Azulfidine

Generic name: Sulfasalazine

What is Azulfidine?

Azulfidine, an anti-inflammatory medicine, is prescribed for the treatment of mild to moderate ulcerative colitis and as an added treatment in severe ulcerative colitis. This medication is also prescribed to decrease severe attacks of ulcerative colitis.

Azulfidine EN-tabs are prescribed for people with ulcerative colitis who cannot take the regular Azulfidine tablet because of symptoms of stomach and intestinal irritation such as nausea and vomiting when taking the first few doses of the drug, or for those in whom a reduction in dosage does not lessen the stomach or intestinal side effects. The EN-tabs are also prescribed for adults and children with rheumatoid arthritis who fail to get relief from salicylates (such as aspirin) or other nonsteroidal anti-inflammatory drugs (such as ibuprofen).

What is the most important information I should know about Azulfidine?

Although ulcerative colitis rarely disappears completely, the risk of recurrence can be substantially reduced by the continued use of this drug.

Who should not take Azulfidine?

If you are sensitive to or have ever had an allergic reaction to Azulfidine, salicylates (aspirin), or other sulfa drugs, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Unless you are directed to do so by your doctor, do not take Azulfidine if you have an intestinal or urinary obstruction or if you have porphyria (an inherited disorder involving the substance that gives color to the skin and iris of the eyes).

What should I tell my doctor before I take the first dose of Azulfidine?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Azulfidine. Also, talk to your doctor about your complete medical history, especially if you have kidney or liver damage or any blood disease.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Rheumatoid Arthritis

Adults: The usual dose of Azulfidine EN-tabs is 2 grams (g) a day, divided into smaller doses. Your doctor may have you start with a lower dose, then raise the dosage to 3 g after 12 weeks.

Children: The typical recommended daily dosage is 30 to 50 mg per 2.2 pounds of body weight, up to a maximum of 2 g, taken in 2 equally divided doses. To reduce the chance of digestive side effects and other reactions, the doctor will probably start with a fraction of the typical dose and build up to it over a period of weeks.

Ulcerative Colitis

Adults: The usual recommended initial dose of Azulfidine and Azulfidine EN-tabs is 3 to 4 g daily divided into smaller doses (intervals between nighttime doses should not exceed 8 hours). In some cases the initial dosage is set at 1 to 2 g daily to lessen side effects. As therapy continues, the dose is usually reduced to 2 g daily.

Children: The usual recommended initial dose is 40 to 60 milligrams (mg) per 2.2 pounds of body weight in each 24-hour period, divided into 3 to 6 doses. For the longer term, the dose is usually reduced to 30 mg per 2.2 pounds of body weight in each 24-hour period, divided into 4 doses.

How should I take Azulfidine?

Take this medication in evenly spaced, equal doses, as determined by your doctor, preferably after meals or with food to avoid stomach upset. Swallow Azulfidine EN-tabs whole. If you are taking Azulfidine EN-tabs for rheumatoid arthritis, it may take up to 12 weeks for relief to occur.

What should I avoid while taking Azulfidine?

Avoid becoming dehydrated. It is important that you drink plenty of fluids while taking this medication to avoid kidney stones.

What are possible food and drug interactions associated with Azulfidine?

If Azulfidine is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Azulfidine with the following: digoxin, folic acid (a B-complex vitamin), and methotrexate.

What are the possible side effects of Azulfidine?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: abdominal pain, anemia, bluish skin, fever, headache, hives, inflammation of the mouth, itching, lack of appetite, nausea, rash, stomach distress, vomiting

Can I receive Azulfidine if I am pregnant or breastfeeding?

The effects of Azulfidine during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Azulfidine?

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

How should I store Azulfidine?

Store at room temperature.