olsalazine sodium

Action

Unknown. Converts to active form, mesalamine, which blocks cyclooxygenase and inhibits prostaglandin production in colon.

Availability

Capsules: 250 mg

Indications and dosages

➣ Ulcerative colitis in patients who can't tolerate sulfasalazine

Adults: 500 mg P.O. b.i.d.

Contraindications

• Hypersensitivity to drug or other salicylates

Precautions

Use cautiously in:

• hepatic or renal impairment, severe allergy, bronchial asthma

• pregnant or breastfeeding patients

• children younger than age 14.

Administration

• Give with meals to reduce GI irritation.

Adverse reactions

CNS: headache, fatigue, depression, vertigo

GI: nausea, vomiting, diarrhea, abdominal pain, cramps, dyspepsia, bloating, stomatitis

Musculoskeletal: joint pain

Respiratory: upper respiratory infection

Skin: rash, itching

Interactions

Drug-drug. Anticoagulants, coumarin derivatives: prolonged prothrombin time, increased International Normalized Ratio

Drug-food. Any food: decreased GI irritation

Patient monitoring

• Monitor neurologic status. Stay alert for depression.

• Assess GI symptoms. Encourage adequate fluid intake to avoid dehydration.

• Monitor urinalysis, blood urea nitrogen, and creatinine in patients with renal impairment.

Patient teaching

• Instruct patient to take with food and to continue taking drug even after symptoms improve.

• Tell patient to eat appropriate foods in small, frequent servings to minimize GI upset.

• Advise patient to contact prescriber if symptoms worsen or don't improve after 1 to 2 months of therapy.

• Tell patient he may require periodic proctoscopy and sigmoidoscopy to determine response to drug.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects mood and wakefulness.

• As appropriate, review all significant adverse reactions and interactions, especially those related to the drugs and foods mentioned above.