Olsalazine Brand Name– Dipentum
What is Olsalazine
Olsalazine is an oral diazo-bonded 5-aminosalicylate (5-ASA) and is a prodrug; bacterial azoreduction in the intestines releases the anti-inflammatory agent mesalamine (5-ASA) to produce the active effect.
Olsalazine is used for the maintenance of remission in patients with ulcerative colitis (UC) who are intolerant to sulfasalazine.
The guidelines support the use of standard-dose diazo-bonded 5-ASAs (e.g., olsalazine) for induction and maintenance of remission in patients with extensive mild to moderate UC.
Those with moderate UC symptoms may benefit from early use of combination oral and rectal 5-ASA products. 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 therapy, 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 products, such as olsalazine.
Those patients with suboptimal response or intolerance to rectal 5-ASA may opt to use rectal corticosteroids.
Olsalazine use is commonly associated with dose-related diarrhea, which may occur anytime during therapy and may result in discontinuation and may be difficult to distinguish from the underlying symptoms of the disease.
Indications
- ulcerative colitis
For the maintenance of remission of ulcerative colitis in patients intolerant of sulfasalazine
Side Effects
- abdominal pain
- alopecia
- anemia
- angioedema
- anorexia
- aplastic anemia
- arthralgia
- blurred vision
- bronchospasm
- chest pain (unspecified)
- chills
- cholestasis
- cirrhosis
- colitis
- depression
- diarrhea
- dizziness
- drowsiness
- dyspepsia
- dyspnea
- dysuria
- elevated hepatic enzymes
- eosinophilia
- erythema
- erythema nodosum
- fatigue
- fever
- flatulence
- headache
- hematuria
- hemolytic anemia
- hepatic failure
- hepatic necrosis
- hepatitis
- hot flashes
- hyperbilirubinemia
- hypertension
- impotence (erectile dysfunction)
- increased urinary frequency
- infection
- insomnia
- interstitial nephritis
- irritability
- jaundice
- lethargy
- leukopenia
- lymphopenia
- menorrhagia
- muscle cramps
- myalgia
- myocarditis
- nausea
- nephrotic syndrome
- neutropenia
- orthostatic hypotension
- palpitations
- pancreatitis
- pancytopenia
- paresthesias
- peripheral edema
- peripheral neuropathy
- photosensitivity
- proteinuria
- pruritus
- pyrosis (heartburn)
- rash
- sinus tachycardia
- stomatitis
- thrombocytopenia
- tinnitus
- tremor
- vertigo
- vomiting
- xerophthalmia
- xerostomia
Monitoring Parameters
- serum creatinine
Contraindications
- 5-aminosalicylates hypersensitivity
- asthma
- breast-feeding
- children
- colitis
- diarrhea
- hepatic disease
- infants
- neonates
- pregnancy
- renal disease
- renal failure
- renal impairment
- salicylate hypersensitivity
Interactions
- Amlodipine; Celecoxib
- Azathioprine
- Celecoxib
- Digoxin
- Mercaptopurine, 6-MP
- Thioguanine, 6-TG
- Warfarin
