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Azulfidine (Sulfasalazine) is a Disease Modifying Anti-Rheumatic Drug (DMARD) that is used in the treatment of rheumatoid arthritis, psoriatic arthritis, and many other types of arthritis. Sulfasalazine may also be used to treat inflammatory bowel diseases like ulcerative colitis and Crohn’s disease.

Sulfasalazine is an old medicine that was first developed in the 1950s. It is a combination of a salicylate (a chemical like Aspirin) and a sulfa antibiotic. The exact mechanism of how Sulfasalazine works to control arthritis is not understood, but it is believed that the sulfa portion of the medication is responsible for the benefits that are seen in patients taking the medicine.

Taking Azulfadine | Salazopyrin

Sulfasalazine is available in 500mg oral tablets. The dosage is decided by a doctor. It usually ranges from 2 tablets (1000 mg) twice a day to 3 tablets twice a day (1500 mg).

A common dose is 2 tablets in the morning, taken with breakfast; and two tablets at night, taken before bed. It is good to take Sulfasalazine with food.

Sulfasalazine is usually started slowly: either one tablet daily or one tablet twice daily. The dose is then increased by a tablet or two every week.

Your doctor will determine if Sulfasalazine is working after 3 months. When Sulfasalazine works most patients start to feel improvement after 6-8 weeks. The maximum effect can take 6-12 months. If it isn’t working at all after 3 months then it is usually stopped.

Important Tests and Risks

Patients starting Sulfasalazine should have their blood tested two weeks after starting the medicine, and then every month after that. It is important to make sure the medicine isn’t harming the liver, kidneys, or affecting blood counts.