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Aminosalicylates (5-ASAs)

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By Editorial Team

2 min read

Reviewed by: HU Medical Review Board | Last reviewed: January 2025 | Last updated: January 2025

Inflammatory bowel disease (IBD) is a group of long-term (chronic) health conditions that include Crohn’s disease and ulcerative colitis (UC). There is currently no cure for IBD. But there are drugs that help manage inflammation in the intestines, which causes Crohn’s and UC symptoms.1

One group of drugs sometimes prescribed for IBD are aminosalicylates. These IBD drugs may:1

  • Help treat and manage IBD symptoms during flares
  • Help increase the time between flares or keep the disease in remission
  • Improve quality of life

How do aminosalicylates (5-ASAs) work?

Aminosalicylates are a group of drugs called anti-inflammatories. These drugs reduce inflammation in the lining of the digestive tract. They may be used for people with mild-to-moderate UC and sometimes Crohn’s disease. When given for Crohn’s disease, aminosalicylates may be paired with other types of drugs.1,2

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Because aminosalicylates contain a chemical compound called 5-aminosalicylic acid (5-ASA), you may also see these drugs called 5-ASAs.2

Aminosalicylates come in several forms, including pills, enemas, and suppositories. The
type prescribed depends on many factors, such as the part of your digestive tract that is
inflamed.1

Examples of aminosalicylates

Aminosalicylates used to treat people with ulcerative colitis and Crohn’s disease include:2,3

  • Sulfasalazine (Azulfidine®, Azulfidine-EN®)
  • Mesalamine (Apriso®, Asacol®, Asacol HD®, Canasa®, Delzicol™, Lialda™, Pentasa®, Rowasa®)
  • Balsalazide (Colazal®)
  • Olsalazine (Dipentum®)

What are the possible side effects?

Side effects can vary depending on the specific 5-ASA you are taking. However, common side effects for all drugs in this group include:2

  • Headache
  • Nausea and vomiting
  • Diarrhea
  • Abdominal pain and cramping
  • Loss of appetite
  • Rash
  • Fever

These are not all the possible side effects of 5-ASAs. Talk to your doctor about what to expect when taking a 5-ASA. You also should call your doctor if you have any changes that concern you when taking a 5-ASA.

Other things to know

Aminosalicylates should be taken with caution by people with kidney disease. All people taking these drugs should receive regular kidney function tests.2

Sulfasalazine may decrease sperm count in some men, but sperm count returns to normal after stopping the drug.2

Aminosalicylates are thought to be safe for people who are pregnant and breastfeeding. However, pregnant people should take a higher dose of folate every day if taking sulfasalazine specifically.2

Sulfasalazine should not be taken by people with a sulfa allergy.2

Before beginning treatment for Crohn’s disease or ulcerative colitis, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

Other drugs that may be prescribed for IBD include:1,3

  • Immunomodulators
  • Antibiotics
  • Corticosteroids