Balsalazide 750mg capsules
Requires a prescription from a doctor or prescriber
Balsalazide is an anti-inflammatory drug used in the treatment of Inflammatory Bowel Disease.
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Safety monitoring data
Yellow Card reports
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Suspected adverse reactions reported for Balsalazide
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Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
EudraVigilance
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Suspected adverse reactions reported for Balsalazide
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EudraVigilance data is published by the European Medicines Agency (EMA). A suspected adverse reaction is not necessarily caused by the medicine.
7 branded products available
MHRA licensed products
View all licensed products for Balsalazide on the MHRA register
Colazide 750mg capsules
This is the NHS Drug Tariff indicative price used for reimbursement purposes. It may not reflect the price paid by patients or pharmacies.
View full Drug TariffSource: NHS Drug Tariff via NHSBSA. Derived from dm+d VMPP (Virtual Medicinal Product Pack) pricing data. Contains public sector information licensed under the Open Government Licence v3.0.
WHO defined daily dose (DDD)
6.75 gram
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via the NHS dm+d supplementary BNF/ATC mapping files (NHSBSA). Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity is based on WHO Anatomical Therapeutic Chemical (ATC) classification and on a factual NHS dm+d therapeutic-grouping code prefix. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Guidelines from the National Institute for Health and Care Excellence
NICE clinical guidance(2)
Crohn's disease: management (NG129)
Pouchitis: rifaximin (ESUOM30)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
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Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
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SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF code shown is the factual mapping value distributed by NHS Business Services Authority (NHSBSA) in the dm+d supplementary file under OGL v3.0; it is not affiliated with, nor licensed from, the publishers of the British National Formulary. ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Academic studies and reviews for this medicine's active substance
Showing the 50 most relevant studies.
Reviews & meta-analyses: 11 · Randomised trials: 2 · 1983–2026
Showing the 50 most relevant studies, sorted by most relevant.
Jhakri K, Al-Shudifat M, Sumra B, et al.
2025
Crohn's disease (CD) and ulcerative colitis (UC) are two forms of inflammatory bowel disease (IBD). This chronic, immune-mediated disorder leads to inflammation in specific gastrointestinal tract regions. Myocarditis is a rare but significant IBD complication that affects roughly 0.3% of cases. Mesalazine-induced myocarditis is a rare side effect of mesalazine therapy, which is considered a standard treatment for IBD. Increased mortality and cardiogenic shock are possible outcomes of this adverse response. The objectives of this study are to characterize the clinical features of mesalazine-induced myocarditis in patients with IBD, to conduct a comprehensive analysis of mesalazine-related myocarditis cases in IBD patients, to review the existing literature, to elucidate the pathophysiological mechanisms of myocarditis in IBD, and to determine whether myocarditis represents an extraintestinal manifestation of IBD or an adverse drug reaction to mesalazine. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Relevant literature was retrieved from Cochrane, ScienceDirect, Google Scholar, PubMed, and PubMed Central (PMC). Only articles published in English or with a full English translation available within the last 10 years (2014-2024) were included. A rigorous quality assessment tool was applied to ensure the quality of evidence-based medicine that will be utilized to construct a conclusion and direct future reviews. Among 43 patients analyzed, 29 (67%) developed myocarditis attributable to mesalazine treatment, while 14 (33%) exhibited myocarditis unrelated to the medication. Our findings indicate that myocarditis in IBD is more likely to be a severe drug reaction than an extraintestinal manifestation of IBD progression. In drug-induced myocarditis cases, mesalazine derivatives, including sulfasalazine, mesalamine, and balsalazide, were most frequently implicated. Potential mechanisms underlying mesalazine-associated myocarditis include IgE-mediated hypersensitivity reactions, direct cardiotoxicity, cell-mediated hypersensitivity, or humoral antibody responses to drug metabolites. When treating myocarditis in IBD, whether due to medication or as an extraintestinal manifestation, discontinuing the offending drug and initiating immunosuppressive therapy appear to be the most effective approach.
Abstract licence: CC BY
R. Rahimi, S. Nikfar, A. Rezaie, et al.
Digestive Diseases and Sciences, 2009
- Anti-Inflammatory Agents, Non-Steroidal
- Colitis, Ulcerative
- Phenylhydrazines
A. Tursi, G. Brandimarte, G. Giorgetti, et al.
Medical science monitor : international medical journal of experimental and clinical research, 2004
- Aminosalicylic Acids
- Colitis, Ulcerative
- Phenylhydrazines
Philip W. Lowry, C L Franklin, A L Weaver, et al.
Gut, 2001
- Aminosalicylic Acids
- Analysis of Variance
- Anti-Inflammatory Agents, Non-Steroidal
Jonathan R.B. Green, Alan Lobo, Charles D. Holdsworth, et al.
Gastroenterology, 1998
- Aminosalicylic Acids
- Anti-Inflammatory Agents, Non-Steroidal
- Anti-Ulcer Agents
Christopher D. Jahraus, Doug Bettenhausen, Uzma Malik, et al.
International Journal of Radiation Oncology*Biology*Physics, 2005
- Acute Disease
- Aminosalicylic Acids
- Anti-Ulcer Agents
Zhi-Feng Zhang, Zhi-Jun Duan, Gang Zhao, et al.
World Chinese Journal of Digestology, 2008
Rosalind P. Chan, D J POPE, Andrew P. Gilbert, et al.
Digestive Diseases and Sciences, 1983
- Aminosalicylic Acids
- Chemistry
- Clinical Trials as Topic
D. Levine, D. Riff, R. Pruitt, et al.
American Journal of Gastroenterology, 2002
- Aminosalicylic Acids
- Anti-Inflammatory Agents, Non-Steroidal
- Anti-Ulcer Agents
C JAHRAUS, D BETTENHAUSEN, M SELLITTI, et al.
International Journal of Radiation OncologyBiologyPhysics, 2004
Sources: aggregated from Europe PMC (EMBL-EBI), OpenAlex, Crossref, PubMed and other open scholarly databases. Retracted articles are excluded. Study information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
160 found
Half-life
Not available
Mechanism
The mechanism of action of 5-aminosalicylic acid is unknown, but appears to exer…
Food interactions
1 warning
Human targets
4 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
Half-life
Protein binding
99%
Metabolism
Elimination
750 mg
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
The chemical name is (E)-5-[[-4-(2-carboxyethyl) aminocarbonyl] phenyl]azo] -2-hydroxybenzoic acid. It is usually administered as the disodium salt.
Balsalazide works by deliverying mesalazine to the large intestine to act directly on ulcerative colitis. Mesalazine is also known as 5-aminosalicylic acid, or 5-ASA.
Known interactions with other medications. Always consult a healthcare professional.
Showing 50 of 1498 interactions
How the body processes this drug — absorption, distribution, metabolism, and elimination
Proteins and enzymes this drug interacts with in the body
Key regulator of adipocyte differentiation and glucose homeostasis. ARF6 acts as a key regulator of the tissue-specific adipocyte P2 (aP2) enhancer. Acts as a critical regulator of gut homeostasis by suppressing NF-kappa-B-mediated pro-inflammatory responses.
Plays a role in the regulation of cardiovascular circadian rhythms by regulating the transcription of BMAL1 in the blood vessels (By similarity)
PMID:11939906 PMID:16373578 PMID:19540099 PMID:22942274 PMID:26859324 PMID:27226593 PMID:7592599 PMID:7947975 PMID:9261177
The cyclooxygenase activity oxygenates AA to the hydroperoxy endoperoxide prostaglandin G2 (PGG2), and the peroxidase activity reduces PGG2 to the hydroxy endoperoxide prostaglandin H2 (PGH2), the precursor of all 2-series prostaglandins and thromboxanes .
PMID:16373578 PMID:22942274 PMID:26859324 PMID:27226593 PMID:7592599 PMID:7947975 PMID:9261177
This complex transformation is initiated by abstraction of hydrogen at carbon 13 (with S-stereochemistry), followed by insertion of molecular O2 to form the endoperoxide bridge between carbon 9 and 11 that defines prostaglandins. The insertion of a second molecule of O2 (bis-oxygenase activity) yields a hydroperoxy group in PGG2 that is then reduced to PGH2 by two electrons .
PMID:16373578 PMID:22942274 PMID:26859324 PMID:27226593 PMID:7592599 PMID:7947975 PMID:9261177
Similarly catalyzes successive cyclooxygenation and peroxidation of dihomo-gamma-linoleate (DGLA, C20:3(n-6)) and eicosapentaenoate (EPA, C20:5(n-3)) to corresponding PGH1 and PGH3, the precursors of 1- and 3-series prostaglandins .
PMID:11939906 PMID:19540099
In an alternative pathway of prostanoid biosynthesis, converts 2-arachidonoyl lysophopholipids to prostanoid lysophopholipids, which are then hydrolyzed by intracellular phospholipases to release free prostanoids .
PMID:27642067
Metabolizes 2-arachidonoyl glycerol yielding the glyceryl ester of PGH2, a process that can contribute to pain response .
PMID:22942274
Generates lipid mediators from n-3 and n-6 polyunsaturated fatty acids (PUFAs) via a lipoxygenase-type mechanism. Oxygenates PUFAs to hydroperoxy compounds and then reduces them to corresponding alcohols .
PMID:11034610 PMID:11192938 PMID:9048568 PMID:9261177
Plays a role in the generation of resolution phase interaction products (resolvins) during both sterile and infectious inflammation .
PMID:12391014
Metabolizes docosahexaenoate (DHA, C22:6(n-3)) to 17R-HDHA, a precursor of the D-series resolvins (RvDs) .
PMID:12391014
As a component of the biosynthetic pathway of E-series resolvins (RvEs), converts eicosapentaenoate (EPA, C20:5(n-3)) primarily to 18S-HEPE that is further metabolized by ALOX5 and LTA4H to generate 18S-RvE1 and 18S-RvE2 .
PMID:21206090
In vascular endothelial cells, converts docosapentaenoate (DPA, C22:5(n-3)) to 13R-HDPA, a precursor for 13-series resolvins (RvTs) shown to activate macrophage phagocytosis during bacterial infection .
PMID:26236990
In activated leukocytes, contributes to oxygenation of hydroxyeicosatetraenoates (HETE) to diHETES (5,15-diHETE and 5,11-diHETE) .
PMID:22068350 PMID:26282205
Can also use linoleate (LA, (9Z,12Z)-octadecadienoate, C18:2(n-6)) as substrate and produce hydroxyoctadecadienoates (HODEs) in a regio- and stereospecific manner, being (9R)-HODE ((9R)-hydroxy-(10E,12Z)-octadecadienoate) and (13S)-HODE ((13S)-hydroxy-(9Z,11E)-octadecadienoate) its major products (By similarity).
During neuroinflammation, plays a role in neuronal secretion of specialized preresolving mediators (SPMs) 15R-lipoxin A4 that regulates phagocytic microglia (By similarity)
The insertion of a second molecule of O2 (bis-oxygenase activity) yields a hydroperoxy group in PGG2 that is then reduced to PGH2 by two electrons .
PMID:7947975
Involved in the constitutive production of prostanoids in particular in the stomach and platelets. In gastric epithelial cells, it is a key step in the generation of prostaglandins, such as prostaglandin E2 (PGE2), which plays an important role in cytoprotection. In platelets, it is involved in the generation of thromboxane A2 (TXA2), which promotes platelet activation and aggregation, vasoconstriction and proliferation of vascular smooth muscle cells (Probable).
Can also use linoleate (LA, (9Z,12Z)-octadecadienoate, C18:2(n-6)) as substrate and produce hydroxyoctadecadienoates (HODEs) in a regio- and stereospecific manner, being (9R)-HODE ((9R)-hydroxy-(10E,12Z)-octadecadienoate) and (13S)-HODE ((13S)-hydroxy-(9Z,11E)-octadecadienoate) its major products (By similarity)
PMID:19022417 PMID:21233389 PMID:22516296 PMID:23246375 PMID:24282679 PMID:24893149 PMID:31664810 PMID:8615788 PMID:8631361
Also catalyzes the oxygenation of arachidonate into 8-hydroperoxyicosatetraenoate (8-HPETE) and 12-hydroperoxyicosatetraenoate (12-HPETE) .
PMID:23246375
Displays lipoxin synthase activity being able to convert (15S)-HETE into a conjugate tetraene .
PMID:31664810
Although arachidonate is the preferred substrate, this enzyme can also metabolize oxidized fatty acids derived from arachidonate such as (15S)-HETE, eicosapentaenoate (EPA) such as (18R)- and (18S)-HEPE or docosahexaenoate (DHA) which lead to the formation of specialized pro-resolving mediators (SPM) lipoxin and resolvins E and D respectively, therefore it participates in anti-inflammatory responses .
PMID:17114001 PMID:21206090 PMID:31664810 PMID:32404334 PMID:8615788
Oxidation of DHA directly inhibits endothelial cell proliferation and sprouting angiogenesis via peroxisome proliferator-activated receptor gamma (PPARgamma) (By similarity). It does not catalyze the oxygenation of linoleic acid and does not convert (5S)-HETE to lipoxin isomers .
PMID:31664810
In addition to inflammatory processes, it participates in dendritic cell migration, wound healing through an antioxidant mechanism based on heme oxygenase-1 (HO-1) regulation expression, monocyte adhesion to the endothelium via ITGAM expression on monocytes (By similarity). Moreover, it helps establish an adaptive humoral immunity by regulating primary resting B cells and follicular helper T cells and participates in the CD40-induced production of reactive oxygen species (ROS) after CD40 ligation in B cells through interaction with PIK3R1 that bridges ALOX5 with CD40 .
PMID:21200133
May also play a role in glucose homeostasis, regulation of insulin secretion and palmitic acid-induced insulin resistance via AMPK (By similarity).
Can regulate bone mineralization and fat cell differentiation increases in induced pluripotent stem cells (By similarity)
ATC A07EC04
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Balsalazide
Additional database identifiers
ChemSpider
10662422
ZINC
ZINC000003952881
HUGO Gene Nomenclature Committee (HGNC)
HGNC:9236
GenAtlas
PPARG
GeneCards
PPARG
GenBank Gene Database
U79012
GenBank Protein Database
1711117
Guide to Pharmacology
595
UniProt Accession
PPARG_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:9605
GenAtlas
PTGS2
GeneCards
PTGS2
GenBank Gene Database
L15326
GenBank Protein Database
291988
Guide to Pharmacology
1376
UniProt Accession
PGH2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:9604
GenAtlas
PTGS1
GeneCards
PTGS1
GenBank Gene Database
M31822
GenBank Protein Database
387018
Guide to Pharmacology
1375
UniProt Accession
PGH1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:435
GenAtlas
ALOX5
GeneCards
ALOX5
GenBank Gene Database
J03600
GenBank Protein Database
187193
Guide to Pharmacology
1385
UniProt Accession
LOX5_HUMAN
GenBank Gene Database
AB032601
GenBank Protein Database
10281002
UniProt Accession
AZRB_BACOY
DrugBank citations
If you use DrugBank data in your research, please cite the following publications:
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Structured knowledge from the free knowledge base
ATC classifications (Wikidata)
Linked open data from Wikidata (Q347337), a free and open knowledge base operated by the Wikimedia Foundation. Data is available under the Creative Commons CC0 1.0 Public Domain Dedication. WHO INN from the World Health Organization.