Asacol (mesalamine) does not cause bleeding, ordinarily. There are
rare case reports of patients who have developed low platelet counts
(which could lead to bleeding)and others where patients have developed
other blood dyscrasias (essentially, it can rarely cause bone marrow
suppression, leading to low counts of various types of cell lines).
It should be emphasized that this is essentially an all-or-nothing
proposition. It does not increase the risk of bleeding in any kind of
proportional way to the amount you take. It's just that some people
appear to have an idiosyncratic reaction to it.
So no, you should not avoid taking it if you had bleeding from your
nose BEFORE you started taking it. If you developed bleeding AFTER
you started taking it, you may be one of the unfortunate people who
has developed one of the above idiosyncratic reaction. Stop taking it
and go immediately to your doctor to have your blood counts checked.
Incidently, if you have bleeding from your nose chronically, you
should have this checked by your doctor as well.
Source: micromedix.com
Excerpt from the adverse effects of Mesalamine:
A. HEMATOLOGIC EFFECTS
1. Following the use of oral mesalamine, THROMBOCYTOPENIA,
EOSINOPHILIA, LEUKOPENIA, ANEMIA, and LYMPHADENOPATHY have developed.
AGRANULOCYTOSIS has occurred rarely. Based upon uncontrolled clinical
trials and postmarketing surveillance, a higher incidence of blood
dyscrasias such as agranulocytosis, NEUTROPENIA, and PANCYTOPENIA have
been reported in patients 65 years of age or older receiving
Asacol(R). Patients with impaired renal function, including elderly
patients, may experience a greater risk of toxic reactions with
Asacol(R) administration. (Prod Info Asacol(R), 2001).
2. Following the use of mesalamine, thrombocytopenia developed in a
patient with polycystic kidney disease, hypertension, Crohn's disease,
and progressively deteriorating renal function. The patient had
previously received prednisone and sulfasalazine, then mesalamine 800
mg 3 times daily was initiated. The patient's renal function was
deteriorating and the patient was admitted for bronchopneumonia and
septic shock. Thrombocytopenia appeared to be secondary to
myelosuppression and the hypocellular evidence suggested a
drug-induced cause. The patient died 5 days later, despite aggressive
therapy (Daneshmend, 1991).
3. A 71-year-old man with non-insulin-dependent diabetes mellitus was
taking mesalamine 800 mg twice daily for about six months for
treatment of ulcerative colitis when he presented with purpura. He was
also taking prednisolone 5 mg daily. Blood tests showed pancytopenia
with a hemoglobin concentration of 88 g/L, white cells 1.3 x 109/L,
neutrophils 0.4 x 109/L, and platelets 12 x 109/L. Bone marrow
aspirate and trephine biopsy were consistent with severe APLASTIC
ANEMIA. The patient was treated with a 5-day course of rabbit
antithymocyte globulin (ATG, Thymoglobuline, Pasteur Merieux) at a
dose of 1.5 vials/10 kg body weight, and regular red cell and platelet
transfusions. Four weeks after ATG treatment, the patient died from
overwhelming septicemia and pneumonia (Abboudi et al, 1994). |
