Pentasa® Enema for Ulcerative Colitis

This mesalamine enema supports localized relief for ulcerative colitis in the distal colon and rectum. The guide below explains key uses, safety, and ways to manage costs without insurance. We provide US delivery from Canada.

What Pentasa Is and How It Works

Pentasa® contains mesalamine, a 5-aminosalicylic acid medicine that acts locally in the colon. It helps calm mucosal inflammation by reducing inflammatory mediators in the lining of the bowel. As a rectal suspension, it targets the affected area directly and limits systemic exposure compared with some oral options.

Border Free Health connects U.S. patients with licensed Canadian partner pharmacies; prescriptions are verified with prescribers before dispensing.

A Mesalamine enema is typically used for disease limited to the rectum and left side of the colon. It may be used alone or alongside oral therapy as directed by your prescriber. Always review the official patient information before starting.

Learn more about the condition in our category page for Ulcerative Colitis, and see broader gut health options in Gastrointestinal.

Who It’s For

This treatment is for adults with mild to moderate ulcerative colitis involving the rectum and left colon. It can help with rectal bleeding, urgency, and stool frequency when disease is limited to these areas. A clinician may combine it with oral therapies if disease extends further or if symptoms persist.

Do not use if you have a known allergy to salicylates, aminosalicylates, or any component of the enema. People with severe kidney or liver problems, or a history of myocarditis or pericarditis linked to 5-ASA products, should discuss risks and alternatives with a healthcare professional first. For pediatric use, follow the official label and your prescriber’s advice.

Dosage and Usage

The Pentasa enema dosage is typically once daily, often at bedtime, so the medicine can be retained for several hours. Your prescriber determines the exact schedule and duration based on your condition. Shake the bottle well before use, insert the applicator gently, and instill the full contents unless told otherwise.

Lie on your left side to instill, then remain still briefly to reduce leakage. Try to retain the liquid as long as comfortable to allow mucosal contact. If your clinician has advised combining rectal and oral 5-ASA therapy, follow their plan without changing doses on your own. For step-by-step technique, your pharmacist or prescriber can coach you on how to use the bottle and applicator safely.

Explore more IBD options and education in Inflammatory Bowel Disease.

Strengths and Forms

This medicine is supplied as single-use enema bottles for rectal administration. Availability may vary by market and by partner pharmacy.

• Mesalamine enema 1g per bottle, often paired with an appropriate volume for rectal delivery
• Some markets also offer higher-strength presentations suitable for left-sided disease

If your prescriber specifies a particular presentation such as Pentasa enema 4g, we will dispense according to the prescription and local availability. Your order will list the brand, strength, and quantity clearly at checkout. If a requested item is not available, a licensed pharmacist may coordinate with your prescriber for a suitable alternative.

Missed Dose and Timing

If you miss a dose, use it when you remember unless it is close to the next scheduled time. Do not use two enemas back-to-back. Resume the usual routine at the next dose. Establish a bedtime habit to support consistent use and better retention, and consider setting reminders to help stay on track.

Storage and Travel Basics

Store the bottles at room temperature as directed on the label. Keep them in the original carton to protect from light. Do not freeze. Keep out of reach of children and pets. When traveling, pack the bottles in a sealable bag to prevent leaks and carry a copy of your prescription. For sensitive products in our catalog, we use temperature-controlled handling when required.

Do not use damaged or discolored bottles. If the liquid’s color changes from the usual appearance, refer to the patient leaflet or ask a pharmacist. Dispose of used bottles safely in household trash unless local guidance directs otherwise.

Benefits

Topical rectal therapy can focus the anti-inflammatory effect where symptoms occur. This approach may reduce systemic exposure compared to some oral regimens. Many patients appreciate once-daily, bedtime use, which can fit routine habits and may aid retention. When paired with clinician guidance, the treatment can be part of a comprehensive plan to reduce rectal bleeding, urgency, and nighttime stools.

Side Effects and Safety

Common Pentasa enema side effects can include rectal discomfort, abdominal pain, gas, nausea, headache, or mild cramping. Some people notice urgency or a sensation of needing to pass stool shortly after dosing. Skin rash may occur.

• Rectal discomfort or leakage
• Abdominal pain or cramping
• Gas, nausea, or headache
• Mild dizziness or fatigue
• Skin rash or itching

Serious reactions are less common but require attention. These can include allergic reactions, worsening colitis, pancreatitis, kidney problems, liver issues, blood count changes, or rare heart-related inflammation. Stop the medicine and seek care if you develop severe abdominal pain, chest pain, shortness of breath, dark urine, yellowing of the skin, unusual bleeding, or severe rash. Your clinician may monitor kidney function before and during therapy, especially with long-term use or pre-existing risk factors.

Drug Interactions and Cautions

Tell your prescriber and pharmacist about all medicines, vitamins, and herbal products you use. Mesalamine may interact with azathioprine or 6-mercaptopurine, which can increase the risk of blood-related side effects. Use caution with other agents that affect the kidneys, including certain NSAIDs and nephrotoxic drugs. Warfarin effects may be altered in rare cases, so closer monitoring may be needed.

Discuss use if you have kidney disease, liver disease, or a history of hypersensitivity to salicylates. If pregnant, planning pregnancy, or breastfeeding, review the benefits and risks with your healthcare professional and follow current label guidance.

What to Expect Over Time

Rectal 5-ASA therapy works locally, so many patients notice qualitative symptom changes after consistent nightly use. It may take steady adherence over several weeks to understand your response. Track bleeding, stool frequency, and urgency in a simple log to share with your prescriber. If symptoms persist, your clinician may adjust therapy, add oral options, or consider rectal steroids. Do not stop suddenly without guidance, particularly during a flare.

Compare With Alternatives

Two rectal options are often discussed for left-sided disease or proctosigmoiditis. Your prescriber can help select the right approach based on disease extent, tolerance, and prior response:

• Uceris Rectal Foam — a budesonide foam that may suit those needing a topical steroid or for whom liquid enemas are hard to retain
• Entocort Enema — another budesonide rectal option that some clinicians use for targeted steroid therapy

For disease limited to the rectum, suppositories may be considered. Explore more IBD care across our condition pages, and review current guidance with your clinician.

Pricing and Access

We list transparent details for strength, quantity, and the Pentasa enema price on the product page. Because we source through licensed Canadian partners, many patients benefit from Canadian pricing with US shipping from Canada. You can review options and see if a multi-month fill reduces per-unit pricing.

If you are comparing cash price and out-of-pocket scenarios, see our guide on pharmacy spending: Prescription Costs Without Insurance. Looking for seasonal offers? Check Promotions for current deals when available.

Availability and Substitutions

Supply can vary by strength and package size. If an item is temporarily unavailable, your prescriber may recommend a therapeutically appropriate alternative. Generic mesalamine enemas are available in some markets and may be considered when clinically suitable. We will dispense exactly what your prescription specifies unless your prescriber authorizes a change.

Patient Suitability and Cost-Saving Tips

This therapy may suit adults with distal disease who can use and retain a rectal liquid. It may not suit those with severe renal or hepatic impairment, or people with salicylate hypersensitivity. Discuss your history of heart, kidney, or liver conditions with your clinician before starting.

Cost-saving tips:

• Multi-month fills — fewer repeats and often better unit value
• Refill reminders — set calendar alerts to prevent gaps
• Align refills — coordinate rectal and oral meds together
• Ask prescriber — verify the lowest practical strength and frequency
• Compare options — consider foam or suppositories if advised

For country-of-origin and sourcing transparency, see Canada. For related conditions, review Crohns Disease to understand differences from ulcerative colitis.

Questions to Ask Your Clinician

• Is rectal mesalamine appropriate for my disease extent?
• How long should I continue nightly dosing before reassessment?
• Could I combine this with an oral 5-ASA, and why?
• When would a rectal steroid like foam be considered?
• What monitoring do I need for kidney function or blood tests?
• What should I do if retention is difficult or leakage occurs?
• Are there signs that suggest I should contact you urgently?

Authoritative Sources

Ferring Pharmaceuticals (Canada)

FDA DailyMed

Health Canada Drug Product Database

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