Sulphasalazine is used to treat inflammatory arthritis and some inflammatory bowel diseases. It is given to reduce inflammation in your joints. diarrhea (stool frequency), rectal bleeding, and abdominal pain in patients with ulcerative colitis, a condition in which the bowel is inflamed. Sulfasalazine delayed-release (Azulfidine EN-tabs) is also used to treat rheumatoid arthritis in adults and children whose disease has not responded well to other medications. Sulfasalazine is in a class of medications called anti-inflammatory drugs. It works by reducing inflammation (swelling) inside the body.
In recent British research involving animal studies, and more recently, human trials for the treatment of chronic alcoholics, sulfasalazine has been found to reverse the scarring associated with cirrhosis of the liver. Cells called myofibroblasts, which contribute to scar tissue in a diseased liver, also appear to secrete proteins that prevent the breakdown of the scar tissue. Sulfasalazine appears to retard this secretion.
A study at University of Newcastle found that the drug may also act to aid the healing of cirrhosis of the liver
It is usually not given to children under 2 years of age
Adult: PO Inflammatory bowel disease Initial: 1-2 g 4 times/day till remission. Maintenance: 2 g/day in divided doses. Rheumatoid arthritis As enteric-coated tab: Initial: 500 mg/day for the 1st wk, increase slowly if needed. Max: 3 g/day in 2-4 divided doses. Rectal Inflammatory bowel disease As supp: 0.5-1 g in the morning and night. As enema: 3 g/day at night, retained for at least 1 hr.
Take sulfasalazine after a meal or with a light snack, then drink a full glass of water. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sulfasalazine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
In Crohn's disease and ulcerative colitis, it is thought to be an antinflammatory drug that is essentially providing topical relief inside the intestine. It does this via a number of mechanisms such as reducing the synthesis of inflammatory mediators known as eicosanoids and inflammatory cytokines. However, unlike glucocorticoids (another class of drug used in the treatment in inflammatory bowel disease), sulfasalazine is a mild immunosuppressant.
When treatment for arthritis is successful, pain, joint swelling and stiffness will be reduced and this may slow down or stop the development of joint damage. The precise reasons why sulfasalazine are effective in various forms of arthritis is not clearly understood.
Because sulfasalazine and its metabolite 5-ASA are poorly absorbed into the bloodstream, it is surprising that the drug is effective against symptoms outside of the intestine. One possible explanation is that, given that ulcerative colitis produces arthritic symptoms, the arthritic symptoms are actually a product of unrecognized ulcerative colitis,which is effectively treated with sulfazalazine.
The other metabolite, sulfapyridine, is absorbed into the blood, and is believed to be the source of the side-effects discussed below. It is possible that the sulfapyridine is responsible for some of the anti-arthritic effects of sulfasalazine.
Swallow tablets whole; do not crush or chew them.
Drink plenty of fluids (at least six to eight glasses of water or other beverage per day) while taking sulfasalazine.
Continue to take sulfasalazine even if you feel well. Do not stop taking sulfasalazine without talking to your doctor.
SPECIAL PRECAUTIONS -
Before taking sulfasalazine,
tell your doctor if you are allergic to sulfasalazine, sulfapyridine, aspirin, choline magnesium trisalicylate (Triosal, Trilisate), choline salicylate (Arthropan), mesalamine (Asacol, Pentasa, Rowasa), salsalate (Argesic-SA, Disalcid, Salgesic, others), sulfa drugs, trisalicylate (Tricosal, Trilisate),or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially digoxin (Lanoxin), folic acid, and vitamins.
tell your doctor if you have or have ever had asthma, kidney or liver disease, porphyria, blood problems, or blockage in your intestine or urinary tract.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking sulfasalazine, call your doctor.
plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Sulfasalazine may make your skin sensitive to sunlight.
SIDE EFFECTS -
Sulfasalazine may cause side effects. Sulfasalazine causes temporary infertility in males. Fertility returns when the medicine is stopped. It can also cause your urine or skin to turn yellowish-orange; this effect is harmless.
Tell your doctor if any of these symptoms are severe or do not go away:
diarrhea, headache, loss of appetite, upset stomach, vomiting, stomach pain.
If you have any of the following symptoms, stop taking sulfasalazine and call your doctor immediately:
skin rash, itching, hives, swelling, sore throat , fever, joint or muscle aches, pale or yellow skin, difficulty swallowing , tiredness , unusual bleeding or bruising , weakness
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
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