Posted 1/28/2020 11:45 AM (GMT -6)
Sulfasalazine and Lialda are both mesalamines/5-ASA. The only difference is how the medication is delivered. Lialda is mesalamine in a pill that has a PH delayed-release coating on it, which dissolves when the pill arrives within the large intestine releasing the medication. Sulfasalazine has no coating, rather it is a more complex molecule and gut bacterium cleave it into mesalamine and a byproduct (a sulfite). So regardless of which of those pills you take, the same result occurs mesalamine is delivered to the large intestine, just a difference of the mechanism used. The sulfite byproduct within sulfasalazine is an allergen to some, and can cause headaches in some. Sulfasalazine is an older medication, been on the market for many decades, it's inexpensive. Unprotected mesalamine within the stomach would cause nausea and vomiting, just key that mesalamine passes the stomach protected, and is released only within the intestines.
If you have a known sulfite allergy or are worried about the potential for headaches, then do consider balsalazide disodium. Balsalazide disodium is another more complex molecule than mesalamine, that gut bacterium cleave into mesalamaine by the byproduct is NOT a sulfite. So, no headache issue and no allergen issue either.