Sulfasalazine is a medication used to treat inflammatory bowel disease such as ulcerative colitis, proctitis, and Crohn's Disease. It helps to control symptoms by reducing inflammation in the bowel. It also can be used to treat rheumatoid arthritis when treatment with other medications has not helped.

Dosage

Dose varies widely according to condition being treated and the needs of the person. Children are treated on the basis of body weight. The uncoated tablets should be taken with a meal if possible.

Presentation

Salazopyrin® is available as tablets or enteric-coated tablets.

Enteric-coated tablets

Each orange, elliptical, enteric-coated tablet, engraved with "KPh" on one side and "102" on the other side, contains sulfasalazine 500mg.

Nonmedicinal ingredients

beeswax, carnauba wax, cellulose acetate phthalate, glyceryl monostearate, polyethylene glycol, propylene glycol, and talc.

Tablets

Each yellow-orange, round tablet, engraved with "KPh" on one side and "101" and a score on the other side, contains sulfasalazine 500mg.

Nonmedicinal ingredients

silicon dioxide, starch, and magnesium stearate.

This medication does not contain tartrazine.

Precautions

People allergic to sulfonamides or salicylates (e.g., ASA) should not take this drug.

Infants under 2 years of age should not be given sulfasalazine.

People with intestinal and urinary obstructions (blockage) should not use the drug.

Those with porphyria (a type of liver condition) should not receive sulfonamides, as these drugs have been reported to bring on an attack.

Should not be used by people in whom acute asthmatic attacks, hives, rhinitis or other allergic symptoms are brought on by ASA or other nonsteroidal anti-inflammatory agents.

Pregnancy

Sulfasalazine should only be used during pregnancy if clearly needed.

Breastfeeding

Caution should be exercised when sulfasalazine is taken by a nursing woman, since it is excreted in the milk.

Side Effects

Most side effects are worse in high doses, and the symptoms can be relieved by the doctor reducing the dose.

Side effects involving the stomach are drastically reduced when the enteric coated tablets are used.

The most commonly reported side effects are:

• nausea
• vomiting
• stomach upset
• loss of appetite
• headache

These occur in about one-third of patients.

Less frequent adverse reactions are skin rash, itching, hives, and fever.

Infertility had been observed in some men treated with sulfasalazine. Withdrawal of the drug appears to reverse these effects.

People allergic to furosemide, thiazide water pills, carbonic anhydrase inhibitors, may also be allergic to this medication.

Sulfasalazine should be used with caution in patients with reduced kidney or liver function.

Sulfasalazine may produce an orange-yellow color of the urine. Similar discoloration of the skin and yellow staining of soft contact lenses have occasionally been reported.

If Enteric coated tablets are noticed intact in stool, report this to the doctor.

Adequate fluid intake must be maintained in order to prevent crystal and stone formation.

Drug Interactions

Sulfasalazine may interact with a number of different drugs. Be sure to tell any health professional involved in your care of all the drugs you are taking, including those that can be bought without a prescription.

Commonly used brand names are

In the U.S.

Azulfidine; Azulfidine EN-Tabs

In Canada

Alti-Sulfasalazine; PMS-Sulfasalazine; PMS-Sulfasalazine E.C.; Salazopyrin; Salazopyrin EN-Tabs; S.A.S.-500; S.A.S. Enteric-500