Compare Asacol vs. Sulfasalazine

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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.
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)
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Reviews & ratings
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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 »
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
          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