Balsalazide

INTRODUCTION

Indications

Treatment of mild-to-moderately active ulcerative colitis.

Action

Drug is metabolized in the colon to mesalamine (5-aminosalicylic acid), which is a local anti-inflammatory. Therapeutic Effects: Reduction in the symptoms of ulcerative colitis.

Adverse Reactions/Side Effects

GI: HEPATOTOXICITY, abdominal pain, diarrhea.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Be alert for signs of hepatotoxicity, including anorexia, abdominal pain, severe nausea and vomiting, yellow skin or eyes, fever, sore throat, malaise, weakness, facial edema, lethargy, and unusual bleeding or bruising. Notify physician of these signs immediately.

Patient/Client-Related Instruction

• Advise patient to avoid alcohol and foods that may cause an increase in GI irritation.

• Instruct patient to report troublesome GI effects such as diarrhea and abdominal pain.

Pharmacokinetics

Absorption: Absorption is low and variable; drug is delivered intact to the colon.

Distribution: Mostly delivered intact to the colon; remainder of distribution unknown.

Protein Binding: ≥99%.

Metabolism and Excretion: Following delivery to the colon, bacteria break balsalazide down into mesalamine (5-aminosalicylic acid) and an inactive metabolite; mostly excreted in feces.

Half-life: Mesalamine—12 hr (range 2–15 hr).

Contraindications/Precautions

Contraindicated in: Hypersensitivity to salicylates or other metabolites.

Use Cautiously in: Pyloric stenosis (may have prolonged gastric retention of capsules); OB: Use only if clearly needed; Lactation/Pedi: Safety not established.

Interactions

Drug-Drug: None known.

Route/Dosage

PO (Adults): 3 750-mg capsules 3 times daily for 8–12 wk.

PO (Children 5–17 yr): 3 750-mg capsules 3 times daily for up to 8 wk or 1 750-mg capsule 3 times daily for up to 8 wk.

Availability

Capsules: 750 mg.