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Sulfasalazine- 500 mg, 100 stk.

Anti-inflammatory agent for RA and ulcerative colitis

Description

Generic Name: Sulfasalazine
Brand Name: Salazopyrin, Azulfidine
Drug Class: Aminosalicylate (5-ASA derivative), Disease-Modifying Antirheumatic Drug (DMARD)


This is a prescription medicine, which requires a valid prescription!

Indications

  • Rheumatoid Arthritis (RA): Used as a conventional DMARD, especially in early or mild RA, alone or in combination.
  • Inflammatory Bowel Disease (IBD): Treats ulcerative colitis and sometimes Crohn’s disease (mild-to-moderate flares and maintenance).
  • Juvenile Idiopathic Arthritis (JIA): Off-label in pediatric populations.
Mechanism of Action

Sulfasalazine is a prodrug that:

  • Is broken down in the colon into sulfapyridine and 5-aminosalicylic acid (5-ASA)
  • 5-ASA reduces inflammation in the colon (local anti-inflammatory effect)
  • Sulfapyridine is absorbed systemically and may modulate inflammatory responses in joints
  • Inhibits prostaglandin and leukotriene synthesis; scavenges free radicals
Dosage and Administration
  • Form: Oral tablets (500 mg)
  • Typical Adult Dose (RA):
    • Start with 500 mg/day, increase to 1,000–3,000 mg/day in divided doses
  • Typical Dose (UC):
    • 2,000–4,000 mg/day in divided doses
  • Best taken after meals with plenty of fluids
  • Enteric-coated tablets may reduce GI side effects
Side Effects
  • Common:
    • Nausea, abdominal pain, loss of appetite
    • Headache, dizziness
    • Skin rash
    • Reversible male infertility (oligospermia)
  • Serious (rare):
    • Hepatotoxicity
    • Agranulocytosis, leukopenia
    • Hemolytic anemia (especially in G6PD deficiency)
    • Stevens-Johnson Syndrome
    • Hypersensitivity reactions
Contraindications
  • Hypersensitivity to sulfonamides, salicylates, or sulfasalazine
  • Intestinal or urinary obstruction
  • Porphyria
  • Severe hepatic or renal impairment

Information

Warnings and Precautions

  • Monitor CBC and liver function regularly
  • Use cautiously in patients with G6PD deficiency
  • May cause photosensitivity – use sunscreen
  • Can stain soft contact lenses yellow-orange
  • Discontinue if signs of blood dyscrasias or hypersensitivity appear

Drug Interactions

  • May reduce absorption of digoxin and folic acid
  • May increase the risk of myelosuppression when used with other bone marrow suppressants
  • May potentiate effects of anticoagulants, oral hypoglycemics

Pregnancy & Lactation

  • Pregnancy: Category B — generally considered safe; folic acid supplementation recommended
  • Lactation: Caution advised; small amounts in breast milk may cause diarrhea in infants

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