Classifications: mucous membrane; antiinflammatory agent;
Therapeutic: antiinflammatory
; gi
Prototype: Mesalamine
Pregnancy Category: C


250 mg capsules


Converted to 5-aminosalicylic acid (5-ASA) by colonic bacteria. The 5-ASA is absorbed slowly, resulting in a very high local concentration in the colon. 5-ASA inhibits prostaglandin production in the colon, thus leading to anti-inflammatory properties of the drug.

Therapeutic Effect

5-ASA has antiinflammatory activity in ulcerative colitis.


Maintenance therapy in patients with ulcerative colitis.

Unlabeled Uses

Acute flare-up of ulcerative colitis.


Hypersensitivity to salicylates or 5-ASA; pregnancy (category C).

Cautious Use

Patients with preexisting kidney disease; lactation. Safety and effectiveness in children are not established.

Route & Dosage

Ulcerative Colitis
Adult: PO 500 mg b.i.d., may increase up to 1.5–3 g/d in 2–4 divided doses


  • Give with food in two evenly divided doses.

Adverse Effects (≥1%)

CNS: Headache. GI: Diarrhea, nausea, abdominal pain, indigestion, vomiting, bloating. Skin: Rash. Body as a Whole: Arthralgia.


Absorption: 1–3% from GI tract; high colonic concentrations are associated with efficacy. Metabolism: Olsalazine, a prodrug, is composed of 2 molecules of 5-ASA; colonic bacterial azo-reductases break the azo bond, releasing 2 active molecules of 5-ASA. Elimination: Primarily in feces as 5-ASA. Half-Life: At least 6 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor kidney function in patients with preexisting renal disease.
  • Monitor for S&S of a hypersensitivity reaction (see Appendix F). Withhold olsalazine and notify physician at first sign of an allergic response.

Patient & Family Education

  • Report diarrhea, a possible adverse effect, to the physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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