Azulfidine

Sulfasalazine is made up of two primary components: molecules called 5-ASA and sulfapyridine. Taken as a tablet, sulfasalazine is not active in its ingested form, but is broken down into its two components by bacteria in the colon. It was the first aminosalicylate widely given to patients suffering from IBD (approved by the FDA in 1950), and is effective for mild to moderate forms of the disease. The relative low cost of sulfasalazine is offset by its side effects, so while usage has declined, it still presents an effective and relatively inexpensive treatment for patients who can tolerate the drug.

The mode of operation for sulfasalazine is as an anti-inflammatory drug in the colon. The products of the breakdown of sulfasalazine act as topical agents to provide relief from inflammation inside the colon, though there may be beneficial immune-suppressant effects in the system as well. Side effects include, but are not limited to, nausea, headache, rash, fever, loss of appetite, orange-yellow discoloration of the skin and/or urine, and a decrease in sperm count leading to temporary infertility.