Which medications in the drug class 5-Aminosalicylic Acid Derivatives are used in the treatment of Inflammatory Bowel Disease?

Updated: Oct 17, 2017
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Answer

5-Aminosalicylic Acid Derivatives

The 5-aminosalicylic acid (ASA) derivatives are effective in reducing inflammatory reactions. All of the aminosalicylates are useful for treating flares of mild to moderate ulcerative colitis and occasionally Crohn colitis and for maintaining remission.

Sulfasalazine (Azulfidine, Azulfidine EN-tabs, Sulfazine, Sulfazine EC)

Sulfasalazine is considered best for colonic disease, although it is also considered first-line therapy for Crohn disease. This agent is used for acute disease and for maintenance of remission.

Mesalamine (Asacol HD, Pentasa, Canasa, Rowasa, Lialda, Apriso, Delzicol)

Mesalamine is a 5-ASA that acts systemically and also has activity as a topical anti-inflammatory.

Balsalazide (Colazal, Giazo)

Balsalazide is a prodrug 5-ASA connected to a 4-aminobenzoyl-(beta)-alanine carrier by an azo bond; colonic bacteria break the azo bond, releasing the active 5-ASA. Metabolites of the drug may decrease inflammation by blocking the production of arachidonic acid metabolites in colonic mucosa.

Olsalazine (Dipentum)

Olsalazine is useful for active disease and maintenance of remission in ulcerative colitis. Dipentum is a 5-ASA connected to a 5-ASA by an azo bond; colonic bacteria break the azo bond, releasing the active 5-ASA. Note that an adverse event of high ileal secretion of chloride creates a different type of diarrhea, which lessens its acceptability.


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