Azulfidine and Azulfidine EN-tabs (sulfasalazine) dosages vary based on the condition the drug is used to treat. Typical starting dosages are 3 to 4 grams per day for ulcerative colitis and 0.5 grams per day for rheumatoid arthritis. Your doctor will likely adjust your dosage during treatment.
Azulfidine and Azulfidine EN-tabs (sulfasalazine) are prescription drugs used to treat ulcerative colitis (UC) or certain kinds of arthritis. These drugs come as tablets that you swallow. It’s usually taken a few times per day. Azulfidine and Azulfidine EN-tabs are used in adults and some children to:
- treat mild to moderate UC
- treat severe UC, when used together with other medications
- 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 (JIA) 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 antirheumatic drugs (DMARDs).
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, including their side effects and uses, see this in-depth Azulfidine and Azulfidine EN-tabs article.
Your doctor will likely start you on a low dosage and adjust it over time to reach the right amount for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
The following table highlights the basics of adult dosages for Azulfidine and Azulfidine EN-tabs. To learn more about the recommended children’s dosages, see the “Azulfidine and Azulfidine EN-tab dosage for children” section.
Always take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs. In some cases, doctors may adjust your dosage from those shown here.
| Azulfidine forms | Azulfidine strength | Condition being treated | Usual starting dosage | Usual maintenance dosage |
| Azulfidine tablet Azulfidine EN-tab | 500 milligrams (mg) | UC (adults) | 3 to 4 grams (g) per day | 2 g per day, divided into equal doses and taken throughout the day |
| Azulfidine EN-tab | 500 mg | RA (adults) | your doctor may start you on a low dose | 2 g per day, divided into equal doses and taken throughout the day |
Azulfidine and Azulfidine EN-tab forms
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.
Azulfidine and Azulfidine EN-tab strengths
Azulfidine and Azulfidine EN-tabs come in one strength of 500 milligrams (mg).
Azulfidine and Azulfidine EN-tabs are approved to treat the following conditions:
- ulcerative colitis (UC)
- rheumatoid arthritis (RA)
- polyarticular juvenile idiopathic arthritis (JIA)
Azulfidine EN-tabs are also approved to treat the following:
- RA in certain adults who have tried nonsteroidal anti-inflammatory drugs (NSAIDs)
- polyarticular JIA (affects five or more joints) in certain children ages 6 years and older who have tried NSAIDs
The prescribed Azulfidine and Azulfidine EN-tab dosage may vary depending on the condition they’re being used to treat. Always follow your doctor’s instructions. Notify them if you experience any side effects that may prevent you from taking your medication.
Dosage for adult ulcerative colitis (UC)
When used for UC, the recommended adult starting dosage of Azulfidine and Azulfidine EN-tabs is 3 to 4 grams (g) per day. Note that 1 gram is equal to 1,000 mg. 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 per 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.
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 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 per 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 |
Azulfidine and Azulfidine EN-tabs are used to help treat UC and polyarticular JIA in children ages 6 years and older. The dosage for children is 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 to 60 mg per kilogram (kg) of body weight. Note that 1 kg is equal to about 2.2 pounds. 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.
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 to 50 mg per kilogram of body weight. Note that 1 kg is equal to about 2.2 pounds. 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.
The following are answers to some commonly asked questions about Azulfidine and Azulfidine EN-tab’s dosage.
What is the dosage of Azulfidine and Azulfidine EN-tab (sulfasalazine) for Crohn’s disease or ankylosing spondylitis?
Azulfidine and Azulfidine EN-tabs are not approved for Crohn’s disease or ankylosing spondylitis. But in some cases, your doctor may prescribe it off-label for these uses. (With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.)
Because Azulfidine and Azulfidine EN-tabs aren’t approved for Crohn’s disease or ankylosing spondylitis, the drug manufacturer doesn’t provide recommended dosages for this use. Your doctor will prescribe the dosage that’s right for you.
To learn more about your treatment options for Crohn’s disease or ankylosing spondylitis, including Azulfidine and Azulfidine EN-tabs, talk with your doctor.
What if I miss a dose of Azulfidine or Azulfidine EN-tabs?
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.
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.
Are Azulfidine and Azulfidine EN-tabs used long term? How long can you stay on Azulfidine?
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.
You can stay on Azulfidine for as long as is needed to keep your symptoms at bay. Most people taking Azulfidine will experience symptom relief soon after beginning treatment and complete symptom relief after about 4 to 6 weeks. However, continuous lifelong treatment with Azulfidine may be recommended in some cases.
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 of Azulfidine or Azulfidine EN-tabs 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 America’s Poison 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.
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.
