Plaquenil vs. Azulfidine

Plaquenil (hydroxychloroquine) and Azulfidine EN-tabs (sulfasalazine delayed release tablets) are used to treat rheumatoid arthritis.

Plaquenil is also used to treat or prevent malaria, and to treat symptoms of discoid or systemic lupus erythematosus.

Azulfidine EN-tabs is also used to treat moderate to severe ulcerative colitis.

Plaquenil and Azulfidine belong to different drug classes. Plaquenil is an antimalarial medication and Azulfidine EN-tabs is an anti-inflammatory agent and immunomodulatory agent.

Side effects of Plaquenil and Azulfidine that are similar include nausea, vomiting, loss of appetite, diarrhea, dizziness, spinning sensation, headache, ringing in your ears, or itching or skin rash.

Side effects of Plaquenil that are different from Azulfidine include stomach pain or cramps, weight loss, mood changes, nervousness, irritability, or hair loss.

Side effects of Azulfidine that are different from Plaquenil include stomach upset, unusual tiredness, white patches or sores inside your mouth or on your lips, or sleep problems (insomnia).

Plaquenil may interact with acetaminophen, cancer medications, tuberculosis medications, birth control pills or hormone replacement therapy, arthritis medications, ACE inhibitors, antibiotics, antifungals, cholesterol medications, HIV/AIDS medications, nonsteroidal anti-inflammatory drugs (NSAIDs), or seizure medications.

Azulfidine may interact with digoxin, folic acid, or vitamin or mineral supplements that contain folic acid.

Common side effects of Plaquenil include:

• nausea,
• vomiting,
• stomach pain or cramps,
• loss of appetite,
• weight loss,
• diarrhea,
• dizziness,
• spinning sensation,
• headache,
• ringing in your ears,
• mood changes,
• nervousness,
• irritability,
• skin rash,
• itching, or
• hair loss.

Tell your doctor if you experience serious side effects of Plaquenil including:

• muscle weakness,
• twitching,
• uncontrolled movement,
• loss of balance or coordination,
• blurred vision,
• light sensitivity,
• seeing halos around lights,
• pale skin,
• easy bruising or
• bleeding,
• confusion,
• unusual thoughts or behavior, or
• seizures (convulsions).

Common side effects of Azulfidine include:

• stomach upset,
• nausea,
• vomiting,
• loss of appetite,
• diarrhea,
• headache,
• ringing in your ears,
• dizziness,
• spinning sensation,
• unusual tiredness,
• white patches or sores inside your mouth or on your lips,
• sleep problems (insomnia), or
• itching or skin rash.

Azulfidine may cause temporary male infertility. This effect is reversible when Azulfidine is stopped. Tell your doctor if you have serious side effects of Azulfidine including:

• sun sensitivity,
• hearing changes,
• mental/mood changes,
• painful urination,
• blood in the urine,
• changes in the amount of urine,
• new lump or growth in the neck (goiter),
• numbness or tingling of the hands or feet,
• signs of low blood sugar (e.g., hunger, cold sweat, blurred vision, weakness, fast heartbeat), or
• swollen glands.

Plaquenil (hydroxychloroquine) is an antimalarial medication used to treat or prevent malaria, a disease caused by parasites, which enter the body through the bite of a mosquito. Plaquenil is also used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus. Plaquenil is available in generic form.

Azulfidine EN-tabs (sulfasalazine delayed release tablets) is an anti-inflammatory agent and immunomodulatory agent used to treat moderate to severe ulcerative colitis. Azulfidine is also used to treat rheumatoid arthritis in children and adults who have received other arthritis medications without successful treatment of symptoms.

Plaquenil may interact with acetaminophen, cancer medications, tuberculosis medications, birth control pills or hormone replacement therapy, arthritis medications, ACE inhibitors, antibiotics, antifungals, cholesterol medications, HIV/AIDS medications, NSAIDs (non-steroidal anti-inflammatory drugs), or seizure medications. Tell your doctor all medications you use.

Azulfidine EN-tabs may interact with digoxin, folic acid, or vitamin or mineral supplements that contain folic acid. There may be other drugs that can interact with Azulfidine. Tell your doctor about all the prescription and over-the-counter medications and supplements you use. During pregnancy, Azulfidine EN-tabs should be used only when prescribed. Caution is advised if this medication is used near the expected delivery date because similar drugs may cause harm to a newborn. This medication may lower folic acid levels, increasing the risk of spinal cord defects. Consult your doctor about taking enough folic acid. This drug passes into breast milk and could have undesirable effects on a nursing infant. Consult your doctor before breastfeeding.

The adult dose of Plaquenil to suppress malaria is 400 mg on the same day each week. The pediatric weekly suppressive dosage is 5 mg/kg of body weight. The adult dose of Plaquenil to treat an acute attack of malaria is an initial dose of 800 mg followed by 400 mg in six to eight hours and 400 mg for two more days. To treat lupus erythematosus, the average adult dose is 400 mg once or twice daily.

Adult doses of Azulfidine range from 1000 mg to 4000 mg daily, taken 2 to 4 times daily depending on the condition being treated. Pediatric doses are determined by weight.