Question

I am a breastfeeding mother and i want to know if it is safe to use Balsalazide? Is Balsalazide safe for nursing mother and child? Does Balsalazide extracts into breast milk? Does Balsalazide has any long term or short term side effects on infants? Can Balsalazide influence milk supply or can Balsalazide decrease milk supply in lactating mothers?

Balsalazide lactation summary

Balsalazide is safe in breastfeeding
  • DrLact safety Score for Balsalazide is 1 out of 8 which is considered Safe as per our analyses.
  • A safety Score of 1 indicates that usage of Balsalazide is mostly safe during lactation for breastfed baby.
  • Our study of different scientific research also indicates that Balsalazide does not cause any serious side effects in breastfeeding mothers.
  • Most of scientific studies and research papers declaring usage of Balsalazide safe in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About Balsalazide usage in lactation

Prodrug of Mesalamine: medication compounded by Mesalazine and an inert transporter that is degraded by bacteria into Mesalazine (5-ASA) in the large intestine. It is badly absorbed by the intestine, serum levels are low with scant excretion into breast milk. No harm effects among breastfed infants from treated mothers have been reported, except for rare cases of diarrhea reported in the 80's with the use of Mesalazine compounds different to Balsalazide. In a review of 121 cases and 121 controls, the authors failed to observe those findings. (Moretti, 1989). Expert consensus supports the compatibility of Mesalazine and/or its prodrugs during breastfeeding.

Answer by DrLact: About Balsalazide usage in lactation

Although no information exists on the excretion of balsalazide into breastmilk, it is metabolized to the active drug mesalamine. A few cases of diarrhea have been reported in infants exposed to mesalamine, although the rate is not high. Most experts consider mesalamine derivatives to be safe during breastfeeding.[1][2][3][4] If balsalazide is required by the mother, it is not a reason to discontinue breastfeeding, but observe breastfed infants for diarrhea.

Balsalazide Side Effects in Breastfeeding

The active metabolite of balsalazide, mesalamine, was probably responsible for diarrhea in a 6-week-old whose diarrhea recurred 4 times after rechallenge of the mother 4 times during breastfeeding.[5] Diarrhea has also been reported anecdotally by some nursing mothers taking mesalamine,[6] but a small controlled study reported only in abstract form found no higher rate of diarrhea in the breastfed infants of mothers taking mesalamine than in control infants.[7]
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