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Imuran vs. Azulfidine

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Azathioprine (Imuran, Azasan) and sulfasalazine (Azulfidine) are both prescription medications, but they serve different purposes and belong to different drug classes. Azathioprine is an immunosuppressant used mainly to prevent kidney transplant rejection and to treat rheumatoid arthritis (RA). It works by weakening your immune system to stop it from attacking your body. On the other hand, sulfasalazine is an anti-inflammatory medication used to treat ulcerative colitis (UC) and RA. It works by breaking down into chemicals that reduce inflammation and pain. Azathioprine requires regular blood tests due to its risk of causing infections, liver damage, and certain cancers, while sulfasalazine can cause stomach issues and may lower sperm count. Both medications are available in generic forms, making them more affordable. However, sulfasalazine is also safe for children 6 years and older, unlike azathioprine.

Imuran

(azathioprine)

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Sulfasalazine

(Azulfidine)

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Summary for Imuran

Prescription only

Imuran (azathioprine) is a medication used after kidney transplantation and also for rheumatoid arthritis. It's not a first choice medication because of many side effects. Your provider may also use Imuran (azathioprine) for other indications as well, although these are off-label (not FDA-approved) uses.

Indications for Imuran

  • To prevent the body from rejecting a transplanted kidney
  • Rheumatoid arthritis

Pros and Cons for Imuran

Pros

  • Works well for the treatment of rheumatoid arthritis, although it's not commonly used unless other medications don't work
  • Lowers the pain, stiffness, and swelling caused by rheumatoid arthritis
  • Available in a generic form which is more affordable
  • Can be used in people who have had a kidney transplant and are planning to become pregnant

Cons

  • Regular blood tests are required
  • Raises risk of getting an infection
  • Not a first choice medication because of many side effects

Common Side Effects for Imuran

  • Nausea
  • Vomiting
  • Leukopenia (lowering of white blood cells in the body)
  • Infections

Warnings for Imuran

  • Cancer
  • Fewer Blood Cells
  • Greater Risk for Infections
  • Liver Damage

Summary for Azulfidine

Prescription only

Sulfasalazine (Azulfidine) is an anti-inflammatory medication that comes in immediate-release and delayed-release tablets. Both formulations are used to treat ulcerative colitis (UC). The delayed-release tablets can also be used for rheumatoid arthritis (RA). Adults and children 6 years and older can take sulfasalazine (Azulfidine). It's best to split your total daily dose into a few smaller doses throughout the day. This medication can commonly cause stomach problems, such as nausea and indigestion, as side effects.

Indications for Azulfidine

  • Ulcerative colitis (UC) - immediate-release and delayed release tablets
  • Rheumatoid arthritis (RA) - delayed-release tablets only
  • Polyarticular juvenile rheumatoid arthritis - delayed-release tablets only

Pros and Cons for Azulfidine

Pros

  • Available as a lower-cost generic medication
  • Safe to take for children 6 years and older
  • Available as immediate-release and delayed-release tablets
  • Delayed-release tablets helpful for people with bothersome stomach upset from the medication

Cons

  • Can cause side effects like nausea, vomiting, and stomach upset
  • Might cause low sperm count
  • Might require regular blood work and lab tests to make sure your liver, kidneys, and blood counts are healthy and normal
  • Might not be safe for people with allergies to sulfa drugs, aspirin, or other salicylates

Common Side Effects for Azulfidine

For UC:

  • Nausea (33%)
  • Vomiting (33%)
  • Stomach upset (belly pain and cramping; 33%)
  • Low appetite (33%)
  • Headache (33%)

For RA (delayed-release tablets only):

  • Nausea (19%)
  • Indigestion (13%)
  • Headache (9%)
  • Belly pain (8%)
  • Vomiting (8%)
  • Fever (5%)

Warnings for Azulfidine

  • Risk of liver, kidney, and blood problems
  • Low sperm count
  • Serious infections
  • Severe skin and allergic reactions

Prices with our coupons for Imuran vs. Azulfidine

Price Card Drug Icon
Azathioprine90 tablets / 50mg
$21.27$533.12
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Price Card Drug Icon
Sulfasalazine120 tablets / 500mg
$18.95$61.00
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