Details of the Drug

General Information of Drug (ID: DM7I1T9)

• Drug Name: Balsalazide
• Synonyms: Balsalazida; Balsalazida [Spanish]; Balsalazide Disodium; Balsalazide [INN:BAN]; Balsalazido; Balsalazido [Spanish]; Balsalazidum; Balsalazidum [Latin]; BX-661A; Colazide; BALSALAZIDE; P80AL8J7ZP; (E)-5-((4-(((2-Carboxyethyl)amino)carbonyl)phenyl)azo)-2-hydroxybenzoic acid; (E)-5-((4-((2-Carboxyethyl)carbamoyl)phenyl)diazenyl)-2-hydroxybenzoic acid; (E)-5-({p-[(2-carboxyethyl)carbamoyl]phenyl}azo)-2-salicylic acid; 80573-04-2; C17H15N3O6; CHEBI:267413; UNII-P80AL8J7ZP

Indication

Disease Entry	ICD 11	Status	REF
Inflammatory bowel disease	DD72	Approved	[1]

• #Ro5 Violations (Lipinski): 0:
  Molecular Weight (mw); 357.32
  Logarithm of the Partition Coefficient (xlogp); 2.2
  Rotatable Bond Count (rotbonds); 7
  Hydrogen Bond Donor Count (hbonddonor); 4
  Hydrogen Bond Acceptor Count (hbondacc); 8
• ADMET Property: Metabolism: The drug is metabolized via the bacterial azoreduction []
• Chemical Identifiers:
  Formula: C17H15N3O6
  IUPAC Name: 5-[[4-(2-carboxyethylcarbamoyl)phenyl]diazenyl]-2-hydroxybenzoic acid
  Canonical SMILES: C1=CC(=CC=C1C(=O)NCCC(=O)O)N=NC2=CC(=C(C=C2)O)C(=O)O
  InChI: IPOKCKJONYRRHP-UHFFFAOYSA-N
  InChIKey: 1S/C17H15N3O6/c21-14-6-5-12(9-13(14)17(25)26)20-19-11-3-1-10(2-4-11)16(24)18-8-7-15(22)23/h1-6,9,21H,7-8H2,(H,18,24)(H,22,23)(H,25,26)
• Cross-matching ID:
  PubChem CID: 54585
  ChEBI ID: CHEBI:267413
  CAS Number: 80573-04-2
  DrugBank ID: DB01014
  INTEDE ID: DR2414

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Prostaglandin G/H synthase 1 (COX-1)	TT8NGED	PGH1_HUMAN	Inhibitor	[2]

Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Azoreductase (azoR)	DEEHWOG	AZOR_ECOLI	Substrate	[3]
FMN-dependent NADH-azoreductase (azoR1)	DETQAEP	AZOR1_PSEAE	Substrate	[4], [5]

Molecular Expression Atlas of This Drug

• The Studied Disease: Inflammatory bowel disease
• ICD Disease Classification: DD72

Molecule Name	Molecule Type	Gene Name	p-value	Fold-Change	Z-score
Prostaglandin G/H synthase 1 (COX-1)	DTT	PTGS1	3.97E-03	0.16	0.43

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Balsalazide (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Remdesivir	DMBFZ6L	Moderate	Decreased renal excretion of Balsalazide caused by Remdesivir mediated nephrotoxicity.	1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019]	[6]
Glibenclamide	DM8JXPZ	Moderate	Increased risk of hypoglycemia by the combination of Balsalazide and Glibenclamide.	Acute diabete complication [5A2Y]	[7]
Glipizide	DMZA5PQ	Moderate	Increased risk of hypoglycemia by the combination of Balsalazide and Glipizide.	Acute diabete complication [5A2Y]	[7]
Inotersen	DMJ93CT	Major	Increased risk of nephrotoxicity by the combination of Balsalazide and Inotersen.	Amyloidosis [5D00]	[8]
Kanamycin	DM2DMPO	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Kanamycin.	Bacterial infection [1A00-1C4Z]	[9]
Streptomycin	DME1LQN	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Streptomycin.	Bacterial infection [1A00-1C4Z]	[9]
Etidronic acid	DM1XHYJ	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Etidronic acid.	Bone paget disease [FB85]	[10]
Iodipamide	DMXIQYS	Major	Increased risk of nephrotoxicity by the combination of Balsalazide and Iodipamide.	Cholelithiasis [DC11]	[11]
Methoxyflurane	DML0RAE	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Methoxyflurane.	Corneal disease [9A76-9A78]	[9]
177Lu-DOTATATE	DMT8GVU	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and 177Lu-DOTATATE.	Hepatitis virus infection [1E50-1E51]	[9]
Givosiran	DM5PFIJ	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Givosiran.	Inborn porphyrin/heme metabolism error [5C58]	[9]
Moxetumomab pasudotox	DMN63DZ	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Moxetumomab pasudotox.	Mature B-cell leukaemia [2A82]	[9]
Mercaptopurine	DMTM2IK	Moderate	Decreased metabolism of Balsalazide caused by Mercaptopurine mediated inhibition of non-CYP450 enzyme.	Mature B-cell lymphoma [2A85]	[12]
Exjade	DMHPRWG	Major	Increased risk of nephrotoxicity by the combination of Balsalazide and Exjade.	Mineral absorption/transport disorder [5C64]	[13]
Gallium nitrate	DMF9O6B	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Gallium nitrate.	Mineral excesses [5B91]	[9]
Temsirolimus	DMS104F	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Temsirolimus.	Renal cell carcinoma [2C90]	[9]
Colistimethate	DMZ9BMU	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Colistimethate.	Respiratory infection [CA07-CA4Z]	[9]
Salsalate	DM13P4C	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Salsalate.	Rheumatoid arthritis [FA20]	[9]
Telavancin	DM58VQX	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Telavancin.	Staphylococcal/streptococcal disease [1B5Y]	[9]
Tolbutamide	DM02AWV	Moderate	Increased risk of hypoglycemia by the combination of Balsalazide and Tolbutamide.	Type 2 diabetes mellitus [5A11]	[7]
Plazomicin	DMKMBES	Moderate	Increased risk of nephrotoxicity by the combination of Balsalazide and Plazomicin.	Urinary tract infection [GC08]	[9]

References

• [1] FDA Approved Drug Products from FDA Official Website. 2009. Application Number: (ANDA) 077806.
• [2] Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34.
• [3] Studies of two novel sulfasalazine analogs, ipsalazide and balsalazide. Dig Dis Sci. 1983 Jul;28(7):609-15.
• [4] Role of tyrosine 131 in the active site of paAzoR1, an azoreductase with specificity for the inflammatory bowel disease prodrug balsalazide. Acta Crystallogr Sect F Struct Biol Cryst Commun. 2010 Jan 1;66(Pt 1):2-7.
• [5] Arylamine N-acetyltransferases: from drug metabolism and pharmacogenetics to drug discovery. Br J Pharmacol. 2014 Jun;171(11):2705-25.
• [6] Cerner Multum, Inc. "Australian Product Information.".
• [7] Abad S, Moachon L, Blanche P, Bavoux F, Sicard D, Salmon-Ceron D "Possible interaction between glicazide, fluconazole and sulfamethoxazole resulting in severe hypoglycaemia." Br J Clin Pharmacol 52 (2001): 456-7. [PMID: 11678792]
• [8] Cerner Multum, Inc. "UK Summary of Product Characteristics.".
• [9] Novis BH, Korzets Z, Chen P, Bernheim J "Nephrotic syndrome after treatment with 5-aminosalicylic acid." Br Med J (Clin Res Ed) 296 (1988): 1442. [PMID: 3132281]
• [10] Chang JT, Green L, Beitz J "Renal failure with the use of zoledronic acid." N Engl J Med 349 (2003): 1676-9 discussion 1676-9. [PMID: 14573746]
• [11] Wong GT, Lee EY, Irwin MG. Contrast induced nephropathy in vascular surgery.?Br J Anaesth. 2016;117 Suppl 2:ii63-ii73. [PMID: 27566809]
• [12] Lewis LD, Benin A, Szumlanski CL, et al. "Olsalazine and 6-mercaptopurine-related bone marrow suppression: a possible drug-drug interaction." Clin Pharmacol Ther 62 (1997): 464-75. [PMID: 9357398]
• [13] Product Information. Exjade (deferasirox). Novartis Pharmaceuticals, East Hanover, NJ.