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Colazal
Colazal (balsalazide disodium) is an anti-inflammatory drug used to treat ulcerative colitis, a type of inflammatory bowel disease (IBD). It works by reducing inflammation in the colon, which helps manage symptoms such as diarrhea, rectal bleeding, and stomach pain. Colazal is generally prescribed for individuals with mild to moderate ulcerative colitis and is particularly useful for maintaining remission. It is a prodrug, meaning it is converted into its active form in the colon, where it has its anti-inflammatory effects.
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Frequently Asked Questions
How long does it take for Colazal to work?
Most patients begin to see improvement in their ulcerative colitis symptoms within 2 to 4 weeks of starting Colazal, but it may take up to 8 weeks for full effects.
Can I take Colazal with other medications for ulcerative colitis?
Yes, Colazal can often be used in combination with other medications such as corticosteroids or immunosuppressants. However, always consult your healthcare provider before starting any new medications.
Is Colazal safe during pregnancy?
Colazal is classified as Pregnancy Category B, which means it is generally considered safe during pregnancy. However, it should only be used if clearly needed and under the guidance of a healthcare provider.
What should I do if I miss a dose of Colazal?
If you miss a dose, take it as soon as you remember. If it’s close to the time of your next dose, skip the missed dose and continue with your regular schedule. Do not take extra doses to make up for a missed one.
Can Colazal cure ulcerative colitis?
No, Colazal does not cure ulcerative colitis, but it helps manage the symptoms and maintain remission by reducing inflammation in the colon. Long-term therapy is often needed to keep symptoms under control.
Comprehensive Drug Guide
How Does Colazal Work?
Colazal contains balsalazide, which is a prodrug that is metabolized in the colon to release mesalamine (5-aminosalicylic acid), its active form. Mesalamine works by reducing inflammation directly in the lining of the colon. It inhibits the production of inflammatory chemicals, such as prostaglandins and leukotrienes, which are responsible for the symptoms of ulcerative colitis.
Common Dosages
- Capsules: 750 mg balsalazide disodium
Typical Dosing
- For adults: The recommended dose is three 750 mg capsules taken orally three times daily (total of 6.75 grams per day) for up to 8 to 12 weeks or as directed by your healthcare provider.
- For pediatric patients aged 5 and older: The dose is generally the same as for adults, though adjustments may be made based on individual needs.
Typical Dosing
FDA Approved Indications
- Mild to moderate ulcerative colitis in adults and children aged 5 and older
Who Shouldn't Take Colazal?
- Known hypersensitivity to balsalazide, mesalamine, or any other component of the formulation
- Severe liver impairment
Advice From The Pharmacist
- Take Colazal with or without food, but try to take it at the same time each day for consistency.
- If you have difficulty swallowing the capsules, you may open them and sprinkle the contents on applesauce. Be sure to swallow the mixture without chewing and take it immediately.
- Continue taking Colazal for the full course of treatment, even if symptoms improve before the medication is finished.
- Stay hydrated, as dehydration may worsen some of the side effects, especially in patients with ulcerative colitis.
Side Effects of Colazal
Common Side Effects
- Headache
- Stomach pain or cramping
- Diarrhea
- Nausea
- Joint pain
Uncommon/Severe Side Effects
- Worsening of ulcerative colitis symptoms (severe diarrhea, bloody stools, cramping)
- Liver issues (yellowing of the skin or eyes, dark urine)
- Severe allergic reactions (rash, swelling, difficulty breathing)
Risks and Warnings of Colazal
- Liver Function: Patients with liver disease or compromised liver function should use Colazal with caution, as it may increase the risk of liver toxicity. Regular monitoring of liver enzymes is recommended during treatment.
- Kidney Function: Colazal may affect kidney function, especially in patients with pre-existing kidney disease. It is important to have kidney function tests performed periodically.
- Hypersensitivity: Some individuals may experience hypersensitivity reactions to mesalamine, the active form of balsalazide. Signs of allergic reactions include rash, swelling, and difficulty breathing, and patients should discontinue use immediately if they experience these symptoms.
Interactions with Colazal
Common Drug Interactions
- Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Using Colazal with NSAIDs may increase the risk of kidney damage. Use with caution and under the guidance of a healthcare provider.
- Azathioprine or 6-Mercaptopurine: These medications, commonly used to treat inflammatory bowel disease, may increase the risk of bone marrow suppression when taken with Colazal.
- Warfarin (Coumadin): Colazal may affect blood clotting. Patients on anticoagulants should be monitored closely.
Alternatives to Colazal
- Mesalamine (Asacol, Lialda, Pentasa): An alternative 5-ASA drug commonly used to treat ulcerative colitis.
- Sulfasalazine: Another aminosalicylate used for ulcerative colitis, though it may cause more side effects, particularly in individuals sensitive to sulfa drugs.
- Corticosteroids (Prednisone, Budesonide): Used to reduce inflammation during more severe flare-ups of ulcerative colitis.
- Biologics (Infliximab, Adalimumab): Advanced therapies for patients with moderate to severe ulcerative colitis who do not respond to aminosalicylates or steroids.
