Sulfasalazine: Medication Profile

Summary or Key Points

Sulfasalazine is a medication primarily used in treating rheumatoid arthritis, ulcerative colitis, and Crohn’s disease. It helps reduce inflammation, discomfort, and flare-ups in these conditions. This medication should be used as directed by a healthcare provider, and it’s essential to understand its side effects, interactions, and contraindications.

Names of Medication

US Brand Name: Azulfidine

Generic Name: Sulfasalazine

A ‘generic name’ refers to the official medical name for the active ingredient of the medicine. This is the name we’ve provided in parentheses (Sulfasalazine).

Pharmacologic Category

Sulfasalazine is part of the pharmacologic category known as Disease Modifying Antirheumatic Drugs (DMARDs). Other medications in this category include Methotrexate and Hydroxychloroquine.

Dosing

Always consult your healthcare provider before adjusting your dose. Our telemedicine services are readily available for consultation.

• Rheumatoid Arthritis: Initial dose is usually 500 mg per day, which can be increased gradually over several weeks up to 2000-3000 mg daily, depending on patient response.
• Ulcerative Colitis: The usual dosage for acute attacks is 3 to 4 g daily in evenly divided doses.
• Crohn’s Disease: Initial dose is usually 3 to 4 g daily. Once symptoms are controlled, the dose may be decreased.

Dosage Forms and Strengths

Sulfasalazine is available in 500 mg tablets. It also comes in an enteric-coated form, which can be better tolerated by some patients.

Administration Instructions

Take Sulfasalazine after meals or with food to minimize stomach upset. If taking the enteric-coated tablets, do not crush or chew them. Drink plenty of fluids while taking this medication unless directed otherwise by your doctor.

Adverse Reactions and Side Effects

Common side effects may include nausea, vomiting, stomach pain, and loss of appetite. In rare cases, patients may experience severe side effects such as yellowing eyes or skin, or severe stomach or abdominal pain. Always report any unusual or severe side effects to your healthcare provider immediately.

Contraindications

Contraindications refer to specific situations or health conditions where a medicine should not be used because it may be harmful to the patient. Sulfasalazine is contraindicated in patients with porphyrias (a group of rare genetic disorders that affect the nervous system) and those who are hypersensitive to sulfasalazine, its metabolites, sulfonamides, or salicylates. It’s also contraindicated in individuals with intestinal or urinary obstruction due to the potential harm it could cause.

Drug to Drug Interactions

Medications that may interact with Sulfasalazine include Folic Acid (Folvite), Methotrexate (Trexall), and Digoxin (Lanoxin). Always inform your healthcare provider about all medications, supplements, and over-the-counter drugs you are currently taking to avoid potential drug interactions.

Sulfasalazine in Pregnancy

Generally, Sulfasalazine is considered safe to take during pregnancy. It’s important to control disease activity to ensure the health of both the mother and the baby. However, every situation is unique. Always consult your healthcare provider if you are pregnant or planning to become pregnant before starting or adjusting any medication.

Sulfasalazine while Breastfeeding

Sulfasalazine is excreted into breast milk, but it is generally considered safe during breastfeeding. However, the nursing infant’s blood should be monitored for any adverse effects. Discuss any concerns with your healthcare provider.

Estimated Cost of Medication

As of the latest update, the estimated cost for a 30-day supply of Sulfasalazine without insurance, using a GoodRx coupon, is around $20 to $40. However, costs can vary depending on your location and the pharmacy you choose.

Possible Alternatives

Always consult your healthcare provider or one of our telemedicine professionals before making changes to your treatment plan. Potential alternative treatments for each disease include:

• Rheumatoid Arthritis: Physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and other DMARDs like Methotrexate.
• Ulcerative Colitis: Lifestyle changes like dietary modifications, stress management, along with other medications such as corticosteroids and immunosuppressants.
• Crohn’s Disease: Lifestyle changes, including diet and stress management, as well as other medications like corticosteroids, biologic therapies, and immunomodulators.

Recent Updates on Sulfasalazine Research

Recent research on Sulfasalazine has focused on its role in managing other autoimmune and inflammatory conditions. Studies are ongoing to assess its efficacy and safety in conditions such as psoriatic arthritis and ankylosing spondylitis. As more information becomes available, we will ensure it is communicated to patients in a timely and accessible manner.

Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.