Sulfasalazine

Description

Sulfasalazine is a medicine used in the treatment of Ulcerative colitis and Crohn's disease. It may also be used for the treatment of advanced arthritic conditions like rheumatoid arthritis (an autoimmune and chronic inflammatory disorder affecting many joints, including those in the hands and feet) and spondylitis (a condition that causes swelling and stiffness of joints between the vertebrae, the bones that make up the spinal cord.) which do not respond to normal treatments. Sulfasalazine can cause some side effects like weight loss, loss of appetite, vomiting, nausea, stomach upset and diarrhoea. It should be taken with food to reduce the chances of you getting stomach upset, indigestion and other side effects. Inform your doctor if any of these side effects persist or worsen. Do not take this medicine if you are allergic to it or if you are allergic to aspirin. Sulfasalazine is not suitable for you if you have anaemia, asthma, liver or kidney problems. It is advised that you drink plenty of fluids to prevent the formation of kidney stones. Do not consume alcohol while on treatment with this medicine. Consult your doctor before using Sulfasalazine if you are pregnant. It is not recommended for use if you are breastfeeding as it can pass through milk. It can cause a low sperm count in men, which is reversible. This medicine is not recommended for use in children less than 2 years of age.

Side effects

Major & minor side effects for Sulfasalazine

  • Joint pain
  • Skin rash and itching
  • Headache
  • Increased sensitivity of the skin to sunlight
  • Bleeding from nose
  • Dark colored urine
  • Sore throat
  • Abdominal pain
  • Weight loss
  • Fever
  • Loss of appetite

Uses of Sulfasalazine

What is it prescribed for?

  • Ulcerative Colitis
  • Rheumatoid Arthritis
  • Crohn's Disease
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Concerns

Commonly asked questions

  • Onset of action
    The amount of time required for Sulfasalazine to show its action is not known.
  • Duration of effect
    The time until which Sulfasalazine remains active in the body is not known.
  • Safe with alcohol?
    Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
  • Is it habit forming?
    No habit forming tendency has been reported for Sulfasalazine.
  • Usage in pregnancy?
    Sulfasalazine is not recommended to be used in pregnancy unless necessary. Consult your doctor before taking this medicine.
  • Usage while breast-feeding?
    Sulfasalazine is not recommended to be used in breastfeeding unless absolutely necessary as it can pass into the breastmilk and may harm your infant. Consult your doctor before taking this medicine.

Allergy

Sulfasalazine is not recommended for use if you are allergic to sulfasalazine or any other ingredients present in the formulation. Seek immediate medical help if you notice allergic symptoms like swelling of the face, especially around the eyes.

Patients with intestinal and urinary obstruction

Sulfasalazine is not recommended to be used if you have a history of intestinal and urinary obstruction (blockage) due to the increased risk of worsening your condition.

Porphyria

Sulfasalazine is not recommended for use if you have a known history of porphyria, which is a hereditary condition affecting the nervous system and skin as it may worsen your condition.
Warnings for special population

Pregnancy

Sulfasalazine is not recommended to be used in pregnancy unless necessary. Consult your doctor before taking this medicine.

Breast-feeding

Sulfasalazine is not recommended to be used in breastfeeding unless absolutely necessary as it can pass into the breastmilk and may harm your infant. Consult your doctor before taking this medicine.
General warnings

Blood dyscrasias.

Sulfasalazine is not recommended for use if you have blood disorders due to the increased risk of serious side effects. It is advised that inform your doctor about all your medical conditions before taking this medicine.

Liver disease

Use Sulfasalazine with caution if you have a pre-existing liver problem. Your doctor may monitor your liver function closely and adjust the dose of this medicine if required based on your condition.

Oligospermia and infertility

Sulfasalazine can cause a low sperm count. It should be used with caution in men due to the increased risk of impotence. This condition can be reversed by stopping the use of Sulfasalazine

Haemolytic anaemia

Sulfasalazine may cause haemolytic anaemia if you have a glucose-6 phosphate dehydrogenase deficiency (a genetic disorder that most often affects males). This condition causes the breakdown of red blood cells in response to certain medications, infections or other stresses. Your doctor may suggest tests to estimate your complete blood count during the treatment with this medicine.

Use in children

Sulfasalazine is not recommended for use in children less than 2 years of age since the safety and efficacy data is not available. Its delayed-release form can be used from ages 6 years and above.

Missed Dose

If a dose of Sulfasalazine is missed, take it as soon as you remember. If it is almost the time for the next dose, skip the missed dose and take the next dose. Do not double the dose to make up for the missed one.

Overdose

Never take more than the prescribed dose. Seek emergency medical treatment in case of an overdose with Sulfasalazine.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.

Instructions

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Interaction with Medicine

Methotrexate

Digoxin

Insulin

Diclofenac

Azathioprine

Folic Acid

Etodolac

Glimepiride

Disease interactions

Hematologic toxicity

Sulfasalazine is not recommended if you have a known history of blood disorders due to the increased risk of serious side effects. Inform your doctor about all your medical conditions before taking this medicine.

Liver disease

Use Sulfasalazine with caution if you have pre-existing liver problems. Your doctor may monitor your liver function closely and adjust the dose of this medicine if required based on your condition.

Kidney diseases

Use Sulfasalazine with caution if you have a pre-existing kidney problem due to the increased risk of severe side effects. Your doctor may monitor your kidney function closely and adjust the dose of this medicine if required based on your condition.
Food interactions
Information not available.
Lab interactions
Information not available.
Take Sulfasalazine as directed by the doctor. It is recommended to take this medicine with food to avoid any indigestion. Drink plenty of water to prevent the formation of kidney stones. Do not take more or fewer doses than advised/prescribed. Consult the doctor if you experience any undesirable side effects. It may cause your skin, urine, saliva and tears to turn orange. Do not worry as this is normal. It may take 6-8 weeks for it to show its effects. Do not stop using this medicine without consulting your doctor.
Miscelleneous

To be taken with food

To be taken as instructed by doctor

Does not cause sleepiness

How it works
Sulfasalazine is a Disease Modifying Anti-Rheumatoid Drug (DMARD). It works by limiting the activity of the immune system and blocking the actions of substances that cause inflammation (swelling).
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

5-aminosalicylates, Antirheumatics

Schedule

Schedule H

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https://www.medicines.org.uk/emc/medicine/10722>

Dailymed.nlm.nih.gov. 2021. DailyMed - SULFASALAZINE tablet. [online] Available at: < [Accessed 15 September 2021].

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ad13d598-7b1b-48d3-a25b-08635b419f99>

Ebs.tga.gov.au. 2021. TGA eBS - Product and Consumer Medicine Information Licence. [online] Available at: < [Accessed 15 September 2021].

https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-03253-3&d=20210915172310101>

Drugs, H., 2021. Sulfasalazine: MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: < [Accessed 15 September 2021].

https://medlineplus.gov/druginfo/meds/a682204.html>

Accessdata.fda.gov. 2021. [online] Available at: < [Accessed 15 September 2021].

https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/007073s124lbl.pdf>

Dailymed.nlm.nih.gov. 2021. DailyMed - SULFASALAZINE tablet, delayed release. [online] Available at: < [Accessed 20 September 2021].

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=257cee60-b68f-4c2b-b57d-8e4d73d17e09>

Medicines.org.uk. 2021. Salazopyrin En-Tabs - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: < [Accessed 20 September 2021].

https://www.medicines.org.uk/emc/medicine/10722>

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Information on this page was last updated on 24 Sep 2021

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