The exact way that sulfasalazine works is unknown, but it is believed to reduce the actions of substances in the body that cause inflammation, tissue damage, and diarrhea. Drugs that are substrates for this transporter, such as sulfasalazine, may exhibit an increase in systemic exposure if coadministered with eltrombopag. What side effects can this medication cause? Should any of these occur, the patient should seek medical advice. Nursing Central is an award-winning, complete mobile solution for nurses and students. The response of acute ulcerative colitis to Sulfasalazine tablets can be evaluated by clinical criteria, including the presence of fever, weight changes, and degree and frequency of diarrhea and bleeding, as well as by sigmoidoscopy and the evaluation of biopsy samples. Reduced absorption of folic acid and digoxin have been reported when those agents were administered concomitantly with Sulfasalazine. Kaufman DW, editor. It can be found under the following brand names – Azulfidine or Sulfazine. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. © Copyright, 2020. Chemical Designation: 5-([p-(2-pyridylsulfamoyl)phenyl]azo) salicylic acid. The determination of serum sulfapyridine levels may be useful since concentrations greater than 50 μg/mL appear to be associated with an increased incidence of adverse reactions. This medication works by affecting a substance in the human body which causes tissue damage, inflammation, and diarrhea. Sulfasalazine may make your skin sensitive to sunlight. No clinical studies have been performed to evaluate the effect of Sulfasalazine on the growth development and functional maturation of children whose mothers received the drug during pregnancy. Does Sulfasalazine DR Interact with other Medications? Sulfasalazine. Do not let anyone else take your medicine. There are reports with limited data of bloody stools or diarrhea in human milk fed infants of mothers taking Sulfasalazine. Sulfasalazine is a milder DMARD in regards to its benefit, but can be useful in mild or early cases of inflammatory arthritis. Other brands: Azulfidine, Azulfidine EN-tabs, aspirin, prednisone, ibuprofen, meloxicam, naproxen, hydrocortisone topical, hydrocortisone, dexamethasone, methylprednisolone, hydroxychloroquine. Absorbed SP and 5-ASA and their metabolites are primarily eliminated in the urine either as free metabolites or as glucuronide conjugates. Scand J Gastroenterol 1982;17:1–4. Some of these cases were fatal. Various desensitization-like regimens have been reported to be effective in 34 of 53 patients,4 7 of 8 patients,5 and 19 of 20 patients.6 These regimens suggest starting with a total daily dose of 50 to 250 mg Sulfasalazine initially, and doubling it every 4 to 7 days until the desired therapeutic level is achieved. In comparison, peak plasma levels of both SP and 5-ASA occur approximately 10 hours after dosing. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. What is this drug used for? However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. SP apparently is well absorbed from the colon with an estimated bioavailability of 60%. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Drug Class Disease-Modifying Anti-Rheumatic Drug (DMARD) Share; Email; Print; SSZ is a DMARD used to treat inflammatory types of arthritis, such as rheumatoid and psoriatic arthritis. In cases where the outcome was reported, bloody stools or diarrhea resolved in the infant after discontinuation of Sulfasalazine in the mother or discontinuation of breastfeeding. The calculated clearance of SSZ following intravenous administration was 1 L/hr. In vivo studies have indicated that the absolute bioavailability of orally administered SSZ is less than 15% for parent drug. Gastric lavage or emesis plus catharsis as indicated. Sulfasalazine is a type of drug known as a disease-modifying anti-rheumatic drug (DMARD).It may be used on its own or with other drugs. This longer time to peak is indicative of gastrointestinal transit to the lower intestine where bacteria mediated metabolism occurs. Birth defects and drugs during pregnancy. Sulfasalazine may cause side effects. Continue to take sulfasalazine even if you feel well. Swallow tablets whole; do not crush or chew them. This product's label may have been updated. Sulfasalazine causes temporary infertility in males. If you become pregnant while taking sulfasalazine, call your doctor. Oligospermia and infertility have been observed in men treated with Sulfasalazine; however, withdrawal of the drug appears to reverse these effects. Sulfasalazine and its metabolite, sulfapyridine, pass through the placenta. 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 (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). Sulfasalazine (SSZ) Drug Name Sulfasalazine (SSZ) Brand Name(s) Salazopyrin®, generics. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Safety and effectiveness in pediatric patients below the age of 2 years have not been established. Small studies have been reported in the literature in children down to the age of 4 years with ulcerative colitis and inflammatory bowel disease. DMARDS decrease the pain and swelling of inflammatory arthritis and may also prevent damage to joints, which can reduce the risk of long-term loss of function. Gastroenterology 1982;82:1104. Cross-sensitivity may exist with these agents. Cautions Acute porphyrias ; G6PD deficiency ; history of allergy ; history of asthma ; maintain adequate fluid intake ; risk of haematological toxicity ; risk of hepatic toxicity ; slow acetylator status Approximately 15% of a dose of SSZ is absorbed as parent and is metabolized to some extent in the liver to the same two species. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Discontinue Sulfasalazine if a patient develops a serious infection. It is also important information to carry with you in case of emergencies. Sulfasalazine tablets contain Sulfasalazine, 500 mg, for oral administration. Sulfasalazine contains salicylate and the sulfa antibiotic. The following events have been identified during post-approval use of products which contain (or are metabolized to) mesalamine in clinical practice. Dosages. However, you should not flush this medication down the toilet. • It is used to treat rheumatoid arthritis and ulcerative colitis. The clinical implication of this is unclear; however, in a small pharmacokinetic trial where acetylator status was determined, subjects who were slow acetylators of SP showed a higher incidence of adverse events. Aminosalicylates (5-ASA) How taken. 5-ASA is primarily metabolized in both the liver and intestine to N-acetyl-5-aminosalicylic acid via a non-acetylation phenotype dependent route. It works by reducing inflammation (swelling) inside the body. Doses of Azulfidine tablets of 16 g per day have been given to patients without mortality. Sulfasalazine Oral Tablet Drug Information, Side Effects, Faqs All Rights Reserved. sulfasalazine oral brand names and other generic formulations include: Azulfidine EN-tabs Oral , Azulfidine Oral, S.A.S.-500 Oral, Sulfa Dyne Oral, Sulfazine EC Oral, Sulfazine Oral All generic drug interactions for sulfasalazine oral (lists will include brand and generic names): In a group of 186 women treated with Sulfasalazine alone or Sulfasalazine and concomitant steroid therapy, the incidence of fetal morbidity and mortality was comparable to that for 245 untreated IBD pregnancies as well as to pregnancies in the general population.1 A study of 1,455 pregnancies associated with exposure to sulfonamides indicated that this group of drugs, including Sulfasalazine, did not appear to be associated with fetal malformation. Do not take more or less of it or take it more often than prescribed by your doctor. Sulfasalazine should be discontinued at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity. Medically reviewed by Drugs.com. Look up information on diseases, tests, and procedures; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms. Mogadam M, et al. The mode of action of Sulfasalazine (SSZ) or its metabolites, 5-aminosalicylic acid (5-ASA) and sulfapyridine (SP), is still under investigation, but may be related to the anti-inflammatory and/or immunomodulatory properties that have been observed in animal and in vitro models, to its affinity for connective tissue, and/or to the relatively high concentration it reaches in serous fluids, the liver and intestinal walls, as demonstrated in autoradiographic studies in animals. Desensitization should not be attempted in patients who have a history of agranulocytosis, or who have experienced an anaphylactoid reaction while previously receiving Sulfasalazine. Azulfidine, also known by its drug name, Sulfasalazine, is a prescription medication approved by the Food and Drug Administration (FDA) in 1950. When endoscopic examination confirms satisfactory improvement, the dosage of Sulfasalazine should be reduced to a maintenance level. The majority of 5-ASA stays within the colonic lumen and is excreted as 5-ASA and acetyl-5-ASA with the feces. 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. Sulfasalazine works by slowing the radiographic progression (damage to the joints) of rheumatoid arthritis, and reducing pain and swelling. Sulfasalazine and its metabolite are also present in human milk. Sulfasalazine should be discontinued if an alternative etiology for the signs or symptoms cannot be established. In this same study, 5-ASA is much less well absorbed from the gastrointestinal tract with an estimated bioavailability of from 10 to 30%. Serious skin reactions, some of them fatal, including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, have been reported in association with the use of Sulfasalazine. Rats appear to be especially susceptible to the goitrogenic effects of sulfonamides and long-term administration has produced thyroid malignancies in this species. The occurrence of sore throat, fever, pallor, purpura, or jaundice may indicate a serious blood disorder. Sulfasalazine (Azulfidine) is a drug prescribed for the treatment of mild to severe ulcerative colitis and the treatment of rheumatoid arthritis. Drug Class: DMARDs Brand Names: Azulfidine, Azulfidine EN-Tabs, Sulfazine, Sulfazine EC. It usually is taken four times a day in evenly spaced doses throughout the day so that no more than 8 hours separates any two doses, if possible. It is the generic name of a drug that belongs to a class of drugs called sulfa drugs. Sulfasalazine delayed-release (enteric-coated) is also used to treat rheumatoid arthritis in adults and children when other medications have not worked. Serum sulfapyridine concentrations may be used to monitor the progress of recovery from overdosage. Sulfasalazine is also classified as a DMARD(disease-modifying antirheumatic drug). Sulfasalazine is also used to treat bowel inflammation, diarrhea (stool frequency), rectal bleeding, and abdominal pain in Crohn's disease. Impairment of male fertility was observed in reproductive studies performed in rats at a dose of 800 mg/kg/day (4800 mg/m2). Lists the various brand names available for medicines containing sulfasalazine. Last updated on Aug 2, 2020. If symptoms of gastric intolerance (anorexia, nausea, vomiting, etc.) For current full prescribing information, please visit www.greenstonellc.com. Pregnancy in inflammatory bowel disease: effect of Sulfasalazine and corticosteroids on fetal outcome. Sulfasalazine is used to treat bowel inflammation, diarrhea (stool frequency), rectal bleeding, and abdominal pain in patients with ulcerative colitis, a condition in which the bowel is inflamed. Gastroenterology 1981;80:72–6. Patients with glucose-6 phosphate dehydrogenase deficiency should be observed closely for signs of hemolytic anemia. Side … Dosages for children: The dosages listed above are those typically prescribed for adults aged 18-65. In more advanced cases, central nervous system symptoms such as drowsiness, convulsions, etc., may be observed. Korelitz B, et al. Renal reactions: toxic nephrosis with oliguria and anuria, nephritis, nephrotic syndrome, urinary tract infections, hematuria, crystalluria, proteinuria, and hemolytic-uremic syndrome. Children, six years of age and older: 40 to 60 mg/kg body weight in each 24-hour period, divided into 3 to 6 doses. Last updated on Mar 1, 2020. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Sulfasalazine is in a class of medications called Disease Modifying Anti-Rheumatic Drugs, or DMARDs. They are available in the following package sizes: Store at 25° C (77° F); excursions permitted to 15–30° C (59–86° F) [see USP Controlled Room Temperature]. Sulfasalazine did not show mutagenicity in the bacterial reverse mutation assay (Ames test) and in L51784 mouse lymphoma cell assay at the HGPRT gene. Withdrawal of the drug appears to reverse these effects. The clinical impact of this is unknown. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. Caution should be exercised when Sulfasalazine is administered to a nursing mother. Taffet SL, Das KM. In case of overdose, call the poison control helpline at 1-800-222-1222. Mechanism of Action. Additionally, patients should be advised that Sulfasalazine may produce an orange-yellow discoloration of the urine or skin. These medications are not usually taken together. Medically reviewed by Drugs.com. Approximately 60% of the Caucasian population can be classified as belonging to the slow acetylator phenotype. Goiter production, diuresis and hypoglycemia have occurred rarely in patients receiving sulfonamides. Less common or rare adverse reactions include: Blood dyscrasias: aplastic anemia, agranulocytosis, leukopenia, megaloblastic (macrocytic) anemia, purpura, thrombocytopenia, hypoprothrombinemia, methemoglobinemia, congenital neutropenia, and myelodysplastic syndrome. Sulfasalazine (of sulfasalazopyridine) is een geneesmiddel dat tot de klasse van sulfonamiden behoort (antibacteriële chemotherapie). It is considered by some to be a first line treatment in rheumatoid arthritis. Metabolism and nutrition system disorders: Respiratory, thoracic and mediastinal disorders: We comply with the HONcode standard for trustworthy health information -, API MANUFACTURE(59762-5000), MANUFACTURE(59762-5000). Hypersensitivity reactions: erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, epidermal necrolysis (Lyell's syndrome) with corneal damage, drug rash with eosinophilia and systemic symptoms (DRESS), anaphylaxis, serum sickness syndrome, interstitial lung disease, pneumonitis with or without eosinophilia, vasculitis, fibrosing alveolitis, pleuritis, pericarditis with or without tamponade, allergic myocarditis, polyarteritis nodosa, lupus erythematosus-like syndrome, hepatitis and hepatic necrosis with or without immune complexes, fulminant hepatitis, sometimes leading to liver transplantation, parapsoriasis varioliformis acuta (Mucha-Haberman syndrome), rhabdomyolysis, photosensitization, arthralgia, periorbital edema, conjunctival and scleral injection, and alopecia. Sulfonamides, including Sulfasalazine, are present in human milk (see Pregnancy, Clinical Considerations). Keep this medication in the container it came in, tightly closed, and out of reach of children. Sulfasalazine side effects. • You will need to take the vitamin supplement called folic acid while on sulfasalazine • Sulfasalazine can decrease the effect of digoxin and iron • Sulfasalazine can increase the effects of oral anticoagulants (e.g.,Coumadin), oral hypoglycemic medications (e.g.,Glucophage, Avandia, Glucotrol, DiaBeta), and … Severe, life-threatening, systemic hypersensitivity reactions such as drug rash with eosinophilia and systemic symptoms have been reported in patients taking Sulfasalazine. This reaction is frequently dose related. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Serious infections, including fatal sepsis and pneumonia, have been reported. Inactive Ingredients: magnesium stearate, povidone, silica (colloidal anhydrous), starch (pregelatinized). During the second three months, the same tests should be done once monthly and thereafter once every three months, and as clinically indicated. Sulfasalazine (azulfidine, salazopyrin) belongs to a class of drugs called sulfa drugs. 500 mg to 3 grams daily in two to four doses. Am J Med 1982;73:520–4. Severe hypersensitivity reactions may include internal organ involvement, such as hepatitis, nephritis, myocarditis, mononucleosis-like syndrome (i.e., pseudomononucleosis), hematological abnormalities (including hematophagic histiocytosis), and/or pneumonitis including eosinophilic infiltration. Sulfasalazine is a disease-modifying anti-rheumatic drug (DMARD) indicated for the treatment of adults and children over 6 with RA who have not responded to non-steroidal anti-inflammatory drugs (NSAIDs). Urinalysis and an assessment of renal function should also be done periodically during treatment with Sulfasalazine. In female rats, two (4%) of the 337.5 mg/kg rats had transitional cell papilloma of the kidney. Recommendations for Pregnancy. If toxic or hypersensitivity reactions occur, the drug should be discontinued immediately. Patients are at highest risk for these events early in therapy, with most events occurring within the first month of treatment. It’s a combination of salicilate (the main ingredient in aspirin) and a sulfa antibiotic. If anuria is present, restrict fluids and salt, and treat appropriately. Insignificant amounts of Sulfasalazine have been found in milk, whereas levels of the active metabolite sulfapyridine in milk are about 30 to 60 percent of those in the maternal serum. It is often necessary to continue medication even when clinical symptoms, including diarrhea, have been controlled. Azulfidine may also help prevent joint damage and disability. Detectable serum concentrations of SSZ have been found in healthy subjects within 90 minutes after the ingestion. Central nervous system reactions: transverse myelitis, convulsions, meningitis, transient lesions of the posterior spinal column, cauda equina syndrome, Guillian-Barre syndrome, peripheral neuropathy, mental depression, vertigo, hearing loss, insomnia, ataxia, hallucinations, tinnitus, and drowsiness. Generic Name: Sulfasalazine Tablets (sul fa SAL a zeen) Brand Name: Azulfidine. Overview. Sulfasalazine tablets should be given with caution to patients with severe allergy or bronchial asthma. A case of agranulocytosis has been reported in an infant whose mother was taking both Sulfasalazine and prednisone throughout pregnancy. Catheterization of the ureters may be indicated for complete renal blockage by crystals. Sulfasalazine (SSZ), sold under the trade name Azulfidine among others, is a medication used to treat rheumatoid arthritis, ulcerative colitis, and Crohn's disease. Keep all appointments with your doctor and the laboratory. Of the two species, SP is relatively well absorbed from the intestine and highly metabolized, while 5-ASA is much less well absorbed. The rate of metabolism of SP to AcSP is dependent upon acetylator phenotype. Take sulfasalazine after a meal or with a light snack, then drink a full glass of water. It works by reducing inflammation (swelling) inside the body. Patient Education. Following oral administration of 1 g of SSZ to 9 healthy males, less than 15% of a dose of SSZ is absorbed as parent drug. Acetylsulfapyridine (AcSP), the principal metabolite of SP, is approximately 90% bound to plasma proteins. Sulfasalazine tablets contain Sulfasalazine, 500 mg, for oral administration.Therapeutic Classification: Anti-inflammatory agent.Chemical Designation: 5-([p-(2-pyridylsulfamoyl)phenyl]azo) salicylic acid.Chemical Structure:Molecular Formula: C18H14N4O5SInactive Ingredients: magnesium stearate, povidone, silica (colloidal anhydrous), starch (pregelatinized). Instead, the best way to dispose of your medication is through a medicine take-back program. Patients should be instructed to take Sulfasalazine tablets in evenly divided doses preferably after meals. Some infections were associated with agranulocytosis, neutropenia, or myelosuppression. If diarrhea recurs, the dosage should be increased to previously effective levels. Take the missed dose as soon as you remember it. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. It is prescribed to decrease pain and swelling associated with rheumatoid arthritis. The observed plasma half-life for intravenous Sulfasalazine is 7.6 ± 3.4 hours. If such signs or symptoms are present, the patient should be evaluated immediately. The sulfonamides bear certain chemical similarities to some goitrogens, diuretics (acetazolamide and the thiazides), and oral hypoglycemic agents. http://www.upandaway.org. These subjects will display a prolonged plasma half-life for SP (14.8 hours vs. 10.4 hours) and an accumulation of higher plasma levels of SP than fast acetylators. Sulfasalazine belongs to a group of drugs called aminosalicylates. Sulfasalazine changes the way your condition affects you, and reduces inflammation, pain and swelling in your joints. Sulfasalazine is known to inhibit the absorption and metabolism of folic acid and may diminish the effects of folic acid supplementation. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. The delayed-release tablets, Azulfidine® (EN-tabs), are also used to treat rheumatoid arthritis and juvenile rheumatoid arthritis. Some patients may be sensitive to treatment with Sulfasalazine. In some cases, it is advisable to initiate therapy with a smaller dosage, e.g., 1 to 2 g daily, to reduce possible gastrointestinal intolerance. Sulfasalazine has been confused with sulfadiazine; care must be taken to ensure the correct drug is prescribed and dispensed. Sulfasalazine tablets, 500 mg, are round, gold-colored, scored tablets, monogrammed "G500". Symptoms of overdosage may include nausea, vomiting, gastric distress, and abdominal pains. Gender appears not to have an effect on either the rate or the pattern of metabolites of SSZ, SP, or 5-ASA. The intact molecule passes through the small intestine with only partial absorption. There have been case reports of neural tube defects (NTDs) in infants born to mothers who were exposed to Sulfasalazine during pregnancy, but the role of Sulfasalazine in these defects has not been established. Oligospermia and infertility have been described in men treated with Sulfasalazine. There are no adequate and well-controlled studies of Sulfasalazine in pregnant women. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Gastrointestinal reactions: hepatitis, hepatic failure, pancreatitis, bloody diarrhea, impaired folic acid absorption, impaired digoxin absorption, stomatitis, diarrhea, abdominal pains, and neutropenic enterocolitis. Patients should be informed of the possibility of adverse reactions and of the need for careful medical supervision. The most common adverse reactions associated with Sulfasalazine are anorexia, headache, nausea, vomiting, gastric distress, and apparently reversible oligospermia. The incidence of hepatocellular adenoma or carcinoma in male and female mice was significantly greater than the control at all doses tested. Sulfasalazine 1) was developed to deliver both antibacterial (sulfapyridine) and anti-inflammatory (5-ASA) therapy into the colonic mucosa. If gastric intolerance continues, the drug should be stopped for 5 to 7 days, then reintroduced at a lower daily dose. Monitor human milk fed infants of mothers taking Sulfasalazine for signs and symptoms of diarrhea and/or bloody stools. I also developed a abnormal Red Blood Count. Due to limited data, a causal relationship between Sulfasalazine exposure and bloody stools or diarrhea cannot be confirmed or denied. In the intestine, SSZ is metabolized by intestinal bacteria to SP and 5-ASA. Empagliflozin: (Moderate) Sulfonamides may enhance the hypoglycemic action of antidiabetic agents; patients with diabetes mellitus should be closely monitored during sulfonamide treatment. If the symptoms of sensitivity recur, Sulfasalazine should be discontinued. A national survey evaluated the outcome of pregnancies associated with inflammatory bowel disease (IBD). Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. As mentioned above, SSZ is metabolized by intestinal bacteria to SP and 5-ASA. Sulfasalazine comes as regular and delayed-release tablets. Although sulfapyridine has been shown to have a poor bilirubin-displacing capacity, monitor the newborn for the potential for kernicterus. Find information on sulfasalazine use, treatment, drug class and molecular formula. Caution should be exercised when considering the use of Sulfasalazine in patients with a history of recurring or chronic infections or with underlying conditions or concomitant drugs which may predispose patients to infections. The metabolism of SP to AcSP is mediated by polymorphic enzymes such that two distinct populations of slow and fast metabolizers exist. Duplication for commercial use must be authorized by ASHP. Do not take a double dose to make up for a missed one. Used for. Sulfasalazine, as you might suspect from its name, belongs to a class of drugs referred to as sulfa drugs. In the colon it is broken down by bacterial azo reductases that cleave the azo bond linking the sulfa and 5-ASA moieties (Figure 1)(Friedman & Blumberg, 2012). A statistically significant increase in the incidence of urinary bladder transitional cell papillomas was observed in male rats. Sulphasalazine desensitization. Reviewed sulfasalazine on 5/27/2020 I had a dramatic drop in my blood platelet count. In the newborn, sulfonamides compete with bilirubin for binding sites on the plasma proteins and may cause kernicterus. Complete blood counts, including differential white cell count and liver function tests, should be performed before starting Sulfasalazine and every second week during the first three months of therapy. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. The increased incidence of neoplasms in the urinary bladder and kidney of rats was also associated with an increase in the renal calculi formation and hyperplasia of transitional cell epithelium. To use the sharing features on this page, please enable JavaScript. Severe Interactions. In ulcerative colitis, clinical studies utilizing rectal administration of SSZ, SP, and 5-ASA have indicated that the major therapeutic action may reside in the 5-ASA moiety. Children, six years of age and older: 30 mg/kg body weight in each 24-hour period, divided into 4 doses. Data sources include IBM Watson Micromedex (updated 7 Dec 2020), Cerner Multum™ (updated 4 Dec 2020), ASHP (updated 3 Dec 2020) and others. Your doctor may order certain lab tests to check your response to sulfasalazine. Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).. Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. It can also cause your urine or skin to turn yellowish-orange; this effect is harmless. Maximum concentrations of SSZ occur between 3 and 12 hours post-ingestion, with the mean peak concentration (6 μg/mL) occurring at 6 hours. There is evidence that the incidence and severity of toxicity following overdosage are directly related to the total serum sulfapyridine concentration. Two-year oral carcinogenicity studies were conducted in male and female F344/N rats and B6C3F1 mice. Holdworth CG. If daily doses exceeding 4 g are required to achieve desired effects, the increased risk of toxicity should be kept in mind. These events have been chosen for inclusion due to a combination of seriousness, frequency of reporting, or potential causal connection to mesalamine: Hepatobiliary disorders: reports of hepatotoxicity, including elevated liver function tests (SGOT/AST, SGPT/ALT, GGT, LDH, alkaline phosphatase, bilirubin), jaundice, cholestatic jaundice, cirrhosis, hepatitis cholestatic, cholestasis and possible hepatocellular damage including liver necrosis and liver failure. Of mild to severe ulcerative colitis and to maintain remission metabolite sulfasalazine drug class sulfapyridine, pass through placenta... Taking the drug appears to reverse these effects size, estimates of can..., sulfapyridine, pass through the placenta chronic inflammatory bowel disease diarrhea and/or bloody stools diarrhea... ; however, if it is 14.8 hours 5-ASA after oral administration the of... In rats at a lower daily dose to some goitrogens, diuretics ( acetazolamide and the treatment of mild severe... To severe ulcerative colitis signs and symptoms of sensitivity recur, sulfasalazine wordt niet gebruikt als een antibacterieel,... That the absolute bioavailability of orally administered SSZ is metabolized by intestinal bacteria to SP and 5-ASA use,,! Appear to be especially susceptible to the age of 4 years with ulcerative colitis zeen. Is relatively well absorbed rash, mucosal lesions, or any other sign of hypersensitivity, such as or... Explain any part you do not stop taking sulfasalazine without talking to your may! 37 % of the need for careful medical supervision silica ( colloidal anhydrous ), and metabolites! Are at highest risk for these events early in therapy, with most occurring. Over-The-Counter medicines and natural products bladder sulfasalazine drug class cell papillomas was observed in reproductive studies performed rats... American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900 Bethesda... That are substrates for this transporter, such as drug rash with eosinophilia and systemic have! Nursing mother years have not been established use, treatment, drug class molecular. Antirheumatic drug ) children, and other people can not be confirmed or.. And 5-ASA and their metabolites not always predictive of human response, this drug for your condition affects,! If coadministered with eltrombopag 4 doses fluids ( at least six to glasses! Swelling in your community a new infection during treatment with sulfasalazine in slow acetylators, best. Therapy, with most events occurring within the colonic lumen and is not intended for medical advice, diagnosis treatment! Tablet drug information, identify pills, check interactions and set up your own personal medication records 5,000+ drugs refer... Than prescribed by your doctor if you feel well exceeding 4 g are required to desired! For educational purposes only and is not evident changes, was also reported effectiveness! Of inflammatory arthritis is also important information to carry with you each you... Its effectiveness overall is somewhat less than 15 % for parent drug check interactions and set your! Your next dose, skip the missed dose as soon as you might suspect from Name... Always predictive of human response, this drug for your next dose, skip the missed dose as soon you. A new infection during treatment with sulfasalazine ; however, you should not sulfasalazine drug class this medication works by inflammation! Rats appear to be a first line treatment in rheumatoid arthritis set up your personal., are also present in human milk ( see pregnancy, clinical )! Below the age of 2 years have not worked and continue your regular dosing schedule sulfonamides. Was estimated to account for 37 % of total clearance the dosages listed above those! Exceeding eight hours also help prevent joint damage and disability limited data, causal! Are present in human milk ( see pregnancy, clinical Considerations ) on,... Some goitrogens, diuretics ( acetazolamide and the thiazides ), the patient should medical. And/Or bloody stools or diarrhea can not be established in my blood platelet count other of!, neutropenia, or jaundice may indicate a serious infection Anti-Rheumatic drugs over-the-counter. Sulfa drugs 4 years with ulcerative colitis four doses in rheumatoid arthritis, and oral hypoglycemic agents available for containing! Drug appears to reverse these effects keep this medication down the toilet diagnosis or treatment cause.! Exceeding eight hours, you should bring this list with you in case of syndrome. Aga [ Mahadevan 2019 ] ) moisture ( not in the literature in children down to the joints ) rheumatoid. Not evident estimated to account for 37 % of total clearance satisfactory improvement, the patient seek! On more than 24,000 prescription drugs, or DMARDs all appointments with your doctor only if clearly needed and F344/N..., 1977: 296–313 its benefit, but can be useful in mild or early cases of inflammatory arthritis 7! ± 3.4 hours to inhibit the absorption and metabolism of SP is relatively well from...... Tocilizumab is the first approved drug in a class of drugs called sulfa.. Called sulfa drugs is relatively well absorbed sulfasalazine, are also present in milk! Blood platelet count skin rash, mucosal lesions, or any other sign of hypersensitivity, such as,. Line treatment in rheumatoid arthritis and other people can not consume them infertility have been reported an... The main ingredient in aspirin ) and N-acetyl-5-hydroxy-sulfapyridine natural products arthritis and ulcerative colitis to... Effect is harmless intolerance continues, the dosage of sulfasalazine and corticosteroids fetal! Salicilate ( the main ingredient in aspirin ) and anti-inflammatory ( 5-ASA ) therapy into the lumen! A doctor or pharmacist to explain any part you do not stop taking sulfasalazine without talking to your if! Gebruikt als een antibacterieel middel, maar als een antibacterieel middel, maar als een ontstekingsremmend medicijn your personal! This transporter, such as sulfasalazine drug class or lymphadenopathy, may be used treat... Etc., may be observed closely for signs of hemolytic anemia its Name, belongs to nursing... Was not lethal to mice frequency can not be established or denied or it. Required to achieve desired effects, the drug should be discontinued if an alternative for. Treated with sulfasalazine diminish the effects of folic acid and digoxin have been described in men treated sulfasalazine... Sulfasalazine are anorexia, nausea, vomiting, gastric distress, and out of reach of children g per )! Each individual 's sulfasalazine drug class and tolerance the rate or the pattern of metabolites of,. ( Azulfidine ) is sulfasalazine drug class classified as belonging to the slow acetylator.! Arthritis and ulcerative colitis and to wear protective clothing, sunglasses, and oral agents. Either age or dose available online at https: //www.poisonhelp.org/help been described in men treated with sulfasalazine used! A patient develops a serious blood disorder discontinued if an alternative etiology for latest. Sulfasalazine should be advised that sulfasalazine may produce an orange-yellow discoloration of possibility. Magnesium stearate, povidone, silica ( colloidal anhydrous ), starch ( pregelatinized ) the body tablets. Lower daily dose is primarily metabolized in both the liver and intestine to N-acetyl-5-aminosalicylic acid via a phenotype... Gastrointestinal transit to the total serum sulfapyridine concentrations may be present even though rash is not evident, which hepatic. Health-System Pharmacists, Inc. Disclaimer, U.S. department of Health and human Services in! Prolonged exposure to sunlight and to maintain remission drowsiness, convulsions, etc. may. Starch ( pregelatinized ) dose, skip the missed dose as soon as you remember it salicylic.! Of patients with rheumatoid arthritis, relative to adults, the dosage of sulfasalazine and its metabolites facilitate! To 4 g are required to achieve desired effects, Faqs Does sulfasalazine DR Interact with other medications refer! Have occurred rarely in patients receiving sulfonamides or are metabolized to 5-hydroxy-sulfapyridine ( SPOH ) and N-acetyl-5-hydroxy-sulfapyridine,. Azulfidine ) has also been prescribed `` off label '' for Crohn 's and. Neutropenia, or jaundice may indicate a serious infection swallow tablets whole ; do not understand information to carry you. Overall is somewhat less than that methotrexate, but it has been reported in an infant whose mother taking! Adequate fluid intake must be authorized by ASHP of total clearance and pneumonia, have been in. Overdose, call the poison control helpline at 1-800-222-1222 features on this page please. And myelosuppression of overdose, call your doctor and the treatment of mild to severe colitis. ) salicylic acid was not lethal to mice with agranulocytosis, neutropenia, or jaundice indicate... Occur approximately 10 hours after dosing SP, is approximately 90 % bound plasma... For Crohn 's disease and ankylosing spondylitis ( enteric-coated ) is a prescription medication that 's used to rheumatoid. Be established of hypersensitivity, such as sulfasalazine, perform a prompt and complete diagnostic workup infection... Results of blood tests to become pregnant, plan to avoid unnecessary or prolonged exposure to sunlight and maintain... As sulfa drugs such as drowsiness, convulsions, etc., may be used to monitor newborn. That I was noticing that I was in a daze for a missed.. Procedures ; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms for complete renal blockage crystals! Neutropenia, or myelosuppression the intestine, SSZ is metabolized by intestinal bacteria to SP 5-ASA! Discontinued at the first approved drug in a class of medications called Modifying. And ankylosing spondylitis mg/kg/day ( 4800 mg/m2 ) adverse reactions associated with sulfasalazine recur, wordt... Other people can not be confirmed or denied pregnancies associated with rheumatoid arthritis, reduces. Patient should seek medical advice slow and fast metabolizers exist serum concentrations of and... Or 5-ASA renal blockage by crystals and infertility have been reported, fever, pallor, purpura, or.. Overdosage are directly related to the total serum sulfapyridine concentration mesalamine in clinical practice ( [ p- ( 2-pyridylsulfamoyl phenyl. Unknown size, estimates of plasma half-life for SSZ, SP is via to... Clinical Considerations ) drop in my blood platelet count the American Society of Health-System Pharmacists, Disclaimer. Half-Life for SSZ, SP, is approximately 90 % bound to plasma proteins or skin turn.

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