Sulfasalazine

Brand names

• Alti-Sulfasalazine
• Azaline
• Azulfidine
• Azulfidine EN-Tabs
• PMS-Sulfasalazine
• PMS-Sulfasalazine EC
• Salazopyrin
• Salazopyrin EN
• S.A.S
• S.A.S-Enema
• S.A.S-500

Usage

To prevent and treat inflammatory bowel disease (ulcerative colitis, Crohn's disease), and for treatment of rheumatoid arthritis.

How it works

The exact mechanism of action is unknown. One explanation is that it acts as an anti-inflammatory in the bowel. It also has antibiotic properties that may be important in changing the bacteria in the bowel.

Side effects

Serious

Aching joints and muscles; pain in back, legs or stomach; bloody diarrhea; blue fingernails, lips, or skin; chest pain; cough; breathing difficulty; swallowing difficulty; fever; sore throat; general discomfort; loss of appetite; paleness of skin or redness, peeling, blistering, or loosening of skin; unusual bleeding or bruising; unusual fatigue; yellow discoloration of eyes or skin; increased sensitivity to sunlight.

Common

Stomach or abdominal discomfort and cramps, diarrhea, loss of appetite, nausea, vomiting.

Less common

Skin rash, itching, low iron in blood, fever.

Possible interactions

Other medicaments:

Sulfasalazine may increase the effects of:

• anticoagulants (Coumadin, etc.) and increase bleeding risk; more frequent INR (prothrombin time) testing is needed.
• sulfonylureas or other oral hypoglycemic agents and increase the risk of hypoglycemia.

Sulfasalazine may decrease the effects of:

• digoxin (Lanoxin).
• live typhoid vaccine (Vivotif).

Sulfasalazine taken concurrently with:

• ampicillin and perhaps other penicillins may lower therapeutic benefits from sulfasalazine.
• some barbiturates may result in decreased sulfasalazine therapeutic benefits.
• calcium supplements (calcium gluconate) may result in decreased therapeutic benefits from sulfasalazine.
• iron salts or calcium may decrease sulfasalazine's benefits.
• varicella vaccine (Varivax) may result in Reye's syndrome; avoid taking this medicine for 6 weeks following varicella vaccine.

Herbal medicines or minerals:

Since St. John's wort and sulfasalazine may increase sun sensitivity, the combination is not advised. Flaxseed, peppermint oil and psyllium husk have Commission E monograph indications for irritable bowel syndrome.  Aloe, buckhorn berry or bark, cascara sagrada bark, rhubarb root and senna should not be taken by people living with ulcerative colitis.

Alcohol:

Sulfonamide medicaments can increase the intoxicating effects of alcohol.

Exposure to sun:

Use caution-some sulfonamide medicaments can cause photosensitivity

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