Azulfidine: Effective Control for Chronic Inflammatory Conditions
Azulfidine
| Product dosage: 500mg | |||
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Synonyms | |||
Azulfidine, known generically as sulfasalazine, is a time-tested disease-modifying antirheumatic drug (DMARD) with proven efficacy in managing chronic inflammatory conditions. It combines anti-inflammatory and immunomodulatory properties, making it a cornerstone therapy in rheumatology and gastroenterology. This medication is specifically formulated to target the underlying pathological processes, offering patients sustained symptom relief and improved quality of life. Healthcare professionals rely on Azulfidine for its well-documented safety profile and ability to modify disease progression over the long term.
Features
- Contains sulfasalazine as the active pharmaceutical ingredient
- Available in 500 mg delayed-release enteric-coated tablets
- Designed for targeted release in the lower gastrointestinal tract
- Manufactured under strict pharmaceutical quality control standards
- Stable shelf life with proper storage conditions
- Prescription-only medication requiring professional supervision
Benefits
- Reduces joint swelling, pain, and stiffness in rheumatoid arthritis
- Maintains remission in ulcerative colitis and Crohn’s disease
- Slows radiographic progression of joint damage in inflammatory arthritis
- Improves physical function and quality of life measures
- Offers cost-effective long-term management compared to biologic therapies
- Established safety profile with decades of clinical use and monitoring
Common use
Azulfidine is primarily indicated for the management of moderate to severe rheumatoid arthritis in patients who have responded inadequately to salicylates or other non-steroidal anti-inflammatory drugs. It is also approved for the treatment of ulcerative colitis, particularly for maintaining remission and reducing the frequency of acute exacerbations. Off-label uses include management of other seronegative spondyloarthropathies such as psoriatic arthritis and ankylosing spondylitis. The medication works through multiple mechanisms including inhibition of inflammatory pathways and modulation of immune responses.
Dosage and direction
For rheumatoid arthritis in adults: Initial dose is 500 mg daily, gradually increased by 500 mg weekly to a maintenance dose of 2-3 grams daily in divided doses. Maximum recommended dose is 3 grams daily. For ulcerative colitis: Initial dose of 1-2 grams daily in divided doses, increasing to maintenance dose of 2-4 grams daily. Pediatric dosing for juvenile idiopathic arthritis is based on body weight, typically 30-50 mg/kg/day in divided doses. Tablets should be swallowed whole with a full glass of water, preferably with food to minimize gastrointestinal upset. Regular blood monitoring is required during therapy.
Precautions
Patients should undergo complete blood count, liver function tests, and renal function assessment before initiation and regularly during treatment. Those with glucose-6-phosphate dehydrogenase (G6PD) deficiency require careful monitoring due to increased risk of hemolysis. Adequate hydration is essential to prevent crystalluria and renal complications. Sun protection measures are recommended as sulfasalazine may cause photosensitivity reactions. Regular ophthalmologic examinations are advised due to potential ocular effects. Patients should report any signs of infection, unusual bleeding, or persistent fever immediately.
Contraindications
Hypersensitivity to sulfonamides, salicylates, or any component of the formulation. Patients with intestinal or urinary obstruction. Those with porphyria. Patients with severe renal impairment (creatinine clearance less than 30 mL/min). Severe hepatic impairment. History of drug-induced blood dyscrasias including agranulocytosis and aplastic anemia. Children under 2 years of age due to risk of kernicterus.
Possible side effect
Common reactions include nausea (19%), headache (13%), anorexia (9%), and gastrointestinal distress (10%). Orange-yellow discoloration of skin and body fluids occurs frequently but is harmless. Serious adverse effects requiring immediate medical attention include Stevens-Johnson syndrome, toxic epidermal necrolysis, agranulocytosis, aplastic anemia, hepatic necrosis, and severe skin reactions. Less common effects include oligospermia (reversible upon discontinuation), pulmonary fibrosis, and peripheral neuropathy. Approximately 20-30% of patients may require dosage adjustment or discontinuation due to adverse effects.
Drug interaction
Significant interactions occur with digoxin (reduced absorption), warfarin (enhanced anticoagulant effect), and methotrexate (increased risk of hematologic toxicity). Concurrent use with hepatotoxic drugs increases risk of liver damage. Sulfasalazine may reduce cyclosporine levels. Antibiotics may alter intestinal flora and affect drug metabolism. Urinary alkalinizers increase risk of crystalluria. Live vaccines should be avoided during treatment due to immunosuppressive effects.
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed administration. Maintain regular dosing schedule to ensure consistent therapeutic levels. Patients should contact their healthcare provider if multiple doses are missed for guidance on resumption of therapy.
Overdose
Symptoms may include nausea, vomiting, abdominal pain, dizziness, headache, drowsiness, and unconsciousness. Severe overdose can cause hemolytic anemia, methemoglobinemia, jaundice, and crystalluria. Management includes gastric lavage if presented early, forced diuresis with alkaline fluids, and supportive care. Hemodialysis may be effective in removing the drug. Specific antidotes are not available. Immediate medical attention is required for suspected overdose.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) in the original container. Protect from light and moisture. Keep tightly closed and out of reach of children. Do not transfer to other containers. Discard any medication that has expired or shows signs of deterioration. Do not flush medications down the toilet or pour into drainage systems.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Individual patient responses may vary. Treatment decisions should be made in consultation with a qualified healthcare professional familiar with the patient’s complete medical history. The prescribing physician should be consulted regarding specific indications, dosing, and monitoring requirements.
Reviews
Clinical studies demonstrate that approximately 60-70% of rheumatoid arthritis patients achieve significant improvement with Azulfidine therapy. Long-term observational data show sustained efficacy in maintaining remission in ulcerative colitis patients. Many patients report improved quality of life and functional capacity after 3-6 months of consistent therapy. Healthcare providers appreciate the predictable pharmacokinetics and well-established monitoring parameters. The medication continues to be valued as a first-line DMARD in many treatment guidelines worldwide.