Lialda vs. Colazal for Ulcerative Colitis: Important Differences and Potential Risks.

Key takeaways

Mesalamine DR (Lialda) and balsalazide (Colazal) are both used to treat ulcerative colitis (UC), but they have some differences. Both medications belong to the same medication class called aminosalicylates and work by reducing inflammation in the gut. Mesalamine DR is a delayed-release tablet that is taken once a day with food, whereas, balsalazide is a capsule taken three times a day. Additionally, balsalazide can be taken with or without food, and its capsules can be opened and sprinkled on applesauce. Balsalazide may work better than mesalamine for UC flare-ups. Both medications can cause kidney and liver problems and a specific reaction called mesalamine-induced intolerance. Balsalazide can cause respiratory tract infections and joint pain, which is not common with mesalamine DR.

Mesalamine DR

(Lialda)

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Balsalazide

(Colazal)

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Summary for Lialda

Prescription only

Mesalamine DR (Lialda) is an aminosalicylate that's used to treat mild-to-moderate ulcerative colitis (UC) in adults and children. It's a delayed-release (DR) tablet that's taken by mouth once daily with food. Side effects aren't common but can include headache and stomach upset. Mesalamine DR (Lialda) also has a risk for serious skin rash and sensitivity to the sun (e.g., might sunburn more easily).

Indications for Lialda

Mild-to-moderate ulcerative colitis (UC) in adults and children weighing at least 53 lbs

Pros and Cons for Lialda

Pros

Taken by mouth once daily
Available as a generic

Cons

Need to take with food
Only available as an extended-release tablet that can't be crushed, broken, or chewed

Common Side Effects for Lialda

Headache (3%)
Stomach pain (2%)
Diarrhea (2%)
Abnormal liver enzyme levels (2%)

Warnings for Lialda

Kidney damage and kidney stones
Acute intolerance syndrome
Severe allergic reactions
Severe skin reactions
Liver problems
Caution in people with gut blockage
Skin that's sensitive to sun and light

Summary for Colazal

Prescription only

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.