Azulfidine and Azulfidine EN-tabs* are brand-name prescription medications. Both Azulfidine and Azulfidine EN-tabs are approved for the following uses in adults as well as children ages 6 years and older:

  • treating mild to moderate ulcerative colitis
  • treating severe ulcerative colitis in combination with other treatments
  • increasing the amount of time between attacks of ulcerative colitis

In addition, Azulfidine EN-tabs are approved to treat:

* Polyarticular arthritis affects five or more joints.

Azulfidine vs. Azulfidine EN-tabs

Both Azulfidine and Azulfidine EN-tabs come as oral tablets. Azulfidine EN-tabs are a delayed-release form of Azulfidine. “EN-tabs” stands for enteric-coated tablets. The coating delays the breakdown of the tablets until they reach your intestines. This allows the drug to be released into the body slowly throughout the day instead of all at once. To learn more, see the “Azulfidine and Azulfidine EN-tabs dosage” section below.

Azulfidine and Azulfidine EN-tabs contain the same active ingredient, sulfasalazine. They belong to a group of drugs called disease-modifying antirheumatic drugs (DMARDs). Both Azulfidine and Azulfidine EN-tabs are available in one strength: 500 milligrams (mg).

Effectiveness

For information about the effectiveness of Azulfidine and Azulfidine EN-tabs, see the “Azulfidine and Azulfidine EN-tabs uses” section below.

Azulfidine and Azulfidine EN-tabs are brand-name drugs that contain the active drug sulfasalazine. This active drug is also available as a generic medication. A generic drug is an exact copy of the active drug in a brand-name medication.

Azulfidine is available in a generic form called sulfasalazine. Azulfidine EN-tabs are available in a generic form called sulfasalazine delayed-release.

The generics are considered to be as safe and effective as the original drugs. Generics tend to cost less than brand-name drugs.

If you’re interested in taking the generic form of Azulfidine or Azulfidine EN-tabs, talk with your doctor. They can tell you if it comes in forms and strengths to treat your condition.

The Azulfidine or Azulfidine EN-tabs dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of your condition
  • your age
  • whether you take Azulfidine or Azulfidine EN-tabs
  • other medical conditions you may have
  • how your body responds to the medication

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Azulfidine and Azulfidine EN-tabs both come as oral tablets in one strength: 500 milligrams (mg).

Azulfidine EN-tabs are a delayed-release form of Azulfidine. “EN-tabs” stands for enteric-coated tablets. The coating delays the breakdown of the tablets until they reach your intestines. This allows the drug to be released into the body slowly throughout the day instead of all at once.

Azulfidine EN-tabs are recommended for people with ulcerative colitis who have taken Azulfidine and had side effects such as nausea and vomiting. Because Azulfidine EN-tabs are released more slowly than Azulfidine, they may cause fewer and less severe side effects.

Dosage for ulcerative colitis

The starting dosage of Azulfidine or Azulfidine EN-tabs for ulcerative colitis is a total of 3 grams (g) to 4 g per day. These doses are divided into multiple doses per day. For example, your doctor may have you first take 1,000 mg (1 g) every 6 hours. If you have side effects from the starting dose, they may decrease your dose.

Once your body builds a tolerance to the medication and your symptoms improve, your doctor may reduce your dose to a maintenance dose. Usually, the maintenance dosage for ulcerative colitis is a total of 2 grams per day, which may be split into multiple doses. For example, you may take 500 mg (0.5 g) every 6 hours.

Dosage for rheumatoid arthritis

When you first start taking Azulfidine EN-tabs for rheumatoid arthritis (RA), your doctor may recommend a low starting dose so your body can adjust to the medication. For example, they may recommend 500 mg once or twice daily to begin.

Once your body is used to Azulfidine EN-tabs, your doctor may increase your dose. The maintenance dosage of Azulfidine EN-tabs for RA is 2 grams (2,000 mg) per day, divided into two doses. So your doctor may recommend taking 1,000 mg twice per day.

This example of a dosing table shows how your doctor may recommend taking Azulfidine EN-tabs for RA:

WeekMorning doseEvening dose
1none500 mg
2500 mg500 mg
3500 mg1,000 mg
41,000 mg1,000 mg

Azulfidine is not approved to be used for RA.

Dosage for juvenile idiopathic arthritis

The dosage of Azulfidine EN-tabs for children ages 6 years and older with polyarticular* juvenile idiopathic arthritis (JIA) is based on body weight. The recommended dosage is 30 mg to 50 mg per kilogram (kg)† of body weight per day. This dose should be divided into two doses per day.

Here’s an example for a child who weighs 40 kg, which is about 88 pounds (lb). Their dosage would be between 1,200 mg and 2,000 mg per day. Their doctor may recommend a dose of 500 mg in the morning and 1,000 mg at night, or 1,000 mg twice per day.

The maximum dosage of Azulfidine EN-tabs in children with JIA is 2,000 mg per day.

Azulfidine is not approved to be used in children with JIA.

* Polyarticular arthritis affects five or more joints.
† 1 kg is about 2.2 lb.

Children’s dosage

Here’s some information about the dosages of Azulfidine and Azulfidine EN-tabs for children.

Ulcerative colitis

Azulfidine and Azulfidine EN-tabs are approved to treat ulcerative colitis in children ages 6 years and older. The dosage of the drugs is based on your child’s body weight. The starting dose of these medications is between 40 mg and 60 mg per kg of body weight per day. The dose should be divided into three to six doses per day.

For example, if your child weighs 40 kg (about 88 lb), the recommended dosage would be 1,400 mg to 2,400 mg per day. Their doctor may recommend they take 500 mg three to four times per day.

Once the medication begins working, your child’s doctor may reduce the dosage to 30 mg per kg of body weight per day.

Juvenile idiopathic arthritis

Azulfidine EN-tabs are approved to treat children ages 6 years and older with polyarticular juvenile idiopathic arthritis (JIA). For specifics on dosing, see the section above called “Dosage for juvenile idiopathic arthritis.”

Azulfidine is not approved for children with juvenile idiopathic arthritis.

What if I miss a dose?

If you miss a dose of Azulfidine or Azulfidine EN-tabs, talk with your doctor or pharmacist. They may recommend either skipping your missed dose or taking your dose as soon as you remember. It depends on how long it’s been since you missed your dose.

To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to take this drug long term?

Azulfidine and Azulfidine EN-tabs are meant to be used as a long-term treatment. If you and your doctor determine that Azulfidine or Azulfidine EN-tabs is safe and effective, you’ll likely take it long term.

The Food and Drug Administration (FDA) approves prescription drugs such as Azulfidine and Azulfidine EN-tabs to treat certain conditions.

Azulfidine and Azulfidine EN-tabs for ulcerative colitis

Azulfidine and Azulfidine EN-tabs are both approved for use in adults as well as children ages 6 years and older to:

  • treat mild to moderate ulcerative colitis
  • treat severe ulcerative colitis in combination with other treatments
  • increase the amount of time between attacks of ulcerative colitis

Ulcerative colitis is an autoimmune condition. An autoimmune condition occurs when your immune system mistakenly attacks your own body. With ulcerative colitis, the colon (also known as the large intestine) and the rectum are attacked. Symptoms of ulcerative colitis can include diarrhea, abdominal pain, and rectal bleeding.

Effectiveness for ulcerative colitis

Azulfidine and Azulfidine EN-tabs are effective treatment options for people with ulcerative colitis. Guidelines from the American Gastroenterological Association recommend sulfasalazine (the active drug ingredient in Azulfidine and Azulfidine EN-tabs) as a treatment option for ulcerative colitis.

For more information about how these drugs performed in clinical trials, see the prescribing information for Azulfidine and Azulfidine EN-tabs.

Azulfidine EN-tabs for rheumatoid arthritis

Azulfidine EN-tabs are approved to treat rheumatoid arthritis (RA) in certain adults. They must have tried nonsteroidal anti-inflammatory drugs (NSAIDs), but either couldn’t tolerate the drugs or the drugs didn’t help their condition. Examples of NSAIDs include ibuprofen (Motrin, Advil, others) and aspirin (Ecotrin).

Azulfidine is not approved to treat RA.

RA is an autoimmune condition that causes your immune system to mistakenly attack your joints. Symptoms of RA may include joint pain, swelling, and stiffness.

You can visit our arthritis hub for more information about RA.

Effectiveness for rheumatoid arthritis

Azulfidine EN-tabs is an effective medication to treat RA. American College of Rheumatology guidelines recommend sulfasalazine (the active drug ingredient in Azulfidine EN-tabs) as a treatment option for RA. For more information about how the drug performed in clinical trials, see the Azulfidine EN-tabs prescribing information.

Azulfidine EN-tabs for juvenile idiopathic arthritis

Azulfidine EN-tabs are approved to treat polyarticular* juvenile idiopathic arthritis (JIA) in certain children ages 6 years and older. They must have tried NSAIDs but either couldn’t tolerate the drugs or the drugs didn’t help their condition. Examples of NSAIDs include ibuprofen (Motrin, Advil, others) and aspirin (Ecotrin).

To find additional information about arthritis in children, see our arthritis hub.

* Polyarticular arthritis affects five or more joints.

Effectiveness for juvenile idiopathic arthritis

Azulfidine EN-tabs is an effective treatment option for children ages 6 years and older with JIA. It is recommended as a treatment option in the American College of Rheumatology’s treatment guidelines for JIA. For more information about how the drug performed in clinical trials, see the Azulfidine EN-tabs prescribing information.

Azulfidine and Azulfidine EN-tabs and children

Here’s some information about the use of Azulfidine and Azulfidine EN-tabs in children.

Ulcerative colitis

Azulfidine and Azulfidine EN-tabs are approved for use in children ages 6 years and older to:

  • treat mild to moderate ulcerative colitis
  • treat severe ulcerative colitis in combination with other treatments
  • increase the amount of time between attacks of ulcerative colitis

Sulfasalazine (the active drug in both Azulfidine and Azulfidine EN-tabs) is recommended in treatment guidelines as an option for children with ulcerative colitis. The guidelines are from the European Crohn’s and Colitis Organization as well as the European Society of Paediatric Gastroenterology, Hepatology and Nutrition.

For more information, see “Azulfidine and Azulfidine EN-tabs for ulcerative colitis” above.

Polyarticular juvenile idiopathic arthritis

Azulfidine EN-tabs are approved to treat polyarticular* juvenile idiopathic arthritis in certain children ages 6 years and older. They must have tried NSAIDs, but either couldn’t tolerate the drugs or the drugs didn’t help their condition. For more information, see “Azulfidine EN-tabs for juvenile idiopathic arthritis” above.

* Polyarticular arthritis affects five or more joints.

As with all medications, the cost of Azulfidine and Azulfidine EN-tabs can vary. To find current prices for Azulfidine (and Azulfidine EN-tabs tablets) in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Azulfidine or Azulfidine EN-tabs. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Before approving coverage for Azulfidine or Azulfidine EN-tabs, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Azulfidine or Azulfidine EN-tabs, contact your insurance company.

Financial and insurance assistance

Financial assistance to help you pay for Azulfidine or Azulfidine EN-tabs may be available.

Medicine Assistance Tool and NeedyMeds are two websites offering resources that may help decrease the price you pay for Azulfidine or Azulfidine EN-tabs. They also offer tools to help you find low-cost healthcare, as well as educational resources. To find out more, visit their sites.

To learn more about saving money on prescriptions, check out this article.

Mail-order pharmacies

Azulfidine and Azulfidine EN-tabs may be available through a mail-order pharmacy. Using this service may help lower the cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Azulfidine or Azulfidine EN-tabs, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Azulfidine is available in a generic form called sulfasalazine. Azulfidine EN-tabs are available in a generic form called sulfasalazine delayed-release.

A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. To find out how the cost of sulfasalazine compares with the cost of Azulfidine, visit GoodRx.com. You can also visit the site to compare the cost of sulfasalazine delayed-release and Azulfidine EN-tabs.

If your doctor has prescribed Azulfidine or Azulfidine EN-tabs and you’re interested in taking a generic form instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

Azulfidine and Azulfidine EN-tabs can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking these drugs. The lists do not include all possible side effects.

For more information about the possible side effects of Azulfidine and Azulfidine EN-tabs, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Azulfidine and Azulfidine EN-tabs, you can do so through MedWatch.

Mild side effects

Mild side effects* of Azulfidine and Azulfidine EN-tabs can include:

Most of these side effects may go away within a few days to a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Azulfidine and Azulfidine EN-tabs. To learn about other mild side effects, talk with your doctor or pharmacist, or see the prescribing information for Azulfidine and Azulfidine EN-tabs.
† For more information about this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Azulfidine and Azulfidine EN-tabs aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

* For more information about this side effect, see “Side effect details” below.

Side effect details

Here are some details on certain side effects this drug may cause.

Nausea and vomiting

Nausea and vomiting may occur with Azulfidine and Azulfidine EN-tabs. These are some of the most common side effects reported in clinical trials.

If you experience nausea and vomiting when taking Azulfidine or Azulfidine EN-tabs, talk with your doctor. They may be able to recommend ways to ease these side effects. For example, they may advise you to take the medication with food. Or they may decrease your dose so that your body can adjust to the drug.

Weight loss

It’s possible to have weight loss with Azulfidine or Azulfidine EN-tabs. This was one of the most common side effects reported in clinical trials.

In some cases, your weight loss may be due to nausea or vomiting that the medications can cause. By treating the nausea or vomiting, you may be able to increase your appetite and help prevent weight loss. (For more information, see “Nausea and vomiting” above.)

If you notice a decrease in your appetite or lose weight while taking Azulfidine or Azulfidine EN-tabs, talk with your doctor. They can advise you on how to help prevent these side effects from occurring.

Anemia and other blood disorders

It’s possible to develop anemia or other blood disorders with Azulfidine and Azulfidine EN-tabs.

Anemia refers to low levels of red blood cells, and it can cause symptoms such as weakness or dizziness.

Azulfidine and Azulfidine EN-tabs may also cause other blood disorders, such as:

  • Low level of platelets (cells that help your blood clot). If your level is slightly low, you may not have symptoms. But a severely low level may cause symptoms, such as small spots of bleeding in your skin.
  • Low levels of white blood cells, which are cells that help fight infection. Low levels usually don’t cause symptoms. Your doctor may observe the change in blood tests. Low levels can increase your risk of infection.

Throughout your treatment with Azulfidine or Azulfidine EN-tabs, your doctor will monitor your blood cell levels through blood work. If there are any changes, your doctor may recommend that you stop taking the medication and try a different treatment option.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Azulfidine or Azulfidine EN-tabs.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Azulfidine or Azulfidine EN-tabs, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

There are no known interactions between alcohol and Azulfidine or Azulfidine EN-tabs. However, drinking alcohol may worsen side effects from the medications. For example, both alcohol and Azulfidine can cause headaches and nausea. So drinking alcohol while taking either drug may worsen these side effects.

In addition, alcohol may cause liver or kidney problems. These can include hepatitis (liver inflammation) and nephritis (kidney inflammation). Because Azulfidine and Azulfidine EN-tabs may also cause these problems, alcohol can increase your risk further.

If you are interested in drinking alcohol during your treatment, talk with your doctor about how much, if any, is safe to consume.

Azulfidine and Azulfidine EN-tabs can interact with several other medications and a supplement. The drugs aren’t believed to interact with foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Azulfidine and Azulfidine EN-tabs and other medications

Below is a list of medications that can interact with Azulfidine and Azulfidine EN-tabs. This list does not contain all medications that may interact with these drugs.

Before taking Azulfidine or Azulfidine EN-tabs, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drugs that Azulfidine or Azulfidine EN-tabs can interact with include:

  • Folic acid. Azulfidine and Azulfidine EN-tabs prevent your body from absorbing folic acid, which may also be called vitamin B9.
  • Digoxin. Your body may not be able to absorb as much digoxin (Lanoxin) as it should if you take Azulfidine or Azulfidine EN-tabs. Your doctor may monitor your digoxin levels more often than usual or they may increase your dose of digoxin.

Azulfidine and Azulfidine EN-tabs and herbs and supplements

Azulfidine EN-tabs can lower your level of folic acid, so your doctor may recommend taking a folic acid supplement. If you already take a folic acid supplement, they may increase your supplement dose.

Before and during your Azulfidine or Azulfidine EN-tabs treatment, check with your doctor or pharmacist before using any herbs or supplements.

Azulfidine and Azulfidine EN-tabs and foods

There aren’t any foods that have been specifically reported to interact with Azulfidine and Azulfidine EN-tabs. If you have any questions about eating certain foods with these medications, talk with your doctor.

Azulfidine and Azulfidine EN-tabs and lab tests

Azulfidine and Azulfidine EN-tabs may interact with some lab tests. Examples of tests the medications may affect include:

Before you have any lab tests, be sure all your healthcare professionals know you’re taking Azulfidine or Azulfidine EN-tabs.

You should take Azulfidine and Azulfidine EN-tabs according to the instructions your doctor gives you.

Both medications come as oral tablets that you swallow.

When to take

For some conditions, such as rheumatoid arthritis, your doctor may recommend that you take your doses twice daily. But to treat other conditions, such as ulcerative colitis, you may need to take your doses up to every 6 hours. Your doctor will discuss the best dosing schedule for you.

To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Taking Azulfidine and Azulfidine EN-tabs with food

You should take your doses of Azulfidine or Azulfidine EN-tabs after meals.

Can Azulfidine and Azulfidine EN-tabs be crushed, split, or chewed?

If you take Azulfidine, you can check with your doctor or pharmacist to see if it’s safe to split or crush the tablets.

If you take Azulfidine EN-tabs, you should not crush, chew, or split them.

If you have difficulty swallowing either of these drugs, talk with your doctor.

Azulfidine and Azulfidine EN-tabs work to treat ulcerative colitis. Azulfidine EN-tabs also treat rheumatoid arthritis (RA) and polyarticular* juvenile idiopathic arthritis. These are all autoimmune conditions.

With an autoimmune condition, your immune system mistakenly attacks your own body and causes the symptoms you experience. In ulcerative colitis, your immune system attacks your colon (also known as the large intestine) and your rectum. This can cause swelling and ulcers. With RA, your immune system attacks your joints. This causes pain and swelling of the joints.

It’s not known exactly how Azulfidine and Azulfidine EN-tabs work to treat autoimmune conditions. However, it’s believed the drugs decrease the swelling that your immune system causes, which eases symptoms. In addition, the drug may weaken your immune system so that it doesn’t attack your body.

* Polyarticular arthritis affects five or more joints.

How long do they take to work?

Azulfidine and Azulfidine EN-tabs begin working after you take your first dose. However, it may take time for you to notice a difference in your symptoms.

For example, some people with RA who took Azulfidine EN-tabs noticed a difference in symptoms after 4 weeks of treatment. However, it can take up to 12 weeks for some people to notice a difference.

It’s not known if Azulfidine and Azulfidine EN-tabs may harm a fetus. Some pregnant females* who took sulfasalazine during pregnancy did report problems. Sulfasalazine is the active drug ingredient in Azulfidine and Azulfidine EN-tabs. The problems were related to fetal development of the brain or spine and are also called neural tube defects.

However, other information collected from females who took sulfasalazine during pregnancy does not show an increased risk of these problems.

If you’re pregnant or planning to become pregnant, talk with your doctor before taking Azulfidine or Azulfidine EN-tabs. They can review the pros and cons of the medication with you.

Azulfidine and Azulfidine EN-tabs and fertility

Azulfidine and Azulfidine EN-tabs may decrease sperm count in males* who take them. The medications may cause infertility. However, stopping treatment with Azulfidine or Azulfidine EN-tabs causes sperm count and fertility to return to normal.

It’s not known if these drugs affect female fertility. In animal trials of Azulfidine and Azulfidine EN-tabs, the medications did not appear to affect female fertility. However, animal trials don’t always indicate what may happen in humans.

If you have any questions about taking Azulfidine and Azulfidine EN-tabs and fertility, talk with your doctor.

* Sex and gender exist on spectrums. Use of the terms “female” and “male” in this article refers to sex assigned at birth.

It’s not known if Azulfidine and Azulfidine EN-tabs are safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you take these drugs.

For more information about taking Azulfidine and Azulfidine EN-tabs during pregnancy, see the “Azulfidine and Azulfidine EN-tabs and pregnancy” section above.

It’s not known if Azulfidine and Azulfidine EN-tabs are safe to take while breastfeeding. Sulfasalazine (the active drug in both medications) passes into breast milk. This means that a child who is breastfed can be exposed to the drug. However, it’s not known what effects this may have on the child.

Some females* who took sulfasalazine reported diarrhea or bloody stools in children who were breastfed. However, it’s not known for sure if sulfasalazine was the cause.

If you’re breastfeeding or plan to, talk with your doctor before taking Azulfidine or Azulfidine EN-tabs. They can review the drugs’ benefits and risks with you.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Here are answers to some frequently asked questions about Azulfidine and Azulfidine EN-tabs.

Will Azulfidine or Azulfidine EN-tabs cure my condition?

No, Azulfidine or Azulfidine EN-tabs will not cure ulcerative colitis, rheumatoid arthritis, or juvenile idiopathic arthritis (JIA). In fact, there are no cures for these conditions.

Azulfidine and Azulfidine EN-tabs should work to ease the symptoms of your condition. Your doctor can help determine if either drug is right for you.

Are Azulfidine and Azulfidine EN-tabs steroids?

Azulfidine and Azulfidine EN-tabs are not steroids. These two medications belong to a group of drugs called disease modifying anti-rheumatic drugs (DMARDs).

Both steroids and DMARDs may be used to treat autoimmune conditions.

It’s not known exactly how these medications work to treat ulcerative colitis, rheumatoid arthritis, or JIA. However, these conditions are all caused by your immune system mistakenly attacking your own body. It’s thought that Azulfidine and Azulfidine EN-tabs decrease the swelling that your immune system causes, which eases symptoms. In addition, the drug may weaken your immune system so that it doesn’t attack your body.

Steroid medications may also be used to treat autoimmune conditions. For example, you may take prednisone, which is a steroid. Steroids and DMARDs work in different ways to treat your condition.

Can I switch from Azulfidine to Azulfidine EN-tabs, or vice versa?

Yes, in most cases your doctor can switch you from Azulfidine to Azulfidine EN-tabs, or vice versa.

Both drugs contain the same active medication, sulfasalazine. The difference between the drugs is the way the medication releases in your body. Azulfidine releases as soon as you take your dose. However, Azulfidine EN-tabs are delayed-release, so the medication releases in your body slowly over time. This can decrease nausea and vomiting that you may experience from Azulfidine.

Talk with your doctor about whether Azulfidine or Azulfidine EN-tabs is right for you.

Before taking Azulfidine and Azulfidine EN-tabs, talk with your doctor about your health history. Azulfidine and Azulfidine EN-tabs may not be right for you if you have certain medical conditions or other factors affecting your health. These include the ones mentioned below.

Note: For more information about the potential negative effects of Azulfidine and Azulfidine EN-tabs, see the “Azulfidine and Azulfidine EN-tabs side effects” section above.

Blockage in your intestinal tract or urinary tract. If you have a blockage in your intestinal tract or urinary tract, your doctor will likely recommend a treatment other than Azulfidine or Azulfidine EN-tabs. The medications can cause kidney problems and nervous system conditions that can affect digestion and urination. So it’s possible that taking either drug could worsen the blockage.

Blood disorders. Azulfidine and Azulfidine EN-tabs may cause changes in certain blood levels, such as red blood cell or white blood cell levels. If you already have a blood disorder, taking Azulfidine or Azulfidine EN-tabs may make your condition worse. Your doctor may monitor you more often than usual throughout treatment or recommend a different medication.

Genetic blood disorder called porphyria. If you have porphyria, the use of Azulfidine and Azulfidine EN-tabs may cause an attack of acute porphyria. Due to this risk, your doctor will likely recommend a different medication to treat your condition.

Nervous system conditions. Azulfidine and Azulfidine EN-tabs may increase your risk of developing a nervous system condition, such as Guillain-Barré syndrome. If you have a nervous system condition, taking this medication may make your condition worse. Talk with your doctor to see if Azulfidine or Azulfidine EN-tabs is a good treatment option for you.

Liver problems. Azulfidine and Azulfidine EN-tabs may increase your risk of developing liver problems, such as hepatitis. If you have liver problems, these medications can make your condition worse. Before taking Azulfidine or Azulfidine EN-tabs, talk with your doctor about any liver problems you have. They may monitor you more often than usual or recommend a different treatment.

Kidney problems. If you have kidney problems such as nephritis (kidney inflammation), tell your doctor before you start taking Azulfidine or Azulfidine EN-tabs. These medications may cause kidney problems. If you already have a kidney condition, these drugs may make your condition worse. Your doctor may monitor your kidneys or recommend a different treatment option if you have kidney problems.

Allergic reaction. If you’ve had an allergic reaction to Azulfidine or Azulfidine EN-tabs or any of its ingredients, your doctor will likely not prescribe the drug.

Also, if you’re allergic to drugs called sulfonamides or salicylates, your doctor will likely not prescribe Azulfidine or Azulfidine EN-tabs. Examples of sulfonamides include sulfamethoxazole/trimethoprim (Bactrim, Septra). An example of a salicylate is bismuth subsalicylate (Pepto-Bismol).

Ask your doctor about other medications that might be better options for you.

Asthma. If you have asthma, your doctor may monitor you more often than usual during treatment with Azulfidine or Azulfidine EN-tabs. They’ll look to see if the drug worsens your asthma symptoms. Before taking these drugs, tell your doctor if you have asthma.

Glucose-6 phosphate dehydrogenase deficiency. Azulfidine and Azulfidine EN-tabs may increase your risk of certain blood conditions, such as anemia. If you have a glucose-6 phosphate dehydrogenase (G6PD) deficiency, you may have an increased risk of hemolytic anemia. Your doctor may monitor you more than usual to watch for symptoms of this condition. Before taking these drugs, tell your doctor if you have a G6PD deficiency.

Pregnancy. It is not known if Azulfidine or Azulfidine EN-tabs are safe to take during pregnancy. For more information, see the “Azulfidine and Azulfidine EN-tabs and pregnancy” section above.

Breastfeeding. It’s not known if Azulfidine or Azulfidine EN-tabs are safe to take while breastfeeding. For more information, see the “Azulfidine and Azulfidine EN-tabs and breastfeeding” section above.

Taking more than the recommended dosage of Azulfidine and Azulfidine EN-tabs can lead to serious side effects.

Do not take more Azulfidine or Azulfidine EN-tabs than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

  • nausea
  • vomiting
  • abdominal pain
  • drowsiness
  • convulsions (muscle movements that you can’t control)

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Azulfidine or Azulfidine EN-tabs from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid taking expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good to use can depend on many factors, including how and where you store the medication.

You should store Azulfidine or Azulfidine EN-tabs at room temperature (77°F/25°C). However, you may keep these medications between 59°F to 86°F (15°C to 30°C) for a short time, if needed.

Disposal

If you no longer need to take Azulfidine or Azulfidine EN-tabs and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.