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SALOFALK 1000 MG PROLONGED-RELEASE GRANULES

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About the medicine

How to use SALOFALK 1000 MG PROLONGED-RELEASE GRANULES

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

Salofalk 1000 mg prolonged-release granules

Mesalazine

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack and other information

  1. What Salofalk 1000 mg granules are and what they are used for
  2. What you need to know before you take Salofalk 1000 mg granules
  3. How to take Salofalk 1000 mg granules
  4. Possible side effects
  5. Storage of Salofalk 1000 mg granules

Contents of the pack and further information

1. What Salofalk 1000 mg granules are and what they are used for

Salofalk granules contain the active substance mesalazine, an anti-inflammatory that is used to treat inflammatory bowel diseases.

Salofalk 1000 mg granules are used for:

  • Treatment of acute episodes and prevention of new episodes (relapses) of mild to moderate ulcerative colitis, a chronic inflammatory disease of the large intestine (colon).
Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before you take Salofalk 1000 mg granules

Do not take Salofalk granules:

  • If you are allergic to mesalazine, salicylic acid, salicylates such as acetylsalicylic acid (e.g. Aspirin) or any of the other ingredients of this medicine (listed in section 6).
  • If you have severe liver or kidney disorders.

Warnings and precautions

Consult your doctor before starting to take Salofalk 1000 mg granules

  • if you have a history of lung disease, particularly if you suffer from bronchial asthma
  • if you have a history of allergy to sulfasalazine, a substance related to mesalazine
  • if you have liver problems
  • if you have kidney problems
  • If you have ever suffered from a severe skin rash, peeling, or blisters in the mouth after using mesalazine
  • Mesalazine may cause a discoloration of the urine to a reddish-brown color after contact with sodium hypochlorite bleach in the toilet water. This is a chemical reaction between mesalazine and bleach and is harmless.

Additional precautions

During treatment, your doctor may want to keep you under medical supervision, and you may need to have regular blood and urine tests.

Kidney stones can occur with the use of mesalazine. The symptoms include pain in the sides of the abdomen and the presence of blood in the urine. Make sure to drink enough liquid during treatment with mesalazine.

Severe skin rashes, such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SSJ), and toxic epidermal necrolysis (NET), have been observed with mesalazine treatment. Stop taking mesalazine and seek immediate medical attention if you notice any of the symptoms related to these severe skin reactions described in section 4.

Using Salofalk 1000 mg granules with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, in particular:

  • Azathioprine, 6-mercaptopurine or thioguanine(medicines for treating immune system disorders)
  • Certain agents that inhibit blood coagulation(medicines for thrombosis or to thin the blood, such as warfarin)
  • Lactulose(a medicine used for constipation) or other preparations that can change the acidity of your stools

Tell your doctor or pharmacist if you are using or have recently used other medicines, even those obtained without a prescription. It may still be all right to use Salofalk granules, and your doctor will be able to decide what is best for you.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medicine.

You should use Salofalk granules during pregnancy only if your doctor has told you to.

Also, you should only use Salofalk granules during breastfeeding if your doctor has told you to, as this medicine can pass into breast milk.

Driving and using machines

Salofalk granules have no or negligible influence on the ability to drive and use machines.

Salofalk 1000 mg granules contain aspartame, sucrose, and sodium

This medicine contains 2 mg of aspartame in each sachet of Salofalk 1000 mg granules. Aspartame is a source of phenylalanine, which may be harmful if you have phenylketonuria (PKU), a rare genetic disorder in which phenylalanine accumulates because the body is unable to eliminate it properly. If your doctor has told you that you have an intolerance to some sugars, consult with them before taking this medicine. This medicine contains less than 1 mmol of sodium (23 mg) per sachet; this is essentially "sodium-free".

3. How to take Salofalk 1000 mg granules

Follow the instructions for administration of this medicine exactly as told by your doctor. If you are unsure, consult your doctor or pharmacist again.

Method of administration

Salofalk granules are for oral use only.

Salofalk granules must not be chewed. The granules should be taken by placing them directly on the tongue and then swallowing them with plenty of liquid, but without chewing.

Posology:

Age and body weight

Single dose

Total daily dose

Adults, elderly and children over 40 kg body weight

Treatment of acute episodes

Up to 3 sachets of

Salofalk 1000 mg granules

1x3 sachets

or

3x1 sachet

Prevention of new episodes

(for patients with a higher risk of relapse)

3 sachets of Salofalk 1000 mg granules

1x3 sachets

Children 6 years and older

Treatment of acute episodes

30-50 mg of mesalazine/kg body weight/day

once daily

or

divided into several doses

Prevention of new episodes

15-30 mg of mesalazine/kg body weight/day, divided into several doses

Adults and elderly

Unless your doctor has prescribed otherwise, the usual dosage for the treatment of acute episodes of ulcerative colitisis, depending on individual clinical requirements, 3 sachets of Salofalk 1000 mg granules (equivalent to 3g of mesalazine per day) once daily, preferably in the morning, or 1 sachet of Salofalk 1000 mg granules, three times a day (morning, noon, and night).

For the prevention of relapses of ulcerative colitis

The usual dosage for preventing new episodes of ulcerative colitis is:

1 sachet of Salofalk 500mg granules three times a day (equivalent to 1.5g of mesalazine per day).

If, in your doctor's opinion, you have a higher risk of relapse, the dosage for preventing new episodes of ulcerative colitis is:

3 sachets of Salofalk 1000 mg granules, once daily, preferably in the morning (equivalent to 3g of mesalazine per day).

Use in children

There is only limited documentation on the effect in children (from 6 to 18 years).

Children 6 years and older

Please ask your doctor about the correct dosage of Salofalk granules for your child.

In acute episodes:the dose should be determined individually, starting with 30-50 mg of mesalazine per kg body weight and per day, which should be administered once daily, preferably in the morning, or divided into several doses. The maximum dose is 75mg of mesalazine per kg body weight per day. The total dose should not exceed the maximum dose in adults.

For prevention of relapses:the dose should be determined individually, starting with 15-30 mg of mesalazine per kg body weight and per day, which should be administered divided into several doses. The total dose should not exceed the recommended total dose in adults.

It is generally recommended to use half the adult dose for children up to 40kg and the normal adult dose for children over 40kg body weight.

Duration of treatment

Treatment of acute episodes of ulcerative colitis usually lasts 8 weeks. Your doctor will decide how long you need to continue treatment with this medicine, depending on the progression of your disease.

In order to achieve the maximum therapeutic effects of this medicine, you should take Salofalk granules regularly and systematically, both during the acute episode of inflammation and during long-term treatment as prescribed.

If you think that Salofalk granules are too strong or too weak, consult your doctor.

If you take more Salofalk granules than you should

Contact your doctor if you have any doubts, so that they can decide what to do.

If you take too much Salofalk granules at one time, just take the next dose as prescribed. Do not take a smaller dose.

If you forget to take Salofalk granules

Do not take a double dose to make up for forgotten doses.

If you stop taking Salofalk granules

Do not stop taking this medicine until you have spoken to your doctor.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all medicines, Salofalk granules can cause side effects, although not everybody gets them.

If you experience any of the following symptoms after taking this medicine, you should contact your doctor and stop taking Salofalk granules immediately:

  • General allergic reactions such as skin rash, fever, joint pain, and/or difficulty breathing or a general inflammation of the large intestine (which causes severe diarrhea and abdominal pain). These reactions are very rare.
  • A significant worsening of your general health, especially if accompanied by fever and/or throat and mouth pain. These symptoms, very rarely, can be caused by a decrease in the number of white blood cells in the blood (agranulocytosis), which can increase your propensity to contract a serious infection. Other blood cells (such as platelets and red blood cells) can also be affected, causing anemia, aplastic anemia, or thrombocytopenia, which can cause symptoms such as unexplained bleeding, small purple spots on the skin, and anemia (feeling tired and weak and pale, especially in the lips and nails). A blood test can confirm if the symptoms are due to an effect of this medicine on the blood. These reactions are very rare.
  • Severe skin rashes with reddish, non-elevated, circular, or target-shaped patches on the trunk, often with central blisters, peeling of the skin, ulcers in the mouth, throat, nose, genitals, and eyes, generalized rash, fever, and enlargement of the lymph nodes. They can be preceded by fever and flu-like symptoms. These reactions occur in an unknown number of people (frequency not known).
  • Difficulty breathing, chest pain, or irregular heartbeat, or swelling of the limbs, which can indicate cardiac hypersensitivity reactions. These reactions are rare.
  • Kidney problems (which can occur very rarely), such as a change in the color or amount of urine produced and swelling of the limbs or sudden pain in the side (caused by a kidney stone) (occurring in an unknown number of people (frequency not known).

The following side effects have also been reported by patients using mesalazine:

Common side effects (may affect up to 1 in 10 people)

Headache

Skin rash, itching

Uncommon side effects (may affect up to 1 in 100 people)

  • Abdominal pain, diarrhea, dyspepsia, gas (flatulence), nausea, and vomiting
  • Severe abdominal pain due to acute pancreatitis
  • Changes in liver function parameters, changes in pancreatic enzymes

Rare side effects (may affect up to 1 in 1,000 people)

  • Dizziness
  • Jaundice or abdominal pain due to liver or bile flow disorders
  • Increased sensitivity of the skin to sunlight and ultraviolet light (photosensitivity)
  • Joint pain
  • Feeling of weakness or fatigue

Very rare side effects (may affect up to 1 in 10,000 people)

  • Numbness and tingling in hands and feet (peripheral neuropathy)
  • Shortness of breath, cough, wheezing, lung shadow on X-rays due to allergic and/or inflammatory lung conditions
  • Hair loss and development of baldness
  • Muscle pain
  • Reversible decrease in semen production

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly to the Spanish Medicines Agency's Pharmacovigilance System for Human Use: www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Salofalk 1000 mg granules

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton and sachets after EXP.

The expiry date is the last day of the month stated.

This medicine does not require any special storage conditions.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.

6. Contents of the pack and further information

Composition of Salofalk 1000 mg granules

The active substance is mesalazine, and one sachet of Salofalk 1000 mg granules contains 1000 mg of mesalazine.

The other ingredients are: aspartame (E-951); carmellose sodium; microcrystalline cellulose; citric acid; colloidal anhydrous silica; hypromellose; magnesium stearate; methacrylic acid - methyl methacrylate copolymer (1:1) (Eudragit L-100); methylcellulose; polyacrylate dispersion 40% (Eudragit NE 40 D containing 2% nonoxinol 100); povidone K-25; simethicone; sorbic acid; talc; triethyl citrate; vanilla cream flavor (containing sucrose).

Appearance of the product and pack contents

Salofalk 1000 mg prolonged-release granules are rounded or elongated, beige or brown in color, with or without yellowish surface parts.

Each sachet contains 1.83g of granules.

Salofalk 1000 mg granules are available in cartons of 50 and 100 sachets.

Not all pack sizes may be marketed.

Marketing authorisation holder and manufacturer

Dr. Falk Pharma GmbH

Leinenweberstr. 5

79108 Freiburg

Germany

Tel +49 (0) 761 / 1514-0

Fax +49(0) 761 / 1514-321

Email: [email protected]

You can obtain further information on this medicine from the local representative of the marketing authorisation holder:

Spain

Dr. Falk Pharma España

Camino de la Zarzuela, 19-1º D

28023 Madrid

Tel +34 913 729 508

Fax +34 913 729 437

Email: [email protected]

This medicine is authorised in the Member States of the European Economic Area under the following names:

Germany, Bulgaria, Denmark, Slovakia, Slovenia, Spain, Finland, Greece, Hungary, Ireland, Italy, Latvia, Norway, Netherlands, Poland, Portugal, United Kingdom, Czech Republic, Sweden: Salofalk

Belgium, Luxembourg: Colitofalk

Austria: Mesagran

France: Osperzo.

Date of last revision of this leaflet: May 2025

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.es/

Online doctors for SALOFALK 1000 MG PROLONGED-RELEASE GRANULES

Discuss questions about SALOFALK 1000 MG PROLONGED-RELEASE GRANULES, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Doctor

Chikeluo Okeke

General medicine 4 years exp.

Dr Chikeluo Okeke is an internal medicine doctor with extensive international clinical experience. Originally from Nigeria, he has worked across multiple European healthcare systems and currently practises in Sweden. This professional path has given him a strong understanding of different medical approaches and the ability to work effectively with patients from diverse cultural and linguistic backgrounds.

Dr Okeke focuses on general internal medicine and adult primary care, combining clinical accuracy with careful attention to lifestyle, personal context, and everyday health concerns. His consultations are particularly well suited for people who seek medical advice online, live abroad, or need clear guidance without unnecessary complexity.

He provides online consultations covering symptom assessment, prevention, and long-term management of chronic conditions, helping patients understand what is happening and decide on appropriate next steps.

Common reasons for consultation:

  • General internal medicine concerns and initial health assessment.
  • Acute symptoms such as fever, cough, infections, pain, or weakness.
  • Chronic conditions and treatment adjustment.
  • Blood pressure issues, fatigue, metabolic concerns.
  • Preventive consultations and routine check-ups.
  • Interpretation of laboratory results and medical reports.
  • Medical advice for patients receiving care online.

Dr Okeke is known for his clear communication, calm approach, and cultural awareness. He listens carefully, explains medical decisions in a structured way, and supports patients in making informed choices about their health.

Online consultations with Dr Chikeluo Okeke offer reliable internal medicine care without geographic limitations, focused on medical relevance, clarity, and patient comfort.

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Doctor

Hocine Lokchiri

General medicine 21 years exp.

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
  • cough, sore throat, nasal congestion, breathing discomfort
  • bronchitis and mild asthma flare-ups
  • nausea, diarrhoea, abdominal pain, digestive infections
  • rashes, allergic reactions, redness, insect bites
  • muscle or joint pain, mild injuries, sprains
  • headache, dizziness, migraine symptoms
  • stress-related symptoms, sleep disturbances
  • questions about test results and treatment plans
  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

  • Advanced Trauma Life Support (ATLS)
  • Basic and Advanced Cardiac Life Support (BLS/ACLS)
  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
  • aviation medicine
He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
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Andrei Popov

General medicine 7 years exp.

Dr. Andrei Popov is a family physician with specialized training in the management of chronic pain. He provides video consultations for adults in Spain and across Europe: whether you have been living with pain for months that no one has been able to properly explain, or you need to resolve a health issue without waiting weeks for an appointment.

His approach is clear: to listen, organize your case, and provide you with a practical roadmap based on evidence-based medicine and adapted to your medical history and personal needs.

Pain: how he can help

  • Chronic pain (more than 3 months
  • Migraine and recurrent or high-intensity headaches
  •  Neck, lower back, back and joint pain
  •  Post-traumatic pain after injuries or surgeries
  •  Pain of neurological origin: neuralgia, neuropathic pain, fibromyalgia

General medicine

  • Frequent respiratory infections (cold, flu, persistent cough)
  • Hypertension, diabetes and metabolic disorders
  • Review of laboratory tests and MRI/CT reports (explained in clear language)
  • Preventive medicine and health monitoring
  • Second opinions and treatment adjustments (when clinically appropriate)

What the consultation is like
 Each session lasts up to 30 minutes. We review symptoms, medical history, medications and any tests you provide, and you finish the consultation with a clear treatment plan, defined next steps, and criteria to understand when follow-up may be needed. If warning signs are detected, he will clearly advise whether you need in-person care or urgent medical attention.

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Doctor

Yevgen Yakovenko

General surgery 12 years exp.

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
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  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Doctor

Joao Silva

General medicine 6 years exp.

Dr. João Silva is a physician with training and experience in the field of General and Family Medicine, dedicated to providing healthcare focused on the well-being and quality of life of his patients. Throughout his professional career, he has developed broad clinical competencies, striving to maintain a medical practice based on scientific evidence and continuous knowledge updates.

Between 2013 and 2019, he completed the Integrated Master's Degree in Medicine at the Abel Salazar Institute of Biomedical Sciences in Porto, where he acquired a solid academic and clinical education.

Subsequently, between January 2021 and December 2021, he completed the General Internship at the Entre Douro e Vouga Hospital Center in Santa Maria da Feira, where he had the opportunity to work in different hospital settings and deepen his competencies in several areas of medicine.

From January 2022 until March 2026, he works as a Resident Physician in General and Family Medicine at USF Salvador Machado in Oliveira de Azeméis, developing clinical activities in primary healthcare, follow-up of chronic patients, and health promotion in the community.

Complementing his medical training, Dr. João Silva also completed a Postgraduate Degree in Continuing and Palliative Care at CESPU, strengthening his preparation in the comprehensive approach to patient care, especially in situations requiring prolonged care and multidisciplinary support.

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Doctor

Bulat Garipov

General medicine 15 years exp.

Dr. Bulat Garipov is a radiologist with more than 15 years of experience, specializing in magnetic resonance imaging (MRI). Throughout his professional career, he has worked in leading diagnostic imaging centers, both in on-site practice and teleradiology, which has allowed him to develop a broad and versatile approach to radiology.

Over the years, he has gained solid experience in interpreting MRI studies in various areas, including:

  •  Neuroimaging
  •  Musculoskeletal system (MSK)
  •  Angiography
  •  Abdomen and pelvis
  •  Soft tissues

Additionally, Dr. Garipov is open to new collaboration opportunities in radiology and teleradiology projects. He offers his expertise in MRI, providing both first and second readings of studies, as well as advanced image interpretation, ensuring accurate and high-quality diagnostics.

You could consult Dr. Bulat Garipov in cases where accurate interpretation of MRI studies or a second expert opinion is required. His expertise is especially valuable in cases of suspected neurological conditions, back and joint pain, vascular disorders, as well as in the diagnosis of abdominal and pelvic diseases. The doctor also provides support in complex or unclear clinical situations, including the review of previously performed studies, which helps improve diagnostic accuracy and determine the optimal treatment strategy. A teleradiology format is available, allowing you to receive a professional opinion remotely.

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Frequently Asked Questions

Is a prescription required for SALOFALK 1000 MG PROLONGED-RELEASE GRANULES?
SALOFALK 1000 MG PROLONGED-RELEASE GRANULES requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in SALOFALK 1000 MG PROLONGED-RELEASE GRANULES?
The active ingredient in SALOFALK 1000 MG PROLONGED-RELEASE GRANULES is mesalazine. This information helps identify medicines with the same composition but different brand names.
How much does SALOFALK 1000 MG PROLONGED-RELEASE GRANULES cost in pharmacies?
The average pharmacy price for SALOFALK 1000 MG PROLONGED-RELEASE GRANULES is around 79.85 EUR. Prices may vary depending on the manufacturer and dosage form.
Who manufactures SALOFALK 1000 MG PROLONGED-RELEASE GRANULES?
SALOFALK 1000 MG PROLONGED-RELEASE GRANULES is manufactured by Dr. Falk Pharma Gmbh. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of SALOFALK 1000 MG PROLONGED-RELEASE GRANULES online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether SALOFALK 1000 MG PROLONGED-RELEASE GRANULES is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to SALOFALK 1000 MG PROLONGED-RELEASE GRANULES?
Other medicines with the same active substance (mesalazine) include ASACOL 1 G SUPPOSITORIES, ASACOL 1600 mg GASTRO-RESISTANT TABLETS, ASACOL 400 mg GASTRO-RESISTANT TABLETS. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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