Sulfasalazine (Salazopyrin EN tablet, Azulfidine, Azulfidine En-Tabs, SAS-500)

Sulfasalazine is a 5-ASA preparation containing a sulpha group, for use in ulcerative colitis, Crohn’s disease and other inflammatory conditions; it came into use in 1949. It is used sometimes on its own and sometimes together with a steroid. A third of the antibacterial sulpha group is absorbed and passes into the blood, and the rest stays in the bowel and acts as an anti-inflammatory. It is not habit-forming.

How it is used

Take the dose of the drug with plenty of water, and drink a few extra glasses; you will reduce the risk of kidney stones this way. Those with stomach complaints should take care, because the drug can upset the stomach.

The dose of the drug is adjusted to the person. There is no fixed dosage schedule, as there is with azathioprine. Your doctor will decide the dose that best suits your weight and how active your disease is. The aim here is the greatest benefit from the smallest dose.

Take the doses on time and do not miss the time. Do not stop the treatment on your own. Take a multivitamin with the drug every day, because this drug affects the absorption of folic acid from the diet.

Side effects

Some side effects can be seen even in drugs sold over the counter. Continuing headache, rashes, unexplained high fever, bleeding and bruising, and unexplained rashes and blisters should be reported to the doctor.

Side effects such as increased sensitivity to sunlight, stomach upset and heartburn, nausea, vomiting, dizziness and a fall in the sperm count can settle of their own accord even though the drug is not stopped; if they are troublesome, tell your doctor.

Men taking this drug may have a fall in the sperm count, but it has no effect on sexual desire or activity. In families planning a child this drug should be replaced with another. The sperm count returns to normal within a few weeks. If there are side effects other than these, tell your doctor without fail. Do not stay in the sun for long periods while taking this drug.

Take care

You should not use sulfasalazine if you are allergic to antibiotics of the sulpha group, to aspirin, to oral drugs for diabetes, or to diuretics of the thiazide group.

Warn your doctor if you are pregnant or planning to become pregnant soon. Although harm from Salazopyrin at low doses has not been shown in pregnancy and breastfeeding, there is benefit in being cautious.

You should tell your doctor if you have severe kidney or liver disease, if you have porphyria or G6PD deficiency, or if you are taking a drug of the digoxin, phenytoin or warfarin groups.