Compare Imuran vs. Asacol

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

Imuran
(Azathioprine)

Lialda
(Mesalamine)

Prevents organ rejection and relieves joint pain and inflammation. Imuran (Azathioprine) is an effective medication for the treatment of rheumatoid arthritis and transplant rejection, but comes with a heavy list of side effects.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.
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Reviews & ratings
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Side effects
ImuranAsacol

The Imuran FDA package insert doesn’t have numbers about how common side effects are.

More about Imuran 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 »
How it works
ImuranAsacol
Imuran (Azathioprine) is an immunosuppressant medication. It blocks the production of the white blood cells that kill unfamiliar cells.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.
Type of medication
ImuranAsacol
Immunosuppressant
Immunomodulator
Antirheumatic
Biological response modifier
Anti-rejection
Kidney transplant anti-rejection
Anticancer
Purine antimetabolite
Prescription only
Anti-inflammatoryPrescription only
Available as
ImuranAsacol
  • Pill
  • Pill
  • Extended release
  • Enema
  • Suppository
Used for (click to learn more)
ImuranAsacol
Risk factors for serious side effects
ImuranAsacol
        • Sexually active men and women
        • Pregnant women
        • Child-bearing women
        Detailed Imuran (Azathioprine) risks & warnings »
        • 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 »
        Pregnancy category
        ImuranAsacol
        DFDA pregnancy category (Weigh risks vs. benefits)

        Research studies with real people found harmful effects on unborn babies, but the benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

        See the FDA package insert
        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
        Alcohol
        • Drinking alcohol is okay while taking Imuran (Azathioprine).
        No specific alcohol-related info.
        Food
        No specific food-related info.No specific food-related info.
        Kidneys and liver
        No specific kidneys and liver-related info.
        • 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.
        Sex
        • If you're sexually active, you and your partner should use birth control, since Imuran (Azathioprine) can cause birth defects.
        No specific sex-related info.
        Sleep
        No specific sleep-related info.No specific sleep-related info.
        Weight
        No specific weight-related info.No specific weight-related info.
        Upsides and benefits
        ImuranAsacol
        • Imuran (Azathioprine) has proven to be effective in the treatment of rheumatoid arthritis.
        • Imuran (Azathioprine) decreases the pain, stiffness, and swelling that most people have with rheumatoid arthritis.
        • You can still get vaccinated for the flu while taking Imuran (Azathioprine).
        • Drinking alcohol is okay while taking Imuran (Azathioprine).
        • Most side effects are temporary.
        • 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).
        Downsides and risks
        ImuranAsacol
        • If you take Imuran (Azathioprine) for rheumatoid arthritis, you'll likely need to take additional medications to control your symptoms.
        • While taking Imuran (Azathioprine), you will have to get your blood tested once a week for the first month, every other week for the second and third month, and once every month after that.
        • Along with other side effects, your hair may begin to change color or fall out when you first start taking Imuran (Azathioprine), but this is usually temporary.
        • You'll likely have to take additional medications, like methotrexate to keep your rheumatoid arthritis in remission.
        • 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.
        Tips from our pharmacists for people taking the medication
        ImuranAsacol
        • If you're sexually active, you and your partner should use birth control, since Imuran (Azathioprine) can cause birth defects.
        • If you take Imuran (Azathioprine) for rheumatoid arthritis, your joint damage can’t be reversed, so keep up with your physical therapy and get plenty of rest.
        • While taking Imuran (Azathioprine), your body is susceptible to infection; so be sure to wash your hands often and keep distance from with people who are sick.
        • It is typical to have some nausea when you first start taking Imuran (Azathioprine); if it's unbearable, let your doctor know.
        • Don't sun tan while taking this medication. Always use sunscreen and wear a long-sleeved shirt, pants, hat, and sunglasses.
        • 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.
        Learn more
        More about ImuranSide effectsReviews & ratingsAlternativesFDA package insert
        More about AsacolSide effectsReviews & ratingsAlternativesFDA package insert