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Olsalazine (Aminosalicylate)
⚠️ Renal monitoring is essential: Check serum creatinine before starting olsalazine, then: – Every 3 months in year 1 – Every 6 months for the next 4 years – Annually after 5 years of treatment.
💊 About: Always check the BNF link here
- 🔹 Used mainly to treat ulcerative colitis.
- 📌 Systemic absorption is minimal → drug remains largely in colonic lumen.
- 👩⚕️ Considered when mesalazine is not tolerated or when colonic delivery is preferred.
⚙️ Mode of Action
- 🧪 Olsalazine itself is relatively inert.
- 💡 Poorly absorbed in the small intestine → reaches the colon intact.
- 🦠 In the colon, gut bacteria split olsalazine into two molecules of 5-ASA (mesalazine).
- 🔥 5-ASA is the active anti-inflammatory agent, inhibiting prostaglandins, leukotrienes, and cytokines → reduced local inflammation.
- 🌍 Similar mechanism to sulphasalazine but without a sulphapyridine carrier (less systemic toxicity).
🎯 Indications
- 💥 Mild to moderate ulcerative colitis (induction & maintenance).
- 📍 Best taken after meals to reduce risk of diarrhoea.
📊 Dose
- ➡️ Acute flare: 1–3 g/day PO in divided doses.
- ➡️ Maintenance: 500 mg PO BD.
🔄 Interactions
- 📖 See BNF for full list (monitor renal toxicity risk if combined with other nephrotoxic drugs such as NSAIDs).
⛔ Contraindications
- 🚫 Avoid in pregnancy & lactation unless specialist advice obtained.
- ⚠️ Use with caution in renal impairment (monitor function regularly).
⚠️ Side Effects
- 💩 Watery diarrhoea (dose-limiting in some patients).
- 👁️ Blurred vision (rare).
- ❤️ Palpitations.
- Rare: rash, arthralgia, and blood dyscrasias (monitor if unexplained fever or bruising).
📚 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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