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Home > Drug Category > Disorders of the Digestive Tract (IBS,Crohns Disease,Stomach) > Azulfidine and Equivalent

Azulfidine Information

Azulfidine (sulfasalazine) is an anti-inflammatory medication used to treat various inflammatory conditions affecting the gastrointestinal tract and joints. It is primarily used to treat ulcerative colitis, an inflammatory disease that affects only the large bowel and causes abdominal pain, diarrhea, and other symptoms. Sulfasalazine is used alone or with other medications to calm the lining of the colon during an acute flare-up of ulcerative colitis and is often used long-term to maintain remission, helping to prevent further flare-ups.

Although not the first choice, it is sometimes prescribed for the treatment of Crohn's disease, another inflammatory bowel disease that can affect any part of the gastrointestinal tract from the mouth to the anus. Sulfasalazine is also used alone or in combination with other medications to treat rheumatoid arthritis, an autoimmune condition that affects the joints and causes inflammation, stiffness, and swelling. It is most commonly used when the symptoms are poorly controlled despite the use of nonsteroidal anti-inflammatory drugs or other salicylates.

Sulfasalazine is a compound consisting of sulfapyridine and 5-aminosalicylic acid (5-ASA) linked together. Historically classified as both a salicylate and a disease-modifying antirheumatic drug. It is a prodrug that remains intact mainly until reaching the gut. There, gut bacteria break it down, releasing its active components that suppress the immune system’s overactive inflammatory response. Specifically, 5-aminosalicylic acid provides local anti-inflammatory effects in the gastrointestinal tract for bowel conditions such as ulcerative colitis and Crohn's disease.

While it's unclear how this medication works in treating rheumatoid arthritis, its absorbed active components are believed to exert some anti-inflammatory effects on the joints, reducing swelling and stiffness. This effect helps prevent the long-term tissue damage and chronic pain characteristic of these autoimmune diseases. Studies show that sulfasalazine is an effective treatment option for rheumatoid arthritis, with many patients reporting significant improvement in their symptoms within 6 months of use.

Azulfidine Side Effects

Sulfasalazine is generally well tolerated with mostly minimal side effects, although it has the potential to cause some serious side effects. Common mild side effects include indigestion, heartburn, nausea, dizziness, headache, changes in taste, purple discoloration of the skin, increased sensitivity of the skin to sunlight, and ringing in the ears. Contact your doctor if these mild side effects persist or worsen.

Stop taking this medicine and contact your doctor immediately if you experience any serious side effects, including the following:
• Allergic reactions such as breathing difficulties, body itching, body rash, skin blistering, swelling of the face, mouth, tongue, lips, or throat;
• Easy bruising or bleeding;
• Kidney problems with symptoms like a significant change in how much you urinate, blood in urine;
• Liver problems with symptoms such as yellowing of the eyes (jaundice), dark urine, and abdominal pain;
• Lung problems with symptoms such as persistent cough, difficulty in breathing;
• Serum sickness with symptoms like fever, pain in your joints, hives, swollen glands, sore throat, rash, and itching;
• Severe skin rash, affecting the mouth and tongue

Inform your doctor about any other side effects you notice that are not listed here.

Azulfidine Precautions

Do not take this medication if you are allergic to sulfasalazine, other ingredients in Azulfidine, or any other medicines, especially sulfonamide-containing drugs. Before you start taking this medication, ensure that you inform your doctor about any prior or current medical conditions, including the following:
• Asthma;
• Blockage in the intestine or urinary tract;
• Blood disorders such as glucose-6-phosphate dehydrogenase (G-6-P) deficiency;
• Kidney disease;
• Liver disease;
• Porphyria;
• Recurrent infections, especially viral infections;
• Urinating difficulties

Your doctor may order routine tests before and during treatment to check for blood disorders (dangerous drops in blood cell counts) and liver or kidney stress. Ensure to keep up with the blood tests your doctor orders and follow-ups while taking this medication. Sulfasalazine is not recommended for use in children younger than two years because it can cause a specific type of brain damage called kernicterus in infants. Sulfasalazine may increase your skin's sensitivity to sunlight. Use sun protection and limit sun exposure during treatment.

While this medication can be safely taken during pregnancy or while breastfeeding, it is essential to consult your doctor before doing so. Your physician may prescribe folic acid supplements because sulfasalazine impairs folate absorption, putting you at a risk of anemia. Breastfeeding mothers are also advised to watch out for signs of adverse effects in their babies, such as diarrhea and vomiting. This medication can interfere with other common medicines like digoxin and warfarin (a blood thinner), potentially making them less effective or more dangerous. Therefore, before using this medication, inform your doctor about any other medications you are currently taking, including herbal medicines and supplements, to determine if it is safe to use along with sulfasalazine.

Azulfidine/Sulfasalazine is available in 500 mg tablets for oral use. It is generally recommended to take sulfasalazine with meals to prevent gastrointestinal side effects. Do not crush or chew the tablets. Swallow these tablets whole. Your physician will determine the appropriate dose of this medication for you based on your condition. Check out the leaflet in the medication pack for more usage details. Store at room temperature and keep away from children and pets.

Do I need a prescription to order Azulfidine?

Yes, a prescription is required from your physician to order Azulfidine.