Balsalazide Brand Names- Colazal | Giazo
What is Balsalazide
Balsalazide is a diazo-bonded 5-aminosalicylate and is a prodrug; the drug utilizes bacterial azoreduction to release the antiinflammatory agent 5-ASA (also known as mesalamine).
Balsalazide capsules (e.g., Colazal) are indicated for the treatment of mildly to moderately active ulcerative colitis (UC) in adult and pediatric patients 5 years and older.
The tablets (i.e., Giazo) were indicated only in adult male patients with UC but are no longer marketed.
Although there is little evidence to suggest differences in efficacy between the diazo-bonded 5- ASA preparations, balsalazide is the often the preferred diazo-bonded 5-ASA over olsalazine due to its better tolerability.
The guidelines support the use of standard-dose mesalamine (2 to 3 grams/day) or diazo-bonded 5-ASAs (balsalazide or olsalazine) for induction and maintenance of remission in patients with extensive mild to moderate UC.
Those with moderate symptoms may benefit from early use of combination oral and rectal 5-ASA. Use of combined oral and rectal 5-ASA in patients with extensive disease may improve rates of induction of remission, as may escalation to high-dose (more than 3 grams/day) oral with rectal 5-ASA in patients with suboptimal response to standard-dose therapy.
In patients with inadequate response to optimized 5-ASA, consider oral prednisone or budesonide MMX 9 mg/day to induce remission instead of changing to an alternate 5-ASA formulation.
Systemic corticosteroids should not be used for maintenance of remission in patients with UC. In patients with mildly active ulcerative proctitis, rectal 5-ASA at a dose of 1 gram/day should be used to maintain remission rather than oral 5-ASA.
Those patients with suboptimal response or intolerance to rectal mesalamine may opt to use rectal corticosteroids.
- ulcerative colitis
For the treatment of mildly to moderately active ulcerative colitis
- abdominal pain
- anaphylactoid reactions
- back pain
- elevated hepatic enzymes
- eosinophilic pneumonia
- GI bleeding
- hepatic failure
- hepatic necrosis
- interstitial nephritis
- musculoskeletal pain
- pleural effusion
- renal failure (unspecified)
- serum creatinine
- 5-aminosalicylates hypersensitivity
- hepatic disease
- pyloric stenosis
- renal disease
- renal failure
- renal impairment
- salicylate hypersensitivity
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