Olsalazine Side Effects
Brand Names: Dipentum
Please note - some side effects for Olsalazine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
Side Effects of Olsalazine - for the Consumer
Olsalazine
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Olsalazine:
Seek medical attention right away if any of these SEVERE side effects occur when using Olsalazine:Diarrhea; joint pain; nausea; stomach pain or cramps.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); change in the amount of urine; chest pain; dark urine; fast or irregular heartbeat; pale stools; severe stomach pain; trouble urinating; unusual bruising or bleeding; yellowing of the eyes or skin.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
TopSide Effects by Body System - for Healthcare Professionals
General
During clinical trials, olsalazine was discontinued due to side effects in 10.4% of patients compared to 6.7% of patients receiving placebo. The side effects leading to treatment withdrawal included diarrhea/loose stools (5.9%), abdominal pain (1.1%), and rash/itching (1.1%). Side effects leading to olsalazine withdrawal in less than 1% of patients included nausea, headache, heartburn, rectal bleeding, insomnia, dizziness, anorexia, lightheadedness, and depression.
Gastrointestinal
Gastrointestinal side effects have included diarrhea (11.1% to 17%), abdominal pain/cramps (10.1%), nausea (5%), dyspepsia (4.0%), bloating (1.5%), vomiting (1%), and stomatitis (1.0%). Heartburn, upper abdominal pain, diarrhea with dehydration, dry mouth, epigastric discomfort, flare in symptoms, flatulence, pancreatitis, increased blood in stool, rectal bleeding, and rectal discomfort have been reported.
Diarrhea may be minimized by initiating therapy with lower doses and gradually increasing therapy as tolerated. Administration of smaller doses more frequently may also minimize diarrhea. Diarrhea induced by olsalazine differs from diarrhea due to colitis because of the absence of blood.
Nervous system
Nervous system side effects have included headache (5%), vertigo/dizziness (1%), lightheadedness, insomnia, tinnitus, paresthesia, and tremors. Paresthesia and peripheral neuropathy have been reported during postmarketing experience of products containing or metabolized to mesalamine.
Cardiovascular
Cardiovascular side effects have included chest pains, second degree heart block, myocarditis, palpitations, pericarditis, peripheral edema, shortness of breath, tachycardia, hypertension, and orthostatic hypotension.
A patient who developed thyroid disease 9 days after starting olsalazine was given propranolol and radioactive iodine and subsequently developed shortness of breath and nausea. Five days later, the patient died with signs and symptoms of acute diffuse myocarditis.
Musculoskeletal
Musculoskeletal side effects have included arthralgia/joint pain (4%), muscle cramps, muscle stiffness, and weakness. Myalgia has been reported during postmarketing experience of products containing or metabolized to mesalamine.
Dermatologic
Dermatologic side effects have included rash (2.3%), itching (1.3%), alopecia, erythema, and photosensitivity reaction. Angioneurotic edema has been reported during postmarketing experience of products containing or metabolized to mesalamine.
Other
Other side effects have included fatigue/drowsiness/lethargy (1.8%), fever chills, hot flashes, irritability, and rigors. Pyrexia has been reported during postmarketing experience of products containing or metabolized to mesalamine.
Respiratory
Respiratory side effects have included upper respiratory infection (1.5%). Dyspnea and interstitial lung disease have been reported during postmarketing experience of products containing or metabolized to mesalamine.
Hepatic
Cholestatic hepatitis has been reported in one patient. Olsalazine was confirmed as the causative agent by rechallenge. Liver function abnormalities returned to normal within 2 to 8 weeks after discontinuation of the drug.
Hepatic side effects have included granulomatous hepatitis (rare), nonspecific reactive hepatitis (rare), elevated ALT (SGPT) and AST (SGOT), and at least one case of cholestatic hepatitis. Increased hepatic enzymes, increased bilirubin, hepatitis, reports of hepatotoxicity, including elevated liver function tests (SGOT/AST, SGPT/ALT, GGT, LDH, alkaline phosphatase, bilirubin), jaundice, cholestatic jaundice, cirrhosis, and possible hepatocellular damage including liver necrosis and liver failure have been reported during postmarketing experience of products containing or metabolized to mesalamine. Some of these cases were fatal. At least one case of Kawasaki-like syndrome, which included hepatic function changes, was also reported during postmarketing experience of products containing or metabolized to mesalamine.
Hematologic
Hematologic side effects have included anemia, hemolysis, thrombocytopenia, eosinophilia, hemolytic anemia, interstitial pulmonary disease, leukopenia, lymphopenia, neutropenia, and reticulocytosis. Aplastic anemia and pancytopenia have been reported during postmarketing experience of products containing or metabolized to mesalamine.
Renal
Renal side effects have included nephrotic syndrome. Renal toxicity, elevated BUN, and elevated creatinine have been reported with mesalamine.
Renal toxicity findings due to mesalamine have been similar to NSAID-induced renal disease, and included proteinuria, elevated BUN and creatinine, oliguria, polyuria, polydipsia, and rarely ocular symptoms.
Immunologic
Immunologic side effects have included bronchospasm and erythema nodosum.
Genitourinary
Renal toxicity findings due to mesalamine have been similar to NSAID-induced renal disease, and included proteinuria, elevated BUN and creatinine, oliguria, polyuria, polydipsia, and rarely ocular symptoms.
A 71-year-old man who had received olsalazine 250 mg orally two times a day for 8 months for treatment of colitis developed fever and transient blindness in the left eye. Percutaneous renal biopsy revealed severe interstitial nephritis. After discontinuation of the olsalazine, the fever and blindness resolved.
Genitourinary side effects have included dysuria, hematuria, interstitial nephritis, proteinuria, urinary frequency, impotence, and menorrhagia. Oliguria and polyuria have been reported with mesalamine. Interstitial nephritis has been reported during postmarketing experience of products containing or metabolized to mesalamine.
Psychiatric
Psychiatric side effects have included depression (1.5%) and mood swings.
Metabolic
Metabolic side effects have included anorexia (1.3%). Polydipsia has been reported with mesalamine.
Ocular
A case of blurred vision resolved with olsalazine discontinuation and recurred on rechallenge.
Ocular side effects have included dry eyes, blurred vision, watery eyes, and transient blindness. Ocular symptoms have been reported with mesalamine.
Hypersensitivity
Hypersensitivity side effects have included cross-reactivity to sulfasalazine.
Many patients who are allergic to or intolerant of sulfasalazine are able to tolerate olsalazine, although some cross-reactivity has been reported.
TopMore Olsalazine resources
- olsalazine Concise Consumer Information (Cerner Multum)
- olsalazine Advanced Consumer (Micromedex) - Includes Dosage Information
- Olsalazine MedFacts Consumer Leaflet (Wolters Kluwer)
- Dipentum Prescribing Information (FDA)
- Dipentum Monograph (AHFS DI)
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