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Sulfasalazine vs. Colazal

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

Key takeaways

Sulfasalazine (Azulfidine) and Balsalazide (Colazal) are both used to treat ulcerative colitis (UC), but they have some key differences. Sulfasalazine (Azulfidine) is an anti-inflammatory medication that also treats rheumatoid arthritis (RA) and polyarticular juvenile rheumatoid arthritis, while Balsalazide (Colazal) is specifically for mild-to-moderate active UC. Sulfasalazine (Azulfidine) is available in both immediate-release and delayed-release tablets, whereas Balsalazide (Colazal) comes in capsule form. You need to take Sulfasalazine (Azulfidine) with food to avoid stomach upset, but Balsalazide (Colazal) can be taken with or without food. Sulfasalazine (Azulfidine) can cause side effects like nausea, vomiting, and stomach upset, while Balsalazide (Colazal) commonly causes headaches, stomach pain, and diarrhea. Additionally, Sulfasalazine (Azulfidine) might affect your immune system and require regular blood tests, whereas Balsalazide (Colazal) does not weaken your immune system but still requires monitoring for kidney and liver health.

Sulfasalazine

(Azulfidine)

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Balsalazide

(Colazal)

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Summary for Sulfasalazine

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 Sulfasalazine

  • 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 Sulfasalazine

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 Sulfasalazine

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 Sulfasalazine

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

Summary for Colazal

Prescription only

Balsalazide disodium, also known by the brand name Colazal, is an aminosalicylate. It's a first-choice treatment option for treating mild-to-moderate ulcerative colitis (UC) in people age 5 years and older. Balsalazide (Colazal) is available as 750 mg capsules. The typical dosage for adults is 3 capsules by mouth three times per day. Children can take either 1 or 3 capsules by mouth three times per day. Side effects include stomach pain and diarrhea.

Indications for Colazal

Pros and Cons for Colazal

Pros

  • Can start to provide symptom relief after 2 weeks of treatment
  • Can sprinkle the pill contents onto applesauce if you have trouble swallowing it whole

Cons

  • Need to take three times per day
  • Can't take if you're allergic to salicylates, such as aspirin

Common Side Effects for Colazal

  • Stomach pain (6%)
  • Diarrhea (5%)
  • Joint pain (4%)

Warnings for Colazal

  • Kidney damage
  • Kidney stones
  • Acute intolerance syndrome
  • Allergic reactions
  • Severe skin reactions
  • Liver problems
  • Skin that's sensitive to the sun
  • Caution in people with gut blockage

Prices with our coupons for Sulfasalazine vs. Colazal

Price Card Drug Icon
Sulfasalazine120 tablets / 500mg
$18.95$80.13
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Price Card Drug Icon
Balsalazide270 capsules / 750mg
$85.47$402.04
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