Some important information about sulfasalazine
While sulfasalazine has been indicated for a variety of conditions, there are a few things to keep in mind if this is part of your medication list.
At Chemist2U, we make it easy for those with chronic conditions to stay on top of their medications. Read along to learn some important information on sulfasalazine that you can discuss with your doctor.
In this article
How does sulfasalazine work?
Sulfasalazine (commonly sold under the brand name Salazopyrin) is a medication typically prescribed for managing chronic inflammatory conditions. It may play a role in the treatment of rheumatoid arthritis in both children and adults, as well as ulcerative colitis and inflammatory bowel disease.[1]
The exact mechanism of sulfasalazine is not fully understood; however, one suggested mechanism is by inhibiting the nuclear factor kappa-B. This action suppresses the transcription of NF-kB responsive pro-inflammatory genes, including TNF alpha, thus helping to alleviate inflammation associated with these conditions.[2]
How do you take sulfasalazine?
Only your doctor can determine if sulfasalazine is right for you and what dosage would meet your needs. However, the medication is typically taken once or twice daily. Starting with a low dose, which could be one or two 500 mg tablets daily, the dosage might then gradually increase weekly.[3]
It typically comes in two forms: plain and enteric-coated tablets. The enteric-coated variety, designed to withstand stomach acid, is often preferred due to fewer side effects. These tablets may be taken with or after meals, accompanied by a glass of water, and patients must be careful not to break, crush, or chew them to avoid damaging the enteric coating.
Who can take sulfasalazine?
While sulfasalazine could offer relief, it is not always suitable for everyone. It’s crucial to be aware of its limitations, especially if you have sensitivities to aspirin compounds or sulphur-containing medicines.[4] These sensitivities could make sulfasalazine an unsuitable option for you.
Similarly, do not take sulfasalazine if you are allergic to some hypoglycaemics such as glipizide and thiazide diuretics such as chlorothiazide.[5]
If you have any blood, kidney, or liver disorders, a thorough discussion with your doctor is essential. They will consider your medical history and current health status to determine whether the medication is a suitable treatment choice for you or if other anti-inflammatory medications, such as indometacin (e.g. Arthrexin and Indocid), should be considered.
Side effects of sulfasalazine
While sulfasalazine, as an arthritis medication, may be prescribed for those with chronic inflammation, this prescription medicine may still come with potential side effects. Common reactions may include nausea, vomiting, diarrhea, and symptoms resembling a cold or flu.[6]
Sulfasalazine is yellow or orange; people who take it may notice that their urine, tears, and sweat develop an orange tinge, which can stain clothing and contact lenses.[7] It’s important to drink plenty of fluids while on therapy and avoid taking the drug on an empty stomach or with antacids.
This medication has also been linked to male infertility; however, it is reversible upon withdrawal of the drug.[8] Generally, most side effects are mild and tend to emerge within the first three months of treatment. If side effects persist or worsen, seek medical help immediately.
Sulfasalazine and other medications
Navigating medication management, especially when multiple drugs are involved, can be challenging. Sulfasalazine, for example, may interact with other medicines. Be sure to keep your doctor informed about all the medications you’re taking, including over-the-counter and herbal or naturopathic remedies
Specifically, it can affect how warfarin, a blood-thinning medication, works in your body, necessitating dose adjustments. Similarly, if taken with digoxin, another commonly used medication, dosage modifications might be required.[9]
This underscores the importance of communicating with your doctor; they can help you determine which medications may react negatively when taken with sulfasalazine.
Medicines you should not use with sulfasalazine
Antacids can hinder the absorption of sulfasalazine, so your doctor may advise you not to take antacids within two hours of your sulfasalazine dose. Additionally, combining sulfasalazine with isoniazid, a medication used for tuberculosis, has been observed to increase the risk of liver injury.[10]
As sulfasalazine can affect liver health, it’s crucial to be cautious with alcohol consumption. While the exact safe level of alcohol intake isn’t definitively known while on this medication, it is strongly advised to avoid consuming more than four standard drinks on any occasion, even infrequently.[11][12]
How to order sulfasalazine through Chemist2U
At Chemist2U, we’re making medications easy.
Download our app or use this website to get started, then upload your eScript. While you’re at it, feel free to browse a wide selection of over-the-counter medications or general pharmacy goods typically found in your physical pharmacy.
From there, your prescription will be reviewed and filled by a partner pharmacist from your local community. Our dedicated courier will then deliver your medication straight to your door, with same-day delivery available in metro and major regional areas. Note: A minority of products (inc. Ozempic and Mounjaro) are delivered via AusPost. Allow 5 to 7 business days.
We go beyond just delivering medications by sending you reminders so you never miss a refill. If you have general queries related to medications, you can Ask a Pharmacist right from the comfort of your home. For any order-related concerns, our customer service team is ready to assist you.
Experience the Chemist2U difference and join the thousands of Australians we’ve already helped.
References
[1] https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-CMI-05395-3
[2] https://www.ncbi.nlm.nih.gov/books/NBK557809/
[3] https://rheumatology.org.au/For-Patients/Adult-Medication-Information/S-Z/Sulfasalazine
[4] https://arthritisaustralia.com.au/medication-search/sulfasalazine/
[5] https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-CMI-03399-3
[6] https://www.nps.org.au/medicine-finder/salazopyrin-tablets
[7] https://www.uptodate.com/contents/sulfasalazine-and-the-5-aminosalicylates-beyond-the-basics
[8] https://pubmed.ncbi.nlm.nih.gov/7588084/
[9] https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-CMI-03399-3
[10] https://arthritisaustralia.com.au/medication-search/sulfasalazine/
[11] https://www.ncbi.nlm.nih.gov/books/NBK548792/
[12] https://arthritisaustralia.com.au/medication-search/sulfasalazine/
