Delzicol (Mesalamine) is a member of the aminosalycilate family of drugs commonly used to reduce inflammation and swelling. Delzicol is specifically targeted to reduce inflammation in the colon and colon to help alleviate symptoms of ulcerative colitis.

Delzicol is a specialized anti-inflammatory drug protected by a PH-sensitive outer shell that prevents the active ingredient 5-aminosalicylic acid (5-ASA) from being broken down and absorbed by the body in the upper GI. The drug’s enteric coating is specifically designed to break down at the PH level found in the terminal ileum (the last section of the small intestine), allowing the drug to deliver its full payload to the large intestine and colon cells.

Delzicol is most commonly prescribed to help reduce or eliminate the diarrhea, irritation, colon or rectal bleeding, and cramping symptoms often associated with ulcerative colitis and other GI disorders.

Precautions & Warnings

Delzicol is generally considered safe and the standard dose is well-tolerated by most adults and older pediatric patients. However, we will go through general information below about taking Delzicol. As always, if you have any questions about the medication, it is always best to reach out to your prescriber and discuss it with them.

Side Effects of Delzicol

Here are the most commonly reported side effects associated with using Delzicol.

Common Side Effects

These side effects occur most frequently, but are generally mild and resolve quickly. Consult your healthcare provider if you experience side effects that persist or worsen.

  • Headache
  • Sore joints
  • Muscle ache
  • Abdominal tenderness or discomfort
  • Nausea & Vomiting
  • Constipation
  • Diarrhea
  • Flatulence
Serious Side Effects

Serious side effects are rarely reported but should not be ignored. If you experience any of the following symptoms after taking Delzicol, contact your healthcare provider immediately.

  • Elevated temperature or fever (with no known cause)
  • Severe cramping
  • Bloody diarrhea
  • Skin rash (with no known cause)
  • Jaundice (a distinct yellow tint to eyes and skin)

Allergy or Hypersensitivity

If you have experienced an allergic reaction after taking a sulfasalazine drug or another medication conraining salicylates (Aspirin, Ibuprofen, etc.), no matter how mild, there is a risk that you may experience a serious allergic reaction to Delzicol.

This risk increases when taking Delzicol with other salicylate drugs. An adverse allergic reaction or hypersensitivity to Delzicol can lead to more serious health concerns like hepatitis, inflammation of the heart, inflamed kidneys, pneumonitis, or hematologic abnormalities. If symptoms of an adverse reaction are present contact a medical professional for evaluation immediately.

Reduced Kidney Function

Delzicol is metabolized by the kidneys and it can lead to potential nephrotoxicity. Patients should have their kidney values checked before starting a Delzicol regimen. Kidney values should be checked regularly for the duration of the time that the patient is taking Delzicol. Staying well hydrated while using Delzicol can help to reduce the insult to the kidneys.

Liver Damage

Liver failure has occurred in some patients with pre-existing liver disease or liver damage. Be sure to let your doctor know if there is a chance you may have liver damage or regularly consume more than 3 alcoholic beverages per week. Your doctor may want to evaluate your liver health before prescribing Delzicol.


Patients with existing atopic dermatitis, atopic eczema, or other inflammatory skin conditions have reported experiencing increased photosensitivity after taking Delzicol or Sulfasalazine. Let your doctor know if you suffer from a pre-existing skin condition. You will likely need to avoid sunlight, wear protective clothing when outdoors, and use a broad-spectrum sunscreen while taking Delzicol.

Drug Interactions With Delzicol

Certain medications can interact with the active ingredient in Delzicol resulting in unexpected, adverse side-effects. In some cases these interactions can pose a serious health risk. Be sure to inform your doctor of any medications that you will be taking while using Delzicol.

While these are the most commonly reported interactions, there may be others. Talk to your doctor about any concerns you might have and report any unusual symptoms immediately.

Delzicol is know to produce adverse reactions with the following common medications:

  • NSAIDs: NSAIDS like Ibuprofen, or Aleve NSAIDS can increase the risk of kidney injury when combined with Delzicol.
  • Azathioprine/6-MP: Combining Delzicol with Azathioprine/6-MP can create a rare but serious blood disorder
  • Blood Thinners: Delzicol may amplify the effects of blood thinners (such as Eliquis and Xarelto) increasing your risk of uncontrolled bleeding.

Delzicol: Strengths and Dosages

Delzicol is typically distributed in 400mg capsules. It is important to use Delzicol as prescribed by your healthcare provider as different conditions often require different dosing schedules.

The beneficial effects of Delzicol may not be felt immediately. The drug will need to travel through the system and reach the colon before starting work.

TreatmentDelayed-Release Capsule400 mgTake 2 capsules by mouth 3 times daily
Maintenance/RemissionDelayed-Release Capsule400 mgTake 2 capsules by mouth  2 times daily

Delzicol Administration Guidelines

  • Do not crush or chew Delzicol capsules. The capsule must remain intact for the drug to reach its proper target in the large intestine
  • Take Delzicol with food if possible to reduce potential gastric upset and aid absorption
  • Take Delzicol on a consistent schedule for optimal results
  • Always follow the dosing and administration guidelines provided by your physician as different uses may require different doses of Delsicol

Delzicol Alternatives

There is a generic alternative to the Delzicol brand, however it may not be a perfect replacement.

Mesalamine, the generic form of Delzicol, may be used in place of Delzicol in some cases however the dosing may differ slightly.

Asacol, another 5-ASA medication, has similar bioeqivalence to Delzicol and has been shown to have similar therapeutic effects. However Asocol is not available in a delayed-release capsule form which is an important aspect of Delzicol’s effect.

In cases where Delzicol and similar drugs are contraindicated, corticosteroids may be used instead. However, corticosteroids are often associated with more severe systemic adverse effects.

Delzicol and Delzicol HD should be guided by your specific condition, treatment goals, and medical advice.

Frequently Asked Questions With Delzicol

How does Delzicol compare to Asacol ?

Delzicol is a reformulation of Asacol. Both drugs are branded versions of the generic drug, mesalamine. However, Asocol & Asocol HD were removed from the market in 2013 due to the potentially harmful ingredient dibutyl phthalate (DBP).

A new version of Asocol HD returned to the market in 2016. Asocol HD is similar to Delzicol HD and your doctor may prescribe one or the other. There is no Asocol version of standard 400 mg Delzicol.

What is the difference between Delzicol and Delzicol HD?

While both Delzicol and Delzicol HD utilize the same active ingredient, mesalamine, the dosage strength of each unit differs.

Delzicol is distributed as a 400mg delayed-release capsule. Delzicol HD is an 800 mg delayed-release capsule. Your doctor may prescribe Delzicol HD if your condition requires that you take a higher dose of Delzicol. In some cases, Delzicol HD may offer some cost savings as you will need fewer capsules to achieve the same strength.

Can Delzicol be used to treat Crohn’s disease?

Mesalamine, the generic drug known as Delzicol, has shown success in a specific, limited group of patients suffering from Crohn’s disease. However, researchers have not been able to show a successful effect across the full-spectrum of Crohn’s patients.

What are the known side effects of using Delzicol?

Patients may experience headaches, nausea, vomiting, diarrhea, constipation, or increased gassiness when taking Delzicol. More serious side effects may include jaundice, rash, fever and bloody diarrhea. If you are experiencing serious side effects you should contact your doctor immediately.

Is there a generic alternative to Delzicol, and is it as effective?

A generic alternative to Delzicol may be available as mesalamine. Effectiveness is generally considered to be equivalent to the brand-name drug. However, mesalamine may not be widely available at every pharmacy and you may require a different dosage.

What factors affect Delzicol’s cost and is it covered by insurance?

The cost of Delzicol can be influenced by a large variety of factrrors pharmacy pricing and location, to supply chain bottlenecks and drug demand. Health insurance or a pharmacy discount plan may help to reduce the cost of Delzicol, making it accessible to most patients.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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