Difference between Sulfasalazine and Mesalamine

Why would a doctor prescribe one and not the other? I am on Mesalamine but I saw someone mention Sulfasalazine is similar and WAY less expensive. Can I take that instead of my current meds? I am doing well on my current meds so I would be nervous to switch. I am hoping I can get into the patient assistance program through Proctor and Gamble.

Sulfasalazine contains sulfa which is an anti-inflammatory but some people don't do well on sulfa or are allergic to it. I am highly allergic to sulfa and I was on it for a short while. I ended up with welt like hives all over my body. Mesalamines and basalazides do not contain sulfa and is more tolerated by many people. Both mesalamines and basalazide has an anti-inflammatory agent in it that doesn't rely on sulfa.

Oh no. They are not the same. similar in the way they work, but different make up.
I am very allergic to sulfasalazine too! I thought I was going to die when I took that. It's an antibiotic/anti-inflammatory.
I was on asacol and no adverse reactions to it.
So not the same thing.
I wouldn't mess with what works if it were me. Because I know from experience that flares can be hard to get under control.

To At Wit's End, Asacol already comes in 800 mg, that is what I am taking, so hopefully you can start use that soon.

I am one of the ones that swears by Sulfasalazine.  I was on Asacol for over 2 years which did nothing for be, possibly made things worse.  I went on the Sulfasalazine and was in remission within approximately a month to a month and a half.  I will never let another doctor tell me that there are new, more impoved meds that I should go on.  When you find what works for you, definitely stick to it.  If something is not working for you, be willing to try something else.  We are all different and you just never know what is going to work for you if you aren't willing to give other meds a try.  I know that some people can't take it because of the sulfa, I am one of lucky ones that can take it and will not let another doctor tell me to go on something else. 

Sicklygirl,
The splenic flexure is the bend of the colon by your spleen. And the sigmoid colon is close to the last part. They are different places.
I wish your GI would've been clearer about that.
If you think you were better on sulfasalazine, then give it another try! I know asacol is sooooo expensive. It's robbery!

Hi there..
My mother has been suffering with UC for the last 20 years.
She has left sided UC involving the rectum up to sigmoid colon.

She has been on mesacol for most of this period, but the doc asked her to switch to sazo to also help her with the trouble she has been having in her joints because of the steroids.

She has been on sazo for a month now. She sees some signs of bleeding now, which was not this bad with mesacol.
Also she has been complaining of headaches..

What are the common symptoms when you say that you are allergic to sazo?
Is this phase only temporary or should we switch back to mesacol? Any suggestions?

Thanks a ton!

Sulfasalzine breaks down in the colon into mesalamine and sulfpiradine(sp?) 30% of people have intolerance to sulfpiradine severe enough to have to stop taken sulfasalazine. It took me a month and I had headaches and a 101 fever 24/7. I switched to Balasalazine(Colazol) and do fine. Mesalamine (like asacol) must be taken as a pill that is coated for release in the area of the disease or used as a enema or suppository. Reason is that it will be broken down before it gets where needed.

Sulfasalazine's main benefit is it is very inexpensive but it is also more effective as a maintenance drug in trials.The sulfa is antibacterial and believed to be the reason. It doesn't work as well as other drugs to induce remission because intolerance is dose related and almost everyone will have problems at high dosage.

Many doctors refuse to use sulfasalazine because they don't want to deal with the high intolerance rate or have been brainwashed by the pharmacy rep. I think it is a good option for those that can take it and have money issues.

Headaches is intolerance not allergy. Most people get them and they later go away. Sulfasalazine was originally a rheumatoid arthritis drug and does help some people with joint issues.

It might be worth toughing it out.

Post Edited (AZYooper) : 10/9/2012 3:20:45 PM (GMT-6)

kazbern said...
The headaches are a normal (if unpleasant) side effect of sulfazine. An allergy would probably be hives or really acute bowel distress.

Is your mom using any rectal meds in addition to the oral?

None of the ASA products helped me. I was taking them as I rode into the hospital twice. I even tried one of the rectal variations and bled like crazy from it.

Sulfasalazine I suggested to my doc along with Mebeverine ( or Librax in US ).

I do not have any headaches and its dirt cheap. He tried to put me on something really expensive this time and I just said lets move on to prednisone which worked immediately.

oops forgot to take the prednisone again - today I dropped to 10mg missed my 9:00 PM dose by 2.5 hours. 2.5 mg 4 times daily is the new regime and it will be followed by 2 sulfasalazine and one librax. Mebeverine will come when prednisone is at zero.

I think if your doing good, do not tamper with it. If you flare well then what your taking is not so good and you could try switching then.

Good luck

Welcome to the forum charleyh.

Sulfazine is a great med but it does have more potentially serious side effects than mesalamine. If you are interested in trying a generic mesalamine, ask your DR about balsalazide.

After spending thousands and thousands on drugs pushed by the drug rep's on my "specialist" GI doctor that weren't working anyway I decided to do my own research . I then decided to try Sulfazine or Sulfasal-azine DR (or EC) . 2 -- 500mg --4 times a day. Instant relief , total remission. That was 3+ yrs ago . Only a few very brief (1-2 days) flares since . My GI specialist wouldn't prescribe it . Found a good general practice (family) doctor and he has me on it now . Never will go back to the GI doctor . Sulfazine is dirt cheap and works GREAT (wait for it) ...........for..........me ! Don't mean it will for you ! I now only take 2 -500mg tab--2 times a day . Hope this helps you as it did me . My best advice ...........take charge of your own healthcare ! Farmer Jim

Don't wait to be offered it ! I wasn't offered it either . I researched and decided to try it and then found a doctor who thinks a patient should have a voice in his/her treatment ! I told him what I wanted and he got out his laptop and after 20 or 25 min. said "lets try that " . Farmer Jim

ya, but the real question is, who refreshed you farmer jimbo ?