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Azulfidine (Sulfasalazine)

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Do you suffer from arthritis or ulcerative colitis? In this case, you may be prescribed to take Sulfasalazine. However, like any other drug, it should be taken with care after you check the instructions and make sure it’s safe for you. Learn more about Sulfasalazine to enjoy health benefits and avoid unexpected side effects.

What is Azulfidine (Sulfasalazine)?

Sulfasalazine is the drug that is produced in the form of tablets for oral intake. Azulfidine is the brand name of the medicine. You can choose either an original drug or the generic. The main difference is in the cost of the drug. As for the content, it contains the same active ingredients. Take into account that generics may have form and dosage that is different from the one brand drug has.


Highlights for Sulfasalazine

  • Sulfasalazine should be used in cases you suffer from arthritis or ulcerative colitis.
  • Sulfasalazine is the drug that can be taken only orally.
  • Sulfasalazine is produced under the brand name and has the form of a generic that can be bought at a lower price.

Why is Azulfidine Prescribed to Patients?

Such diseases as rheumatoid/juvenile arthritis and ulcerative colitis manifest themselves in severe pain. What is Azulfidine used for? Sulfasalazine Azulfidine is a pain killer that not only helps relieve the pain symptom but also treats the inflammation. In most cases, this medicine is prescribed when the patient has already got treatment with other medications, but they weren’t effective. The action of Sulfasalazine Azulfidine is directed to remove swelling that is one of the must-have symptoms of any type of arthritis. Patients who suffer from mild stomachache will benefit from the use of Azulfidine Sulfasalazine. Those who have severe pain can be prescribed some additional drugs that can be combined with Sulfasalazine.

Sulfasalazine Side Effects

Like any other drug, medicine Azulfidine may cause unwanted reactions. It isn’t a must that you will suffer from side effects when taking it, but you need to get acquainted with all the possible adverse reactions you may experience. Some side effects of Azulfidine Sulfasalazine are more common while others take place in rare cases, but they are more serious. Check what side effects the drug has to be well-informed and know what to expect after the intake of the medication.

More Common Side Effects

Don’t be surprised if you don’t want to eat when taking Sulfasalazine. Most patients claim that they have lost appetite during the period of treatment with Sulfasalazine medicine. In some cases, it’s connected with the feeling of nausea that may also appear when using Sulfasalazine. Headache and sometimes dizziness is also one of the common side effects that may appear for a short period of time and disappear without any special drug treatment. You may also notice that your body itches. It’s the allergic reaction of the body. Some men notice that the amount of sperm has decreased after they have started to use the medication. Don’t worry if this happens to you, as it’s just one of the side effects. After the treatment with Sulfasalazine Azulfidine is over, the sperm count will return to the norm. There is nothing to worry about when these effects show themselves in the mild form within several days. In case you notice that side effects have become more serious, don’t waste time and call your health care specialist who will recommend whether you need to continue taking the same dosage of the drug or not.

Serious Side Effects

The side effects from the list above don’t threaten your life compared to the possible serious effects below. Patients who notice at least one of the following adverse body reactions are strongly recommended to call the emergency services. If you have a high fever, the pale color of skin, spots of the unknown origin, or other skin problems, sore throat, sudden discomfort when urinating – call the doctor immediately.

You should take into account that it is impossible to predict what Azulfidine side effects you will experience as the reaction of the body is individual. The side effects listed here have appeared in patients, but it doesn’t mean you must have any of them at all; you may have a side effect that hasn’t been listed here.

What Other Drugs Will Affect Sulfasalazine?

It’s very important to check what medications Sulfasalazine interacts with before you start the course of treatment. Some interactions may have a negative effect on the action of the medication. It won’t show the desired effect at all, or it will take it longer to start working. Check how Sulfasalazine works in combination with the following drugs.

  • Folic acid. Sulfasalazine Azulfidine prevents Folic Acid from full absorption. The vitamin that is also known as B9 should be taken in the larger dosage if you take Sulfasalazine Azulfidine simultaneously with the vitamin supplement. However, you shouldn’t increase the dosage without the doctor’s consultation.
  • Heart drug. If your doctor has prescribed you to take heart drugs, make sure that they don’t interact with Sulfasalazine Azulfidine; otherwise, they may not be as effective. For example, such heart medication as digoxin shouldn’t be combined with Sulfasalazine Azulfidine. You’ll get the lower dosage of the heart drug as Sulfasalazine Azulfidine will influence the level of its absorption.
  • Disease-modifying antirheumatic drugs. Some of the drugs that refer to the category of disease-modifying antirheumatic drugs may intensify adverse reactions of the body when taking Sulfasalazine Azulfidine simultaneously. Most patients report that they have had nausea when taking Methotrexate together with Sulfasalazine Azulfidine.

The above-mentioned drugs are just examples of the medications that can interact with Sulfasalazine Azulfidine. The list of drugs can be longer. You’re strongly recommended to inform your doctor if you take some other drugs simultaneously with Sulfasalazine to avoid any unexpected and life-threatening side effects. Your pharmacist will make a decision whether you need to continue taking the drug, or it’s possible to take Sulfasalazine Azulfidine after you finish the treatment course with some other medication.

How to Take Sulfasalazine?

“How should I take Sulfasalazine Azulfidine?” – It’s the question you need to ask your healthcare specialist as the dosage may vary. There are several factors that may affect the dosage regimen. The most important one is your current health condition. If it is severe, you may be prescribed to take a larger dosage. You should inform the doctor about all the health problems you have as you may need to decrease or increase the dosage mentioned in the general instructions. Pay attention to the reaction of your body when you take the drug for the first time. Age is also important in making a decision on how much Sulfasalazine Azulfidine you should take.

Forms and strengths: Sulfasalazine generic drug is released in the form of an oral tablet 500 mg. Azulfidine is the brand name of the drug that has the same form of release (oral pill 500 mg).

Dosage for ulcerative colitis

The dosage of Sulfasalazine Azulfidine varies, depending on age.

  • 6-17. It’s necessary to calculate the dosage you need personally using the formula (40-60 mg/kg). Divide the daily dosage into several parts and take three times a day or in smaller dosages up to 5-6 times a day.
  • 18 and older. The dosage may vary from 1000 up to 4000 mg. If you have a stomach upset, start from the smallest dosage. The maximum dosage per day should be taken in parts. If you take Sulfasalazine Azulfidine to maintain the achieved result, you can be prescribed to take 2000 mg of Sulfasalazine Azulfidine dosage per day.

Dosage for rheumatoid arthritis

The medicine can be taken at the age of 18. If your doctor hasn’t prescribed another dosage, you should take a minimum of 500, a maximum of 1000 mg of Sulfasalazine Azulfidine daily. Don’t start with the large dosage of Azulfidine as you may suffer from stomachache.

Dosage for juvenile rheumatoid arthritis

Kids of 6 and older are prescribed medicine Azulfidine in the dosage 30-50 mg/kg a day. It’s obligatory to take Sulfasalazine Azulfidine twice a day. How should Azulfidine be taken? Divide the above-mentioned dosage in two and take in the morning and in the evening.

Take as directed

You should take into account that Sulfasalazine Azulfidine is the drug that doesn’t work fast. Some time is needed for the medicine to start working. You should follow the doctor’s instructions and take the drug as long as it’s necessary to treat your health condition. If it’s severe, then the period of treatment will be longer. Remember that you can’t stop taking the drug when you want; otherwise, you may experience adverse reactions.

Your condition may worsen significantly in case you decide to stop taking Sulfasalazine Azulfidine without professional consultation. One more thing to keep in mind: the guarantee of success is the intake of Sulfasalazine Azulfidine in the prescribed dosage. If you take it at different intervals and don’t follow the instructions, you are unlikely to enjoy health benefits. You will notice the desired positive effect from the intake of Sulfasalazine Azulfidine only if the prescribed amount of the medication is taken regularly. The principle of action is the following: your body accumulates a certain amount of Sulfasalazine Azulfidine to fight the cause of your current health condition.

“How will I know that the drug works for me?” – It’s as easy as ABC. You won’t suffer from the joint pain any longer, or it will become not as severe as it was before the intake of Azulfidine Sulfasalazine.

Important Considerations

Has your doctor told you that you need Azulfidine Sulfasalazine to get rid of your health problems? Then, you’re recommended to get acquainted with the following considerations.


  • You should divide the daily dosage and take it in parts.
  • The producer of the drug recommends taking Azulfidine Sulfasalazine when you have meals to avoid stomachache.
  • Azulfidine Sulfasalazine should be taken orally. Swallow the tablet without crushing it.


Make sure that you haven’t overdosed the drug. If you take a larger dosage, you risk having nausea, stomachache, and other unwanted effects. In case you take too much of the drug, you should go to an emergency room as large doses of Azulfidine are poisonous. Don’t waste time and go to the doctor immediately when you understand that you’ve taken a larger dosage.

Missed Dose

Many people take an extra dosage when they understand that they have missed the dosage. It’s possible to take it only if you remember the missing dose soon. If it’s almost the time for the next intake, you shouldn’t take the same dosage twice as it will lead to an overdose.


You should store the drug Sulfasalazine Azulfidine in the room, not in the refrigerator and places with a damp climate. The optimal temperature required for the storage of Sulfasalazine Azulfidine is 20-25 C.


You will receive many refills from your healthcare specialist who has prescribed you to take Sulfasalazine Azulfidine. This means that you won’t need to get a new prescription every time the drug is over, and you need a new portion.

Clinical monitoring

Clinical monitoring is a must to make sure that the drug has a positive effect on your body. In the process of Sulfasalazine Azulfidine treatment, you will have to go to the hospital from time to time and have the standard blood test. You should take into account that the treatment with Sulfasalazine Azulfidine supposes many blood tests at the beginning due to the risk of infection caused by the medicine. Besides blood tests, you should be ready to test how your liver works as the drug may have a negative effect on this organ. Do you have problems with kidneys? Then, you should tell your doctor about this, and he/she will make a kidney test to prevent possible side effects the drug may cause.

Your diet

You can continue eating the same foods as you did. The only thing to take into account is that Sulfasalazine Azulfidine influences the absorption of folic acid. That’s why you are recommended to ask the doctor whether you need to take an extra dosage of folic acid.

Sun sensitivity

Forget about sunbathing and tan for the period of treatment with Sulfasalazine Azulfidine. The drug may influence your skin health as it becomes more sensitive to the sun. If you take the medication during the summer season, you are recommended to use some creams with UV-protection.

Important Warnings

Check important warnings to avoid any serious side effects as some of them can be fatal (lead to death).

Is Sulfasalazine safe to use during pregnancy or while breastfeeding?

There is no sufficient information on whether the medicine Sulfasalazine Azulfidine is poisonous to pregnant and breastfeeding moms or not. That’s why pregnant women should take it only if the doctor has prescribed them to take the drug. It’s necessary to inform the doctor about your pregnancy before you start the course of treatment. Despite the fact that there is no information that Sulfasalazine Azulfidine can harm the fetus, doctors prescribe it only if there is no other way to help the future mom get rid of the pain and inflammation. If a woman is prescribed to take the drug, she must know about the negative effect of Sulfasalazine Azulfidine on the absorption of folic acid. Women who are waiting for the baby should take a larger dosage of this vitamin as it’s vital for the unborn baby.

Are you breastfeeding and want to take Sulfasalazine Azulfidine? You should know that the baby will get the dosage of the medicine together with milk. That’s why you shouldn’t take the drug without the doctor’s prescription. Otherwise, your baby will suffer from side effects that aren’t fatal but still serious and not completely safe for the baby.

Allergy warning

It is essential to inform the doctor about any allergic reactions you have ever had when you were taking drugs that contain the same active ingredient as Sulfasalazine Azulfidine. You should take the possibility of an allergic reaction seriously as it may become the reason for death. What to do if you don’t know for sure whether you have an allergy to sulfa drugs or not? To be on the safe side, take the small dosage, and watch the body reaction. If you notice that it’s hard to take a breath or you have a sore throat, you need to call the emergency services immediately.

Warnings for people with certain health conditions

  • Patients with asthma.
  • Patients with porphyria.

Warnings refer to people of the groups mentioned above. If patients suffering from the mentioned conditions use Sulfasalazine Azulfidine, they risk suffering from unwanted adverse body reactions, and their condition will worsen.

Warnings for other groups

Kids under 6 shouldn’t take Sulfasalazine Azulfidine as there is no information on how the drug works for this group of patients. Take it according to the instructions where it is written that only kids older than 6 can be prescribed the drug.


Sulfasalazine Oral Tablets 500 mg Azulfidine®, (scored) Pfizer Tablets, delayed- 500 mg Azulfidine® EN-tabs®, release (enteric- Pfizer coated), film-coated

Dosage forms of Sulfasalazine:
Sulfasalazine powder Pms-Sulfasalazine 500 mg Tablet Sulfasalazine 500 mg tablet Sulfazine 500 mg tablet
Salazopyrin 500 mg Tablet Pms-Sulfasalazine 500 mg Enteric-Coated Tablet Sulfasalazine 500 mg Enteric Coated Tabs Salazopyrin En-Tabs 500 mg Enteric-Coated Tablet
Azulfidine 500 mg tablet Azulfidine entab 500 mg Azulfidine EN-tabs 500 mg Enteric Coated Tabs  

Synonyms of Sulfasalazine:

Sulfasalazin, Sulphasalazine

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Therapeutic classes of Sulfasalazine:

Anti-Infective Agents, Antirheumatic Agents, Gastrointestinal Agents, Sulfonamides


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