If you have ulcerative colitis (UC) or certain kinds of arthritis, your doctor might suggest Azulfidine or Azulfidine EN-tabs as a treatment option.
Azulfidine and Azulfidine EN-tabs are prescription drugs used in adults and some children:
- to treat mild to moderate UC
- to treat severe UC, when used together with other medications
- to lengthen the periods of no or few symptoms between UC flare-ups
Azulfidine EN-tabs are also used to treat:
- rheumatoid arthritis (RA) in adults who didn’t respond well enough to certain other medications
- polyarticular juvenile idiopathic arthritis (JIC) in some children who didn’t respond well enough to certain other medications
The active ingredient in Azulfidine and Azulfidine EN-tabs is sulfasalazine. (The active ingredient is what makes a drug work.) Azulfidine and Azulfidine EN-tabs belong to a group of drugs called disease-modifying anti-rheumatic drugs (DMARDs).
Azulfidine and Azulfidine EN-tabs come as tablets that you swallow.
This article describes the dosages of Azulfidine and Azulfidine EN-tabs, as well as their strength and how to take them. To learn more about these drugs, see this in-depth article.
Note: The chart below highlights the basics of adult dosages* for Azulfidine and Azulfidine EN-tabs. Be sure to read on for more detail. And please keep in mind that this article covers the standard dosing schedules for Azulfidine and Azulfidine EN-tabs, which are provided by the drug’s manufacturer. But always follow the dosing instructions your doctor prescribes.
| Azulfidine forms | Azulfidine strength | Condition being treated | Usual starting dosage | Usual maintenance dosage |
| Azulfidine tablet Azulfidine EN-tab | 500 milligrams (mg) | UC (adults) | 3–4 grams (g)/day** | 2 g/day** |
| Azulfidine EN-tab | 500 mg | RA (adults) | your doctor may start you on a low dose | 2 g/day** |
* See “What’s the dosage of Azulfidine and Azulfidine EN-tabs for children?” below for the recommended children’s dosages.
** These tablets would be divided into equal doses that you take at regular times throughout the day.
The information below describes the recommended dosages for Azulfidine and Azulfidine EN-tabs.
What are the forms of Azulfidine and Azulfidine EN-tabs?
Azulfidine and Azulfidine EN-tabs come as tablets that you swallow. They both have the same active ingredient but are released into the body differently. Azulfidine EN-tabs have a coating that delays the drug’s release into your body. These tablets are broken down in your intestines instead of your stomach. This helps prevent stomach irritation.
What strength do Azulfidine and Azulfidine EN-tabs come in?
Azulfidine and Azulfidine EN-tabs come in one strength of 500 milligrams (mg).
What are the typical dosages of Azulfidine and Azulfidine EN-tabs?
Your doctor will usually start you on a low dosage of Azulfidine or Azulfidine EN-tabs. Then they’ll adjust it over time to reach the right amount for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you.
Dosage for ulcerative colitis (UC)
When used for UC, the recommended adult starting dosage of Azulfidine and Azulfidine EN-tabs is 3 grams (g)* to 4 g per day. This is divided evenly into several doses that you’ll take no more than 8 hours apart. In some situations, your doctor may start you on a lower dose.
After your symptoms start to improve and your body adjusts to the drug, your doctor may decrease your dosage. You’ll then take 2 g/day, which will likely also be divided into several doses. This is your maintenance dosage. It’s the amount of medication you’ll take throughout your treatment to maintain the right level of the drug in your body.
* 1 g = 1,000 mg
Dosage for adult rheumatoid arthritis (RA)
Your doctor may have you start on a low dose of Azulfidine EN-tabs for adult RA. This will likely be 500 milligrams (mg) once or twice each day. After your body adjusts to the drug, your doctor may increase your dose. They’ll likely have you take the recommended dosage of 2 g/day in several doses.
As your dosage for adult RA increases, your doctor may recommend a dosing schedule for Azulfidine EN-tabs such as the one below.
Azulfidine EN-tabs dosage for adult rheumatoid arthritis
| Week | Morning dose | Evening dose | Total daily dose |
| 1 | none | 500 mg (1 tablet) | 500 mg (0.5 g) = 1 tablet |
| 2 | 500 mg (1 tablet) | 500 mg (1 tablet) | 1,000 mg (1 g) = 2 tablets |
| 3 | 500 mg (1 tablet) | 1,000 mg (2 tablets) | 1,500 mg (1.5 g) = 3 tablets |
| 4 and after | 1,000 mg (2 tablets) | 1,000 mg (2 tablets) | 2,000 mg (2 g) = 4 tablets |
What’s the dosage of Azulfidine and Azulfidine EN-tabs for children?
In children ages 6 years and older, Azulfidine and Azulfidine EN-tabs are dosed based on body weight.
Dosage for ulcerative colitis (UC)
Both Azulfidine and Azulfidine EN-tabs are treatment options for UC in children. The daily starting dosage for children is 40 milligrams (mg) to 60 mg per kilogram (kg)* of body weight. The daily dosage is divided into three to six doses. Your child’s doctor will calculate your child’s dosage when prescribing this medication.
Your child’s doctor may reduce your child’s dose to a daily maintenance dosage of 30 mg/kg divided into four doses. This will depend on factors such as side effects your child may be having and how their UC is responding to Azulfidine.
* 1 kg is about 2.2 lbs.
Dosage for polyarticular juvenile idiopathic arthritis (JIA)
Azulfidine EN-tabs are used to treat JIA in children ages 6 years and older. The recommended dose is 30 mg to 50 mg per kilogram of body weight. The daily dosage is divided into two doses.
Your child’s doctor will calculate your child’s dosage when prescribing this medication.
Your child’s doctor may also start your child on a lower dosage and slowly increase it over the first month.
The maximum dosage for a child is usually 2 g (2,000 mg) per day.
* 1 kg is about 2.2 lbs.
Are Azulfidine and Azulfidine EN-tabs used long term?
Yes, Azulfidine and Azulfidine EN-tabs are usually taken long term. If you and your doctor determine that Azulfidine or Azulfidine EN-tabs are safe and effective, you will likely take the medication long term.
The dosage of Azulfidine or Azulfidine EN-tabs your doctor prescribes may depend on several factors. These include:
- the type and severity of the condition you’re taking the drug to treat
- your age
- the form of the drug you’re taking
- other conditions you may have
For children ages 6 years and older, it will also be based on their body weight.
Azulfidine and Azulfidine EN-tabs are tablets that you swallow. It’s recommended they be taken after a meal if possible. The total daily dosage is divided evenly into multiple doses. Azulfidine EN-tabs should not be chewed, crushed, or broken.
For information on Azulfidine and Azulfidine EN-tabs expiration, storage, and disposal, see this article.
Accessible drug containers and labels
If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies provide medication labels that:
- have large print or use braille
- feature a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Azulfidine or Azulfidine EN-tabs in an easy-open container. They may also have tips that can help make it easier to open the drug’s container.
If you miss a dose of Azulfidine or Azulfidine EN-tabs, call your doctor. Your doctor may recommend you take the dose right away or skip the missed dose, depending on certain factors.
If you need help remembering to take your dose of Azulfidine or Azulfidine EN-tabs on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Do not take more Azulfidine or Azulfidine EN-tabs than your doctor prescribes. Taking more than this can lead to serious side effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
- belly pain
- nausea
- vomiting
- drowsiness
- convulsions (a type of seizure)
What to do in case you take too much Azulfidine or Azulfidine EN-tabs
Call your doctor right away if you think you’ve taken too much Azulfidine or Azulfidine EN-tabs. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
The sections above describe the typical dosages provided by the drug’s manufacturer. If your doctor recommends Azulfidine or Azulfidine EN-tabs for you, they’ll prescribe the dosage that’s right for you.
Remember, you should not change your dosage of Azulfidine or Azulfidine EN-tabs without your doctor’s recommendation. Only take Azulfidine or Azulfidine EN-tabs exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions you may want to ask your doctor:
- Will my dosage change if I switch from Azulfidine to Azulfidine EN-tabs?
- Will my dosage change the longer I take Azulfidine or Azulfidine EN-tabs?
- How often will you need to change my child’s dosage as they grow?
If you have ulcerative colitis (UC) or rheumatoid arthritis (RA), consider signing up for Healthline’s IBD newsletter or RA newsletter for tips on managing these conditions.
You can also find support and advice from our Bezzy communities for IBD and RA.
Q:
A:
It’s possible, but this is up to you and your doctor to decide.
The drug’s manufacturer hasn’t made a dosage recommendation for people with liver or kidney problems. Your liver and kidney function will be tested before you start treatment. If you have problems with these organs, your doctor will carefully determine if Azulfidine or Azulfidine EN-tabs are right for you. They may decide a different treatment may be a safer choice.
Also, severe liver and kidney problems can be a side effect of Azulfidine and Azulfidine EN-tabs. Your doctor will monitor you during your treatment. They can change your dosage or stop your treatment if you start having these problems.
The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
