Lialda vs Colazal

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For patients with conditions like ulcerative colitis, certain drugs that alter the inflammation levels in the colon can help manage symptoms and improve quality of life. Lialda and Colazal are two such medications commonly prescribed for this chronic disease. Both operate by reducing inflammation in the intestines, but their mechanisms differ slightly.

Lialda (mesalamine) works topically on the lining of the intestine to decrease swelling and irritation associated with flare-ups from ulcerative colitis. It is a delayed-release tablet intended to directly target and treat inflamed areas within your digestive tract.

On another hand, Colazal (balsalazide) also acts as an anti-inflammatory agent specifically for treating mild-to-moderate active ulcerative colitis. However, once ingested, balsalazide is broken down into its active ingredient mesalamine along with an inert chemical compound inside your body.

While both have similar goals - reducing intestinal inflammation - their method of delivering treatment varies; thus patient response may differ based on individual factors.

What is Lialda?

Mesalamine, the generic name for Lialda, is a type of anti-inflammatory drug specifically used to treat ulcerative colitis. It was first approved by the FDA in 2007 and works by reducing inflammation in the colon, helping control symptoms of ulcerative colitis such as diarrhea, rectal bleeding and stomach pain. Unlike other drugs that may affect the entire body systemically, mesalamine acts locally within your gut – this means it's directly delivered to where its action is needed most.

On the other hand, Balsalazide disodium (Colazal) is also an anti-inflammatory medication used for treating ulcerative colitis but with slight differences from Mesalamine. Approved by FDA in 2000 earlier than Lialda, Colazal works similarly by reducing inflammation in the intestines but it goes through a metabolic process where it breaks down into two substances: mesalamine and a carrier molecule after reaching your colon.

Both drugs assist patients with their inflammatory bowel diseases; however they differ slightly in their method of delivery and metabolization. Side effects can vary between these two medicines so consultation with healthcare professional before starting treatment would be advisable.

What conditions is Lialda approved to treat?

Lialda and Colazal are both approved for the treatment of different forms of ulcerative colitis:

  • Lialda is used to induce remission in patients with active, mild to moderate ulcerative colitis
  • Colazal is utilized to treat mild to moderately active ulcerative colitis as well as maintaining remission once achieved.

How does Lialda help with these illnesses?

Lialda helps manage ulcerative colitis by releasing mesalamine in the colon, where it decreases inflammation. It does this by inhibiting the production of inflammatory chemicals in the lining of the colon, which results in reduced swelling and less discomfort or pain for patients. Mesalamine is an aminosalicylate anti-inflammatory drug that acts locally in specific regions within your digestive system to decrease inflammation at those sites. This targeted action minimizes systemic absorption and reduces potential side effects compared to other drugs used for this condition. Therefore, by reducing inflammation with Lialda, individuals can control their symptoms more effectively and potentially extend periods between flare-ups of ulcerative colitis.

What is Colazal?

Colazal, also known as Balsalazide, is a prodrug that delivers mesalazine (5-aminosalicylic acid) to the colon for the treatment of ulcerative colitis. This medication forms part of a class of drugs called anti-inflammatory agents and works by reducing bowel inflammation, diarrhea, rectal bleeding and stomach pain. The FDA approved this drug in 2000. Unlike Lialda which is an extended-release tablet designed to deliver medication throughout the day with just one dose, Colazal must be taken multiple times daily but it has its own advantages over other similar medications since it directly targets inflamed tissue in the colon thereby limiting side effects elsewhere in your body. Its minimal systemic absorption means there may be less risk of certain adverse reactions compared to some other treatments such as corticosteroids or immunosuppressives. Common side effects include headache and abdominal pain however these are typically mild and transient.

What conditions is Colazal approved to treat?

Colazal has been approved by the FDA for the treatment of:

  • Mild to moderate ulcerative colitis, which is an inflammatory bowel disease that can cause long-lasting inflammation and ulcers in your digestive tract.
  • Maintenance of remission (the state where symptoms disappear) in patients with ulcerative colitis. It helps reduce symptoms like abdominal pain, diarrhea, and rectal bleeding caused by inflammation/swelling of the colon/rectum.

How does Colazal help with these illnesses?

Colazal, like Lialda, is an anti-inflammatory medication used to treat ulcerative colitis, a chronic condition characterized by inflammation and sores in the colon. Colazal works by reducing inflammation at the site of active disease in the colon and rectum. This can help alleviate symptoms such as diarrhea, bleeding and abdominal pain associated with this condition. Unlike Lialda which releases throughout the entire digestive tract once consumed, Colazal tends to target specifically the lower part of the gastrointestinal tract where it's needed most. Therefore, for patients who have not responded well to other 5-aminosalicylic acid medications or those whose inflammation is concentrated towards end parts of their bowel system might find a better response from treatment using Colazal.

How effective are both Lialda and Colazal?

Both mesalamine (Lialda) and balsalazide (Colazal) have proven histories of efficacy in treating patients with ulcerative colitis, a form of inflammatory bowel disease. They were initially approved by the FDA within a few years apart. Since they act on different parts of the colon due to varying delivery methods, these drugs may be prescribed under different circumstances.

The effectiveness of Lialda and Colazal in managing ulcerative colitis was directly studied in various clinical trials; both drugs exhibited similar efficacy in reducing inflammation and managing symptoms as well as having comparable safety profiles. None of the metrics used to measure their effectiveness at mitigating the symptoms differed significantly between patients receiving Lialda or Colazal.

A 2007 meta-analysis confirmed that mesalamine is effective at inducing remission from active ulcerative colitis starting from early stages of treatment, its side effect profile is generally favorable compared to other medications for this condition, and it’s well-tolerated even over long periods. Mesalamine has become one of the most widely prescribed drugs for mild-to-moderate ulcerative colitis due to its consistent results across studies.

A 2010 review indicated that balsalazide seems similarly effective when compared with other standard treatments for active ulcerative colitis including other types of aminosalicylates like mesalamine. Nonetheless, choice between balsalazide or another drug often depends more on patient preference regarding dosage forms rather than differences in therapeutic effects among these medicines. Due to its unique formulation which allows targeted delivery to specific areas within the large intestine, balsalazide could be an optimal treatment for patients who did not respond well to alternatives or those requiring precise medication delivery.

abstract image of a researcher studying a bottle of drug.

At what dose is Lialda typically prescribed?

Oral dosages of Lialda range from 2.4-4.8g/day, typically taken once daily for the treatment of ulcerative colitis in adults. For children and adolescents, the dosage should be determined by a healthcare provider based on individual health needs and responses to therapy. If there is no response or symptom improvement after several weeks, your doctor may consider adjusting the dosage or switching medications. The maximum recommended dose is 4.8g/day; exceeding this could potentially lead to adverse effects.

At what dose is Colazal typically prescribed?

Colazal treatment typically begins at a dosage of 750 mg (one capsule) taken three times per day. The dose can then be increased up to nine capsules daily, divided into three doses and spaced out evenly throughout the day. This maximum dosage may be tested if there is no response to initial treatment after several weeks. Regular follow-up with your healthcare provider is essential for monitoring the efficacy of Colazal in managing symptoms and preventing complications associated with inflammatory bowel disease such as ulcerative colitis.

What are the most common side effects for Lialda?

Common side effects of Lialda and Colazal include:

  • Headache
  • Abdominal pain, bloating and discomfort
  • Diarrhea or constipation
  • Nausea, sometimes accompanied by vomiting
  • Fatigue (general weakness)
  • Dizziness
  • Fever
  • Rash or itching skin
  • Joint or muscle pain
    These medications can also cause more severe reactions such as pancreatitis, liver problems, kidney disorders and blood abnormalities. If any unusual symptoms occur while taking these drugs, it's essential to seek medical attention promptly.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Lialda?

While Lialda and Colazal are both used to treat ulcerative colitis, they can have different side effects. With Lialda, you might experience:

  • Allergic reactions: rash, itching or swelling (especially of the face/tongue/throat), severe dizziness or difficulty breathing.
  • Changes in your heart's rhythm such as a fast heartbeat or irregular pulse could signal more serious conditions.
  • Symptoms of kidney problems including change in the amount of urine produced, swelling ankles/feet, unusual tiredness or sudden weight gain.
  • Pancreatitis symptoms: severe abdominal pain that may spread to your back with nausea/vomiting
  • Liver disease symptoms: dark urine, persistent nausea/vomiting/loss of appetite; stomach/abdominal pain; yellowing eyes/skin.

In contrast with Colazal you might notice some different issues such as:

  • Signs of an allergic reaction like skin rash or hives; wheezing; tightness in the chest or throat.
  • Abnormal bleeding – nosebleeds, bleeding gums. -Severe diarrhea -Chest pain

If any adverse effects occur while taking either medication speak immediately with your healthcare provider for advice.

What are the most common side effects for Colazal?

While taking Colazal, you might notice some side effects that can include:

  • Headache
  • Abdominal pain or discomfort
  • Diarrhea
  • Nausea and vomiting
  • Respiratory infection symptoms such as a stuffy nose or sore throat
  • Dizziness or fatigue
  • Rash and other types of skin reactions
  • Joint or muscle pain.

It's important to know these potential side effects, but remember that not everyone experiences them, and they're often manageable with the correct approach. Always discuss any concerns with your healthcare provider.

Are there any potential serious side effects for Colazal?

Colazal, like all medications, can potentially cause side effects. While many of these are mild and manageable, there are some serious adverse reactions that require immediate medical attention. Be watchful for indications such as:

  • Severe nausea or vomiting
  • Abdominal cramps or bloating
  • Unusual bleeding or bruising
  • Yellowing eyes/skin (a sign of liver problems)
  • Dark urine
  • Persistent diarrhea
  • Sudden dizziness/fainting

In the event that you experience any of these symptoms after taking Colazal, it is crucial to seek medical help immediately. It's also important to note that while rare, a serious allergic reaction to this drug could occur. This might be indicated by rash, itching/swelling (especially in the face/tongue/throat), severe dizziness and difficulty breathing.

Contraindications for Lialda and Colazal?

Both Lialda and Colazal, along with most other ulcerative colitis medications, may cause worsening symptoms in some patients. If you notice your condition deteriorating or if you experience severe side effects such as bloody diarrhea, stomach cramps, fever, or sudden weight loss after starting these drugs, please seek immediate medical attention.

Neither Lialda nor Colazal should be taken if you are taking or have recently taken certain types of medicines like nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, warfarin or clopidogrel. Always inform your physician about the medications you are on; NSAIDs and blood thinners might need to be stopped for a period before beginning treatment with Lialda and Colazal to prevent dangerous interactions.

Moreover, it's crucial to mention any history of kidney disease to your doctor before starting these medications as they can affect renal function.

How much do Lialda and Colazal cost?

For the brand name versions of these drugs:

  • The price of 120 tablets of Lialda (1.2 g) averages around $1,200, which works out to approximately $20–40/day, depending on your dose.
  • The price of 100 capsules of Colazal (750 mg) is about $500, working out to roughly $15/day.

Thus, if you are in the higher dosage range for Lialda (i.e., 4.8 g/day), then brand-name Colazal is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.

For the generic versions:

  • Mesalamine DR (Lialda's active drug component; 1.2 g tablets) can be found in packs upwards from 30 tablets and above with approximate costs ranging from $3 to $10 per day based on typical dosages between 2.4 and 4.8 grams per day.
  • Balsalazide disodium - available as capsules or granules - is Colazal's generic counterpart and comes at an average retail cost starting from about $0.80 up to around $5 per day depending upon whether doses vary between one gram three times daily up towards four grams three times daily.

Remember that prices may also depend on insurance coverage and specific pharmacy pricing agreements.

Popularity of Lialda and Colazal

Mesalamine, sold under brand names such as Lialda, is a top-line medication for treating mild to moderate ulcerative colitis. It was estimated that about 600,000 prescriptions were filled in the United States in 2020, making it a commonly used medication for this condition. Mesalamine has been relatively stable in usage over recent years.

On the other hand, balsalazide disodium or Colazal is another drug often prescribed for similar conditions and symptoms. In the year 2020, approximately 100,000 prescriptions were written for Colazal across the United States - significantly fewer than those of Lialda but still indicating its utility as an effective treatment option. The number of prescriptions for Colazal has remained steady over time.

Both medications fall into a class known as anti-inflammatory drugs and are key players when it comes to managing flare-ups and maintaining remission in patients with inflammatory bowel diseases like ulcerative colitis. Choosing between them often depends on each patient’s specific condition and response to therapy.


Both Lialda (mesalamine) and Colazal (balsalazide) have long-standing records of usage in patients with inflammatory bowel disease, specifically ulcerative colitis, and are backed by numerous clinical studies suggesting they are more effective than placebo treatments. In some cases, these drugs may be combined or used sequentially depending on the severity of the condition and patient response. Due to their different mechanisms of action—with Lialda releasing mesalamine throughout the colon whereas Colazal targets delivery to the end part of the colon—they tend to be prescribed under different circumstances.

Lialda is often considered as a first-line treatment option for maintaining remission in mild-to-moderate ulcerative colitis due to its convenient once-daily dosing schedule. On the other hand, Colazal might usually be considered as an alternative therapy in patients who did not respond well to initial treatments or those who need localised drug delivery.

Both drugs are available in generic form, offering substantial savings especially for out-of-pocket paying patients. Both Lialda and Colazal may require an adjustment period—meaning that effects may not be noticeable right away.

The side effect profile is similar between both medications; they're generally well-tolerated but can cause headache, abdominal pain, nausea or diarrhoea. Patients must closely monitor their symptoms when starting treatment and should seek medical help immediately if they notice worsening abdominal pains or bloody stools.