Sulfasalazine Side Effects, Dosage, Uses

Sulfasalazine is used to treat ulcerative colitis and to maintain remission. The delayed-release tablets, Azulfidine (EN-tabs), are also used to treat rheumatoid arthritis and juvenile rheumatoid arthritis.

The exact way that sulfasalazine works is unknown, but it is believed to reduce the actions of substances in the body that cause inflammation, tissue damage, and diarrhea.

You can buy Sulfasalazine under the brand name Azulfidine in the United States.

FDA Information

Sulfasalazine was approved by the Food and Drug Administration in 1950.

Azulfidine EN-tabs is the only formulation of sulfasalazine approved by the FDA for the treatment of both juvenile and adult RA. The enteric-coated formulation of Azulfidine EN-tabs was specifically designed to reduce the likelihood of nausea and stomach upset.


Sulfasalazine is used to treat a certain type of bowel disease called ulcerative colitis. This medication does not cure this condition, but it helps decrease symptoms such as fever, stomach pain, diarrhea, and rectal bleeding. After an attack is treated, sulfasalazine is also used to increase the amount of time between attacks. This medication works by reducing irritation and swelling in the large intestines.

In addition, delayed-release tablets of sulfasalazine are used to treat rheumatoid arthritis and juvenile rheumatoid arthritis. Sulfasalazine helps to reduce joint pain, swelling, and stiffness. Early treatment of rheumatoid arthritis with sulfasalazine helps to reduce and even prevent further joint damage so you can do more of your normal daily activities. This medication is used together with other drugs, rest, and physical therapy in patients who have not responded to other medications (such as salicylates and nonsteroidal anti-inflammatory drugs [NSAIDs]).


Sulfasalazine comes as regular and delayed-release (enteric-coated) tablets. It is usually taken four times a day in evenly spaced doses throughout the day so that no more than eight hours separate any two doses, if possible.

Take sulfasalazine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Each dose should be taken with a full glass of water and usually after meals.

Do not crush, chew, or break the delayed-release tablets (Azulfidine EN-tabs). Swallow them whole. They are specially formulated to release the medication after it has passed through your stomach.

Call your doctor if you find an undissolved delayed-release (Azulfidine EN-tabs) tablet in your stool.

Do not stop taking sulfasalazine, even if you begin to feel better, without first talking to your doctor. It is very important to continue taking sulfasalazine to control your condition.

Missed Dose

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose.

Please do not take a double dose of this medication.


Always keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Please remember to throw away any medication that is outdated or no longer needed. If you have any questions, talk to your pharmacist about the proper disposal of your medication.