• Ulcerative colitis (when patients cannot tolerate sulfasalazine).

Contraindicated in:

• Hypersensitivity reaction to salicylates
• Cross-sensitivity with furosemide, sulfonylureas, or carbonic anhydrase inhibitors may exist
• Glucose-6–phosphate dehydrogenase (G6PD) deficiency
• Urinary tract or intestinal obstruction
• Porphyria
• Lactation: Lactation.

Use Cautiously in:

• Severe hepatic or renal impairment
• Renal impairment (↑ risk of renal tubular damage)
• OB: Safety not established in pregnancy
• Pedi: Children <2 yr (safety and effectiveness not established)
• Geri: ↑ risk of blood dyscrasias (agranulocytosis, neutropenia, pancytopenia) in older adults. Consider ↓ hepatic/renal/cardiac function, concomitant illnesses, and drug therapies.

Derm: ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS (AGEP), DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), itching, photosensitivity, rash, STEVENS-JOHNSON SYNDROME (SJS), TOXIC EPIDERMAL NECROLYSIS (TEN).

GI: diarrhea, abdominal pain, anorexia, exacerbation of colitis, HEPATOTOXICITY, nausea, vomiting.

GU: interstitial nephritis, nephrolithiasis, renal impairment.

Hemat: blood dyscrasias.

Neuro: ataxia, confusion, depression, dizziness, drowsiness, headache, psychosis, restlessness.
Misc: acute intolerance syndrome, hypersensitivity reactions.

Drug-Drug:

• ↑ risk of bleeding after neuraxial anesthesia with low molecular weight heparins and heparin; discontinue olsalazine before initiation of therapy or monitor closely if discontinuation not possible.
• May ↑ levels of and risk of bleeding from warfarin; closely monitor INR.
• May ↑ myelosuppressive effects of mercaptopurine or azathioprine; avoid concurrent use, if possible.
• Concurrent use with NSAIDs may ↑ risk of nephrotoxicity.
• ↑ risk of developing Reye's syndrome; avoid olsalazine during 6 wk after varicella vaccine.

• Capsules: 250 mg;

• PO (Adults): 500 mg twice daily.

Dipentum

• Locally acting anti-inflammatory action in the colon, where activity is probably due to inhibition of prostaglandin synthesis.

• Reduction in the symptoms of inflammatory bowel disease.

Therapeutic Classification: gastrointestinal anti-inflammatories

Absorption: Acts locally in colon, where 98–99% is converted to mesalamine (5-aminosalicylic acid).

Distribution: Action is primarily local and remains in the colon.

Metabolism/Excretion: 2% absorbed into systemic circulation is rapidly metabolized; mostly eliminated as mesalamine in the feces.

Half-life: 0.9 hr.

(plasma concentrations)

• Instruct patient to take medication as directed, even if feeling better. Take missed doses as soon as remembered unless almost time for next dose.
• May cause dizziness. Caution patient to avoid driving or other activities that require alertness until response to medication is known.
• Advise patient to notify health care professional if skin rash, sore throat, fever, mouth sores, unusual bleeding or bruising, wheezing, fever, or hives occurs.
• Advise patient to avoid sun exposure, wear sunscreen and protective clothing to minimize risk of photosensitivity reactions.
• Instruct patient to notify healthcare professional if symptoms do not improve after 1–2 mo of therapy.
• Instruct patient to notify healthcare professional if symptoms worsen or do not improve. If symptoms of acute intolerance (cramping, acute abdominal pain, bloody diarrhea, fever, headache, rash) occur, discontinue therapy and notify health care professional immediately.
• May cause fetal harm. Advise females of reproductive potential to use effective contraception and to notify healthcare professional if pregnancy is planned or suspected and to avoid breastfeeding during therapy. Monitor breast-fed infants for diarrhea.
• Inform patient that proctoscopy and sigmoidoscopy may be required periodically during treatment to determine response.

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