Sulfasalazine Usage

Sulfasalazine is used in the treatment of ankylosing spondylitis, ulcerative colitis, Crohn’s disease and rheumatoid arthritis.

How Sulfasalazine works

Sulfasalazine blocks the action of certain chemical messengers that are responsible for inflammation, swelling and redness associated with certain autoimmune diseases. It suppresses the underlying disease process, rather than simply treating the disease.

Common side effects of Sulfasalazine

Nausea, Headache, Skin rash, Loss of appetite, Increased body temperature

Expert advice for Sulfasalazine

• You have been prescribed Sulfasalazine to control the symptoms and slow down the progression of inflammatory bowel disease or rheumatoid arthritis.
• You may have to wait for 6 to 12 weeks to get the full effect.
• Drink plenty of water while on Sulfasalazine. This will prevent kidney stone and kidney damage.
• You may experience loss of appetite and nausea on starting Sulfasalazine.
• Your urine may change color (to orange). Do not worry if that happens.
• Avoid contact with people who have cold, flu or other contagious illness. Notify your doctor if you have any signs of infection such as a fever or sore throat.
• Inform your doctor if you ever had any form of drug allergy.
• Inform your doctor if you are pregnant or planning to conceive or breastfeeding.
• Inform your doctor if you are suffering from any blood disease e.g. G6PD deficiency.

Frequently Asked Questions

Ques. Q. Is Sulfasalazine a DMARDs?
Yes, Sulfasalazine is a DMARDs (Disease-Modifying Antirheumatic Drugs). It prevents joint damage and preserves joint mobility.

Ques. Q. Can I use Sulfasalazine 1gram BD?
Yes, Sulfasalazine can be used as 1gm BD (twice daily) if you have severe disease.

Ques. Q. How is Sulfasalazine metabolized?
Sulfasalazine is metabolized in the colon by the bacterial enzyme azoreductase to sulfapyridine and 5 aminosalicylic acid (5-ASA).

Ques. Q. How long does Sulfasalazine take to produce the effect?
Sulfasalazine does not work right away. It will take about 6 to 12 weeks to get the full effect.

Ques. Q. Where is sulfasalazine absorbed?
Sulfasalazine is absorbed in the intestine (jejunum and colon). In the colon, it breaks down to sulfapyridine and 5 aminosalicylic acid (5-ASA).

Ques. Q. Can I use Sulfasalazine with hepatitis B?
Yes, Sulfasalazine is relatively safe in hepatitis B infection.

Ques. Q. Can I use Sulfasalazine in hepatitis C?
Sulfasalazine should not be used in hepatitis C patients with bad prognosis.

Ques. Q. Sulfasalazine for alopecia areata?
Sulfasalazine is not approved for treatment of alopecia areata.

Ques. Q. Sulfasalazine for gout?
Sulfasalazine is not approved for treatment of gout.

Ques. Q. Sulfasalazine for IBS (irritable bowel syndrome)?
Sulfasalazine is not approved for treatment of irritable bowel syndrome (IBS).

Ques. Q. Sulfasalazine for IBD(inflammatory bowel disease)?
Yes, Sulfasalazine is used in the treatment of inflammatory bowel disease (IBD).

Ques. Q. Sulfasalazine for psoriatic arthritis?
Sulfasalazine is a DMARD that may be effective for the joint pain and skin lesions associated with psoriatic arthritis.

Ques. Q. Sulfasalazine for psoriasis?
Sulfasalazine is not approved for psoriasis.

Ques. Q. Can I use Sulfasalazine with vitamin c?
Yes, Sulfasalazine can be used with vitamin c.

Ques. Q. Can I use Sulfasalazine with vitamin d?
Yes, Sulfasalazine can be used with vitamin d.

Ques. Q. Sulfasalazine vs mesalamine?
Mesalamine and Sulfasalazine are both used in the treatment of ulcerative colitis. Sulfasalazine having fewer side effects as compared to mesalamine.

Ques. Q. Sulfasalazine vs balsalazide?
Balsalazide has a better tolerability than Sulfasalazine in patients with ulcerative colitis.

Ques. Q. Sulfasalazine with folic acid?
Sulfasalazine inhibits the absorption and metabolism of folic acid.which may cause folic acid deficiency. This can result in serious blood disorders (e.g., macrocytosis and pancytopenia). This can be normalized by administration of folic acid or folinic acid (leucovorin).

Ques. Q. Sulfasalazine interaction with methotrexate?
Coadministration of Sulfasalazine and methotrexate do not alter the pharmacokinetic disposition of the drugs. It may increase the incidence of gastrointestinal adverse events, especially nausea.

Ques. Q. Sulfasalazine with meloxicam?
Meloxicam and Sulfasalazine cause kidney problem if given together.

Ques. Q. Sulfasalazine with antibiotics?
People who are allergic to sulfa drugs antibiotics like cotrimoxazole, sulfisoxazole etc, may have a cross reaction to Sulfasalazine and should therefore not take it.

Ques. Q. Sulfasalazine with prednisone?
Sulfasalazine can be given in conjunction with steroids (prednisone) as part of an intensive management regime during the severe attack of rheumatoid arthritis.

Ques. Q. Sulfasalazine with adalimumab?
Adalimumab can be used with Sulfasalazine in the treatment of moderate to severe, active rheumatoid arthritis in adult patients when the response to disease-modifying antirheumatic drugs (DMARDs) is inadequate.

Ques. Q. Sulfasalazine with the sulfa allergy?
Patients with sulfa drug allergy should avoid Sulfasalazine.

Ques. Q. Sulfasalazine with naproxen?
Sulfasalazine is used in the treatment of rheumatoid arthritis who has failed to respond to non-steroidal anti-inflammatory drugs (NSAIDs) e.g naproxen.

Ques. Q. Sulfasalazine with ibuprofen?
Sulfasalazine is used in the treatment of rheumatoid arthritis who has failed to respond to non-steroidal anti-inflammatory drugs (NSAIDs) e.g ibuprofen.

Ques. Q. Sulfasalazine with methotrexate side effects?
Taking Sulfasalazine and methotrexate together may increase the incidence of gastrointestinal adverse events, especially nausea.

Ques. Q. Sulfasalazine with hydroxychloroquine?
Sulfasalazine and hydroxychloroquine combination have shown better and faster response in rheumatoid arthritis.

Ques. Q. Allergic to Sulfasalazine?
You should not take Sulfasalazine, if you are allergic to Sulfasalazine.

Ques. Q. Is Sulfasalazine a prodrug?
Yes, Sulfasalazine is a prodrug. It gets converted into sulfonamide (sulfapyridine) and 5 aminosalicylic acid (5-ASA) in the body.

Ques. Q. Is Sulfasalazine a sulfa drug?
Yes, Sulfasalazine is a sulfa drug because it contains sulfonamide (sulfapyridine) as active ingredients.

Ques. Q. Is Sulfasalazine an antibiotic?
Sulfasalazine is a combination of antibiotic sulfapyridine and 5 aminosalicylic acid, mainly used in inflammatory bowel disease and rheumatoid arthritis.

Ques. Q. Is Sulfasalazine enteric coated?
Some formulation of Sulfasalazine may be available as enteric-coated. Enteric coating is done to prevent the tablet destruction by stomach acid.

Ques. Q. Sulfasalazine causes weight loss?
Yes, Sulfasalazine can cause loss of appetite which may lead to loss of weight.

Ques. Q. Can Sulfasalazine cause rash?
Yes, Sulfasalazine can cause the rash as a side effect.

Ques. Q. What is the Sulfasalazine drug class?
Sulfasalazine belongs to sulfonamide drug class.

Ques. Q. What is Sulfasalazine delayed-release tablets?
Sulfasalazine delayed release tablets are the enteric coated tablets, which prevent the disintegration of the drug when they come in contact with stomach acid.

Ques. Q. Sulfasalazine cause insomnia?
Yes, Sulfasalazine can cause insomnia as a side effect.

Ques. Q. Sulfasalazine flu-like symptoms?
Sulfasalazine can cause flu-like symptoms like aching of joints, fever, headache, sore throat, rashes.

Ques. Q. Sulfasalazine for ulcerative colitis?
Ulcerative colitis is an inflammatory bowel disease. Sulfasalazine releases 5 aminosalicylic acid which decreases inflammation of the intestines and thus helpful in ulcerative colitis.

Ques. Q. Sulfasalazine for Crohn's disease?
Crohn's disease is an inflammatory bowel disease. Sulfasalazine releases 5 aminosalicylic acid which decreases inflammation of the intestines and thus helpful in Crohn's disease.

Ques. Q. Sulfasalazine in cancer patients?
Sulfasalazine is not approved for treatment of cancer.

Ques. Q. Why does Sulfasalazine cause blood disorders?
Sulfasalazine inhibits the absorption and metabolism of folic acid. Which may cause folic acid deficiency. This can result in serious blood disorders (e.g., macrocytosis and pancytopenia).

Ques. Q. Why does Sulfasalazine cause a sore throat?
Sulfasalazine suppresses the immune system which can manifest with the sign of infections like a sore throat or fever.

Ques. Q. What does Sulfasalazine contain?
Sulfasalazine contains sulfonamide (sulfapyridine) and 5 aminosalicylic acid (5-ASA) as active ingredients.

Ques. Q. Side effects of stopping sulfasalazine?
If Sulfasalazine is stopped, patient can experience withdrawal symptoms like depression, pain, stress, anxiety, back pain, and muscle spasticity.

Ques. Q. Sulfasalazine withdrawal?
Sulfasalazine withdrawal can cause depression, pain, stress, anxiety, back pain and muscle spasticity.