Azulfidine

Azulfidine is a brand name for sulfasalazine, an anti-inflammatory medication used to treat inflammatory bowel disease and rheumatoid arthritis. It is a sulfa-containing prodrug composed of sulfapyridine linked to 5-aminosalicylic acid (5-ASA). After oral administration, colonic bacteria cleave the azo bond, releasing sulfapyridine (providing systemic anti-inflammatory effects) and 5-ASA (exerting local anti-inflammatory action in the colon).

The drug is typically prescribed for mild to moderate ulcerative colitis and for rheumatoid arthritis. It may also be used in other inflammatory conditions with colonic involvement, though indications outside UC and RA vary by country and clinical practice. Azulfidine is taken by mouth, usually in divided doses with meals to minimize gastrointestinal upset; the exact dose is determined by the physician based on the condition being treated and patient tolerance.

Contraindications include a known allergy to sulfonamides or sulfites, and use during pregnancy or breastfeeding is weighed against potential benefits and risks. Because sulfapyridine can cause folate depletion and hematologic effects, patients may require monitoring of blood counts and liver function; folic acid supplementation is sometimes advised. Common adverse effects include nausea, vomiting, diarrhea, rash, headache, and photosensitivity. Urine or skin may take on a yellow-orange color, which is harmless but can alarm patients. Rare but serious reactions can occur, such as severe hypersensitivity, hepatitis, interstitial nephritis, or Stevens-Johnson-like syndromes. Drug interactions and individual risk factors, including liver or kidney disease, should be discussed with a clinician.