Compare Asacol vs. Sulfasalazine

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



Treats inflammatory bowel disease. Lialda (Mesalamine) is an effective first-line medicine for inflammatory bowel disease. There isn't a generic version and you'll have to take it multiple times a day.Reduces inflammation. Azulfidine (Sulfasalazine) is used for moderate to severe inflammatory bowel conditions, and with other meds for treating rheumatoid arthritis.
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Side effects
  • Pain 6%
  • Indigestion 5%
  • Constipation 4%
  • Abdominal pain 4%
  • Vomiting 3%
  • Rash 3%
  • Stiff or rigid muscles 2%
  • Sore throat 2%
  • Joint pain 2%
  • Back pain 2%
More Asacol side effects »

We haven’t found good data for Sulfasalazine side effects.

FDA side effect reports for Sulfasalazine »
How it works
Lialda (Mesalamine) is an anti-inflammatory medication. Researchers don't know exactly how Lialda (Mesalamine) works in the colon, but it seems to lower the chemicals in the body that cause inflammation.Azulfidine (Sulfasalazine) is an anti-inflammatory drug that reduces inflammation and pain. It treats inflammatory bowel diseases and rheumatoid arthritis.
Type of medication
Anti-inflammatoryPrescription only
Biological response modifier
Prescription only
Available as
  • Pill
  • Extended release
  • Enema
  • Suppository
  • Pill
  • Extended release
Used for (click to learn more)
Risk factors for serious side effects
  • Asthma
  • Rhinitis
  • Nasal polyps
  • Aspirin allergy
  • NSAID allergy
  • Phenylketonuria (PKU)
  • Kidney problems
  • Liver problems
  • Age 65 or older
  • Liver problems
  • Taking Lialda (Mesalamine) at the start of treatment
Detailed Lialda (Mesalamine) risks & warnings »
          Detailed Azulfidine (Sulfasalazine) risks & warnings »
          Pregnancy category
          CFDA pregnancy category (Weigh risks vs. benefits)

          Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

          See the FDA package insert
          BFDA pregnancy category (Probably safe)

          Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

          See the FDA package insert
          No specific alcohol-related info.No specific alcohol-related info.
          No specific food-related info.
          • Swallow tablets whole, and take after a meal with a full glass of water.
          Kidneys and liver
          • Not a good option if you have kidney disease.
          • Lialda (Mesalamine) is broken down by the kidney and liver. If you have kidney or liver problems, talk to your doctor because you may need to take a different dose of the medication.
          • Azulfidine (Sulfasalazine) isn't a good option if you have kidney or liver disease.
          • Complete blood counts should be done before starting Azulfidine (Sulfasalazine) and every other week during the first three months of treatment. Since kidney damage can occur, you'll need a urinalysis and an assessment of your kidney function periodically during treatment.
          • Severe hypersensitivity reactions can include internal organ involvement, such as hepatitis (liver), nephritis (kidney), myocarditis (heart), blood abnormalities, or pneumonitis (lungs).
          No specific sex-related info.No specific sex-related info.
          No specific sleep-related info.No specific sleep-related info.
          No specific weight-related info.No specific weight-related info.
          Upsides and benefits
          • Effective first-line medication for treating and lowering the symptoms of mild inflammatory bowel disease.
          • About half the people who have mild to moderate colon inflammation and take Lialda (Mesalamine) will see improvement.
          • Available in tablets, capsules, enemas, and suppositories.
          • Certain forms of Lialda (Mesalamine) can be used during pregnancy. Talk to your doctor if you're pregnant, or plan on becoming pregnant, and you want to take Lialda (Mesalamine).
          • When taken consistently, Azulfidine (Sulfasalazine) can control your symptoms of ulcerative colitis and other bowel diseases.
          • Azulfidine (Sulfasalazine) is usually used in combination with other medications to control rheumatoid arthritis.
          Downsides and risks
          • No generic versions are available for the tablets, capsules, and suppositories (meaning it could be somewhat expensive).
          • Doesn't work well for severe colon inflammation.
          • You may need to take Lialda (Mesalamine) three or four times a day.
          • Not a good option if you have kidney disease.
          • You need to have blood tests every 3 months when taking Azulfidine (Sulfasalazine).
          • Azulfidine (Sulfasalazine) isn't a good option if you have kidney or liver disease.
          • Can't take Azulfidine (Sulfasalazine) if you are allergic to aspirin or sulfa medications.
          • Azulfidine (Sulfasalazine) shouldn't be used if you are breastfeeding.
          Tips from our pharmacists for people taking the medication
          • Don't take Lialda (Mesalamine) if you're allergic to aspirin. Talk to your doctor or pharmacist about any drug allergies you have before starting Lialda (Mesalamine).
          • Taking antacids with Lialda (Mesalamine) can make your inflammation worse. Talk to your doctor before you make any changes.
          • You can sunburn more easily when taking Lialda (Mesalamine). Use sunscreen and protective clothing when you go outdoors.
          • Don't break, chew, or crush the tablets because they're coated and won't work as well.
          • The suppositories should be kept in for at least 1 to 3 hours to get the most benefit.
          • Don't use if you are allergic to sulfa drugs or aspirin.
          • Swallow tablets whole, and take after a meal with a full glass of water.
          • Drink at least six glasses of water daily while on this.
          • Continue to take Azulfidine (Sulfasalazine) even once you feel better.
          • Read the information that come with your medication in the drugstore since there are many conditions you should be aware of before taking Azulfidine (Sulfasalazine).
          • Can cause an orange color in your urine or skin.
          Learn more
          More about AsacolSide effectsReviews & ratingsAlternativesFDA package insert
          More about SulfasalazineSide effectsReviews & ratingsAlternativesFDA package insert