent to 1 g mesalazine), push the pump dome fully once and hold for 5 seconds then release it. Wait 15 seconds for the foam to be delivered;
- To administer the second application, keep the applicator in place and repeat the above process;
- Wait a further 30 seconds before withdrawing the applicator from the rectum;
- Remove the applicator from the spout of the aerosol can and dispose of it in the plastic bag provided as domestic waste;
- Wash your hands thoroughly and try not to empty your bowels again until the next morning;
- You may experience a little discomfort and a feeling of urgency to empty your bowels immediately after enema insertion. This is normal and expected due to the inflammation present in the bowel. Try to resist this urge to empty your bowels for as long as possible. This feeling will subside as treatment continues and the inflammation decreases.
How long to use it
Continue taking your medicine for as long as your doctor tells you.
This medicine helps to control your condition but does not cure it. It is important to keep taking your medicine even if you feel well.
If you forget to use it
If you forget to use Salofalk, leave out that dose completely.
Use your next dose at the normal time it is due.
Do not use a double dose to make up for the dose that you missed.
If you are not sure what to do, ask your doctor or pharmacist.
If you use too much (overdose)
Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26) for advice, or go to Accident and Emergency at the nearest hospital if you think that you or anyone else may have used too much Salofalk foam enema. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
Possible symptoms of overdose may include feeling sick, vomiting and diarrhoea.
While you are using it
Things you must do
Make sure that all doctors and pharmacists who are treating you know you are using Salofalk. Remind them if any new medicines are about to be started.
Tell your doctor immediately if you become pregnant while using this medicine.
Things that you must not do
Do not use Salofalk to treat any other complaint than that directed by your doctor. It may not be safe to use Salofalk for another complaint.
Do not give Salofalk to anyone else even if they have the same condition as you. It may not be safe for another person to use Salofalk.
Do not change the dosage without checking with your doctor.
Things to be careful of
Be careful driving or operating machinery until you know how Salofalk foam enema affects you. Salofalk foam enema generally does not cause any problems with your ability to drive a car or operate machinery. However, as with many other medicines, Salofalk may cause dizziness or light-headedness in some people. Make sure you know how you react to Salofalk before you drive a car, operate machinery, or do anything else that could be dangerous if you are dizzy or light-headed.
Schedule of Salofalk Foam Enema
Salofalk Foam Enema is a Schedule 4 medicine.
Side effects of Salofalk Foam Enema
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are using Salofalk.
Like all medicines, Salofalk may have some side effects. Most side effects are mild and may disappear without stopping this medicine. However, some may be serious and need medical attention.
Tell your doctor or pharmacist if you notice any of the following that is troublesome or ongoing:
- Mild stomach pains;
- Excessive gas in the stomach or bowel;
- Abdominal discomfort;
- Anal discomfort;
- Anal irritation;
- Painful feeling of incomplete emptying of the bowel;
- Increased number of bowel motions;
- Nausea (feeling sick);
- Rash or itchy skin;
- Common cold.
More serious effects
Tell your doctor immediately if you notice any of the following:
- Fever, muscle aches and pains, painful joints and chest pain (sometimes spreading to the neck and shoulders, and sometimes fever);
- Mild skin rash, itching or hives;
- Numbness or weakness in the arms and legs;
- Pain in the upper belly (may be due to inflammation of the pancreas);
- Worsening of ulcerative colitis.
Stop using Salofalk and contact your doctor or go to the Accident and Emergency department of your nearest hospital if any of the following happens:
- Allergic reaction including swelling of limbs, face, lips, mouth or throat which may cause difficulty swallowing or breathing.
Other rare events, which have been reported with mesalazine, include:
- Changes in kidney function and inflammation of the kidney;
- Changes in blood test results such as low white blood cell and/or platelet count;
- Changes in liver function tests;
- Liver disease with nausea, vomiting, loss of appetite, feeling generally unwell, fever, itching, yellowing of the skin and eyes, and dark coloured urine;
- Changes relating to your heart;
- Allergic, inflammatory or other lung conditions;
- Shortness of breath, difficulty breathing, cough, wheezing, chest pain that worsens when breathing.
For further information talk to your doctor.