Balsalazide disodium, also known by the brand name Colazal, is an aminosalicylate. It's a first-choice treatment option for treating mild-to-moderate ulcerative colitis (UC) in people age 5 years and older. Balsalazide (Colazal) is available as 750 mg capsules. The typical dosage for adults is 3 capsules by mouth three times per day. Children can take either 1 or 3 capsules by mouth three times per day. Side effects include stomach pain and diarrhea.
Mild-to-moderate ulcerative colitis (UC) in people age 5 years and older
Balsalazide (Colazal) is an aminosalicylate. Once swallowed, the medication reaches the colon. It blocks the body from making inflammatory proteins and chemicals in the gut. This is thought to lessen inflammation in the gut.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Agitation
bloody diarrhea
blood in the urine
coma
confusion
dark-colored urine
decreased urine output
dizziness
headache
hostility
increased sensitivity of the skin to sunlight
irritability
itching, skin rash
lethargy
light-colored stools
muscle twitching
pain in the groin or genitals
rapid weight gain
redness or other discoloration of the skin
seizures
severe sunburn
sharp back pain just below ribs
stomach pain
swelling of the face, ankles, or hands
unusual tiredness or weakness
vomiting
yellow eyes or skin
Less common
Bladder pain
cloudy urine
difficult, burning, or painful urination
frequent urge to urinate
lower back or side pain
pale skin
trouble breathing
unusual bleeding or bruising
Rare
Tightness in the chest
Incidence not known
Chills
clay colored stools
decreased appetite
dizziness
increased blood pressure
increased thirst
joint pain
loss of appetite
swelling of the ,fingers, feet, or lower legs
unpleasant breath odor
vomiting of blood
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Acid or sour stomach
belching
bloated or full feeling
body aches or pain
bone pain
congestion
cramps
difficulty with moving
dryness of the throat
excess air or gas in the stomach or bowels
general feeling of discomfort or illness
hoarseness
indigestion
muscle pain or stiffness
passing of gas
shivering
stomach discomfort or upset
sweating
swelling or inflammation of the mouth
swollen joints
tender, swollen glands in the neck
trouble with sleeping
trouble with swallowing
unable to sleep
voice changes
Rare
Back pain
ear congestion
loss of voice
pain in the ankles or knees
painful, red lumps under the skin, mostly on the legs
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Incidence not known
Hair loss or thinning of the hair
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Can start to provide symptom relief after 2 weeks of treatment
Can sprinkle the pill contents onto applesauce if you have trouble swallowing it whole
Take balsalazide (Colazal) with or without food at any time of day. If it hurts your stomach, try taking the medication with food to help lessen stomach upset.
Swallow balsalazide (Colazal) capsules whole. Don't crush, chew, or break them.
If you're having trouble swallowing balsalazide (Colazal) capsules whole, you can open them and sprinkle the contents over 2 teaspoonfuls of applesauce. Mix the medication into the applesauce and then eat all of the mixture right away. Don't save it for later. Your teeth or tongue might get stained since the powder inside the capsules is orange to yellow.
While you're taking balsalazide (Colazal), it's normal if you notice that your urine looks reddish-brown if it hits surfaces or water that's been bleached. But if your urine is a reddish-brown color when it comes out of your body, contact your prescriber because this can be a sign that something else is going on.
Make sure to drink plenty of fluids while you're taking balsalazide (Colazal). Staying hydrated helps lessen your risk for kidney stones from the medication.
Your skin might become more sensitive to the sun and be easier to burn while you're taking balsalazide (Colazal). To protect your skin, make sure to wear sunscreen, wear sun-protective clothing, and find shade when you're outside.
Share your most up-to-date medication list with your care team so they can check that all your medications are safe to take together. Certain medications can interact with balsalazide (Colazal). For example, taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), with balsalazide (Colazal) can raise your risk for kidney problems because they both can harm the kidneys.
Balsalazide (Colazal) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of kidney problems | Taking medications that are harmful to the kidneys
Some people who take balsalazide (Colazal) have had kidney damage. Your risk for kidney damage is higher if you have kidney problems or if you take medications that can harm the kidneys, like nonsteroidal anti-inflammatory drugs (NSAIDs) and diuretics (water pills).
You might need blood work or urine tests done every so often during treatment so your prescriber can check your kidney function. Tell your care team if you have any signs or symptoms of kidney problems while you're taking balsalazide (Colazal), including changes in your need to urinate, tiredness, low appetite, and muscle cramps.
Some people who take balsalazide (Colazal) can get kidney stones. Make sure to stay hydrated each day while you're taking this medication to prevent kidney stones. Let your prescriber know if you have trouble urinating, notice a change in how much you urinate, have blood in the urine, or feel back or side pain. These can be signs of a kidney stone.
Although rare, some people who take balsalazide (Colazal) can have a reaction to the medication called acute intolerance syndrome. It typically happens 1 to 3 weeks after starting balsalazide (Colazal). And it usually goes away within a few days after stopping the medication or after starting corticosteroid treatment.
Symptoms of acute intolerance syndrome can be hard to tell apart from a flare-up of UC. Let your care team know if you have symptoms like stomach cramping or pain, bloody diarrhea, fever, headache, and rash. You might need to stop taking balsalazide (Colazal) to help these symptoms go away.
Risk factors: Allergy to sulfasalazine (Azulfidine) | Allergy to other aminosalicylates or salicylates (e.g., aspirin)
Severe allergic reactions to balsalazide (Colazal) are possible. They can include life-threatening reactions like facial swelling, shock, and anaphylaxis (e.g., closing of the throat). Get emergency medical help right away if you notice hives, rash, swelling of the lips or tongue, or difficulty breathing after you take balsalazide (Colazal).
Balsalazide (Colazal) can cause rare but serious skin reactions. These skin reactions can include Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome.
Stop taking balsalazide (Colazal) and get medical attention right away at the first sign of any unusual changes in your skin, like rash, blisters, peeling skin, or skin reddening. These skin reactions can sometimes happen with fever, sore throat, fatigue, and swollen lymph nodes, so watch out for these symptoms as well.
Risk factors: History of liver problems
Although rare, some people with liver problems had liver failure after they took mesalamine, a similar medication to balsalazide (Colazal). Let your prescriber know if you have a history of liver problems before you start taking balsalazide (Colazal). They can weigh the risks and benefits of treatment.
Get medical help as soon as possible if you notice severe nausea, vomiting, right-sided stomach pain, fatigue, low or no appetite, or yellowing of the skin or eyes while you're taking balsalazide (Colazal). These can be signs of liver damage.
Risk factors: Skin conditions (e.g., eczema)
People with skin conditions like eczema who take balsalazide (Colazal) are at higher risk that their skin gets more sensitive to the sun. This means that they can get sunburns more easily than usual.
To lower your risk for sunburn, wear sunscreen and long-sleeved clothing to protect your skin when you're outside, even during the winter and on overcast days. Also try to find shade as much as possible.
People who have or are at risk of a bowel obstruction should avoid taking balsalazide (Colazal). Gut blockages can make it take longer for the medication to reach your colon and help treat your UC. Let your prescriber know right away if you notice symptoms of a bowel obstruction, like severe stomach cramping, severe stomach pain, vomiting, constipation, or a hard or swollen belly.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
750mg | 270 capsules | $71.78 | $0.27 |
Each capsule contains 750 mg of balsalazide.
Age 18 years and older: The typical dose is 3 capsules by mouth three times per day for up 8 to 12 weeks.
Age 5 to under 18 years: The typical dose is either 1 capsule or 3 capsules by mouth three times per day for up to 8 weeks.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Allergy to aspirin or other salicylates, like mesalamine and sulfasalazine (Azulfidine)
Mild-to-moderate ulcerative colitis (UC) in people age 5 years and older
Ulcerative colitis (UC) - immediate-release and delayed release tablets
Rheumatoid arthritis (RA) - delayed-release tablets only
Polyarticular juvenile rheumatoid arthritis - delayed-release tablets only
By providing your email, you consent to receive marketing communications from GoodRx, which may include content and/or data related to men’s health, women's health, reproductive care, or sexual health. You agree to the GoodRx Terms of Use and acknowledge the Privacy Policy. You can unsubscribe at any time.
Apotex Corp. (2025). Balsalazide disodium capsule [package insert]. DailyMed.
Crohn’s and Colitis Foundation. (n.d.). Malnutrition and IBD.
Drugs and Lactation Database (LactMed®). (2024). Balsalazide. National Institute of Child Health and Human Development.
Green, J. R., et al. (1998). Balsalazide is more effective and better tolerated than mesalamine in the treatment of acute ulcerative colitis. The Abacus Investigator Group. Gastroenterology.
Mikami, Y., et al. (2023). Significance of 5-aminosalicylic acid Intolerance in the clinical management of ulcerative colitis. Digestion.
Muijsers, R. B. R., et al. (2012). Balsalazide: A review of its therapeutic use in mild-to-moderate ulcerative colitis. Drugs.
Nakashima, J., et al. (2024). Mesalamine (USAN). StatPearls.
National Kidney Foundation. (2020). 10 signs you may have kidney disease.
National Kidney Foundation. (2023). Tests to check your kidney health.
Rubin, D. T., et al. (2019). ACG clinical guideline: Ulcerative colitis in adults. The American Journal of Gastroenterology.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.