Mesalamine vs Sulfasalazine – Comparison of Uses & Side Effects

Mesalamine

It is the generic name of a drug that belongs to a group of drugs called aminosalicylates. It can be found under the following brand names – Lialda, Asacol HD, Delzicol, Apriso, and Pentasa.

Mechanism of Action

It works by stopping the body from producing a certain substance which may cause inflammation or pain in the colon.

Uses

This prescription medication is used to treat ulcerative colitis, a long-term condition which results in inflammation and ulcers of the rectum and colon.

Dosage

The usual recommended dose is 1 g orally 4 times per day for up to 8 weeks. Take this medication with a full glass of water.

Side Effects and Precautions

Common side effects may include:

  • back pain;
  • constipation;
  • rash;
  • diarrhea;
  • abnormal liver function tests;
  • stomach pain;
  • headache;
  • sore throat;
  • sinus pain;
  • nausea;
  • runny or stuffy nose.

Rare side effects may include:

  • feeling tired or short of breath;
  • bloody diarrhea;
  • jaundice (yellowing of the skin or eyes);
  • cramping;
  • loss of appetite;
  • severe stomach pain;
  • skin rash;
  • clay-colored stools;
  • fever;
  • upper stomach pain;
  • dark urine;
  • swelling in your feet or ankles;
  • painful or difficult urination;
  • coughing up vomit that looks like coffee grounds;
  • easy bruising or bleeding;
  • little or no urination;
  • bloody or tarry stools.

Contraindications

Before taking this aminosalicylate, tell your healthcare provider if you have:

  • allergic or sensitive to salicylates;
  • allergic to mesalamine.

Alcohol

Avoid drinking alcoholic beverages while taking this aminosalicylate since alcohol use can substantially increase the risk of severe side effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • naproxen;
  • aspirin;
  • ibuprofen;
  • Azathioprine;
  • Aspirin Low Strength.

Pregnancy & Breastfeeding

It is unclear what effect this aminosalicylate has on nursing babies, there, talk to your healthcare professional before taking the drug if you are breast-feeding a baby.

The effects of this medication on a pregnant woman’s developing fetus have not been studied. Talk to your healthcare provider about the aminosalicylate if you are pregnant or planning a pregnancy.

Sulfasalazine                   

It is the generic name of a drug that belongs to a class of drugs called sulfa drugs. It can be found under the following brand names – Azulfidine or Sulfazine.

Mechanism of Action

This medication works by affecting a substance in the human body which causes tissue damage, inflammation, and diarrhea.

It is manufactured as Azulfidine by Pfizer. The US Food and Drug Administration originally approved this medication in 1950.

Uses

This prescription medication is used to treat the symptoms of ulcerative colitis including diarrhea, bowel inflammation, abdominal pain, and rectal bleeding.

Dosage

The usual recommended dose is 3 to 4 g per day orally in evenly divided doses.

Side Effects

Common side effects may include:

  • feeling tired or short of breath;
  • painful or difficult urination;
  • severe nausea or vomiting;
  • a red or purple skin rash that spreads and causes blistering and peeling;
  • burning in your eyes;
  • swelling in your face, feet, ankles, or tongue;
  • sore throat;
  • little or no urinating.

Rare side effects may include:

  • fainting;
  • chills;
  • rapid and shallow breathing;
  • sudden weakness or ill feeling;
  • rapid heart rate;
  • trouble breathing;
  • jaundice (yellowing of the skin or eyes);
  • sore throat;
  • unusual bleeding;
  • red or swollen gums;
  • wheezing;
  • easy bruising;
  • skin sores;
  • painful mouth sores;
  • pain when swallowing;
  • cough with yellow or green mucus;
  • stabbing chest pain.

Precautions

Before taking this sulfa drug, tell your healthcare provider if you have:

  • thyroid problems;
  • asthma;
  • severe allergies or allergies to any type of medication;
  • liver disease;
  • kidney disease;
  • a blockage in your stomach or urinary tract;
  • porphyria (a blood disorder);
  • an infection that keeps coming back;
  • anemia or low white blood cell levels;
  • a glucose-6-phosphate dehydrogenase (G6PD) deficiency;
  • rheumatoid arthritis.

Alcohol

Avoid drinking alcoholic beverages while taking this sulfa drug since alcohol use can substantially increase the risk of severe side effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • naproxen;
  • Aleve (naproxen);
  • invega;
  • methotrexate;
  • aspirin;
  • ibuprofen;
  • diphenhydramine;
  • Aspirin Low Strength;
  • Celebrex (celecoxib);
  • Nucala;
  • folic acid.

Pregnancy & Breastfeeding

This sulfa drug can be found in breast milk. You should not breastfeed a baby while taking this medication without first talking to your healthcare provider.

The effects of this sulfa drug on a pregnant woman’s developing fetus have not been studied. Talk to your healthcare provider about the sulfa drug if you are pregnant or planning a pregnancy.

Bottom Line – Mesalamine vs Sulfasalazine                   

Mesalamine (brand names – Lialda, Asacol HD, Delzicol, Apriso, and Pentasa) is a medication that is used to treat mild to moderate ulcerative colitis. In addition, it is used to prevent the symptoms of ulcerative colitis from recurring. This medication works by affecting a substance in the human body which causes tissue damage, inflammation, and diarrhea.

Sulfasalazine (brand names – Azulfidine or Sulfazine) is a medication that is used to treat moderate to severe ulcerative colitis. In addition, it is used to treat rheumatoid arthritis in patients who have used other arthritis drugs without successful treatment of symptoms. This medication works by affecting a substance in the human body which causes tissue damage, inflammation, and diarrhea.

According to a 2012 study, the hematological adverse effects of mesalazine treatment might be greater than those of sulfasalazine treatment.

Regarding their price, the average retail price for 120 tablets of mesalamine 1.2g is $430, while the average retail price for 120 tablets of sulfasalazine 500mg is $18.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314328/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108647/
https://www.sciencedirect.com/topics/neuroscience/mesalazine