Sulfasalazine is an anti-inflammatory drug that is used to relieve symptoms of inflammatory bowel disease or ulcerative colitis, such as abdominal pain, fever, diarrhea, or bleeding at the end of the large intestine (rectum).

Sulfasalazine works by inhibiting inflammatory reactions in the body. In addition to relieving the symptoms of inflammatory bowel disease, sulfasalazine can also be used to treat rheumatoid arthritis, which cannot be treated by other medications.

Sulfasalazine trademarks : Lazafin, Sulcolon, Sulfasalazine, Sulfitis

What is Sulfasalazine

class Prescription drug
Category An anti-inflammatory drug of the aminosalicylic class
Benefit Relieve symptoms of inflammatory bowel disease or ulcerative colitis , in the form of abdominal pain, diarrhea, or bleeding in the rectum, and treat rheumatoid arthritis.
Consumed by Adults and children
Sulfasalazine for pregnant and lactating women Category B: Animal studies have not demonstrated a risk to the fetus, but there are no controlled studies in pregnant women

Category D (if drug administration is close to delivery) : There is positive evidence of risk to the human fetus, but the benefits may outweigh the risks, for example in dealing with a life-threatening situation.

Sulfasalazine can be absorbed into breast milk. It is recommended that breastfeeding mothers consult their doctor before taking this drug.

Drug form Enteric-coated tablets and caplets

Precautions Before Taking Sulfasalazine

Follow the doctor's recommendations and suggestions while undergoing treatment with sulfasalazine. Before taking this drug, you need to pay attention to the following things:

  • Do not take sulfasalazine if you have an allergy to any of these drugs, to aspirin , salicylates, or sulfonamides . Always tell your doctor about any allergies you have.
  • This medicine should not be given to children younger than 2 years.
  • Tell your doctor if you have or currently have aplastic anemia , asthma, kidney disease, liver disease , urinary tract obstruction, intestinal obstruction , infectious disease, deficiency of the enzyme glucose-6-phosphate dehydrogenase ( G6PD deficiency ), or porphyria .
  • Do not drive a vehicle or operate equipment that requires alertness while taking sulfasalazine, because this drug can cause dizziness .
  • Avoid prolonged sun exposure while taking sulfasalazine, because this drug can make your skin more sensitive to light. Always use sunscreen when doing outdoor activities.
  • Try to meet your fluid needs by drinking plenty of water while taking sulfasalazine to prevent kidney problems.
  • Tell your doctor if you are taking certain medications, supplements or herbal products.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy.
  • See your doctor immediately if you have an allergic drug reaction, serious side effects, or overdose after using sulfasalazine.

Dosage and Rules for Use Sulfasalazine

The dosage for each person is different and is generally determined by the doctor based on the age and condition of the patient. The following is the general dosage for sulfasalazine based on the condition and age of the patient:

Condition: Relieves symptoms of inflammatory bowel disease or ulcerative colitis

  • Adult: Initially 1000–2000 mg 4 times daily until symptoms improve. After the symptoms improve, the dose can be reduced to 2,000 mg per day, divided into several consumption schedules.
  • Children ≥2 years: Initial dose of 40–60 mg/kg per day, divided into several consumption schedules. After the symptoms improve, the dose can be reduced to 20-30 mg/kg per day, which is divided into several consumption schedules.

Condition: Rheumatoid arthritis

  • Adult: First week dose 500 mg daily. After that, the dose can be increased by 500 mg weekly. The maximum dose is 3,000 mg per day, which is divided into 2-4 consumption schedules.
  • Children aged ≥6 years: The dose is 30–50 mg/kg per day, which is divided into two consumption schedules. At the start of treatment, the dose given is ¼ to ⅔ of the above dose, and is increased weekly until the desired dose is reached within 1 month. The maximum dose is 2,000 mg per day.

How to Take Sulfasalazine Properly

Follow  the doctor 's recommendations and read the information listed on the drug packaging label before taking sulfasalazine. Do not reduce or increase your dose without consulting your doctor first.

Sulfasalazine enteric-coated tablets or capsules should be taken with food or immediately after food. Swallow the tablet or capsule whole with the help of drinking water. Do not crush or chew it first.

Drink plenty of water after taking this drug to prevent kidney stones from forming.

Try to always take sulfasalazine at the same time every day to make the treatment more effective. Do not stop taking sulfasalazine suddenly, unless directed by your doctor.

If you forget to take sulfasalazine, do it immediately if the break with the next consumption schedule is not too close. If it's close, ignore it and don't double the dose.

Carry out regular checks according to the schedule given by the doctor while undergoing treatment with sulfasalazine so that your condition can be monitored.

This medication can affect the results of certain laboratory tests. Be sure to tell your doctor or healthcare provider that you are taking sulfasalazine.

Store sulfasalazine at room temperature and in a closed container so as not to be exposed to direct sunlight, and keep it out of reach of children.

Sulfasalazine Interactions with Other Drugs

The effects of drug interactions that can occur if sulfasalazine is used together with other drugs are:

  • Decreased absorption of folic acid drugs
  • Decreased blood levels of sulfasalazine when taken with ethambutol or rifampicin
  • Decreased levels of digoxin in the blood
  • Increased risk of damage to blood cells when taken with azathioprine
  • Increased risk of developing leukopenia if taken with drugs containing gold preparations while undergoing treatment for rheumatoid arthritis

Sulfasalazine Side Effects and Dangers

One of the side effects of using sulfasalazine is the change in urine color to yellowish or orange. These side effects are generally harmless and temporary. Some other side effects that can occur after taking this drug are:

  • Decreased appetite
  • Unusual dizziness or tiredness
  • Headache
  • Abdominal pain
  • Diarrhea
  • Nausea or vomiting
  • Temporary reduction in sperm count or production

Check with your doctor if the side effects above don't go away or get worse. Immediately see a doctor if you experience an allergic drug reaction or more serious side effects, such as:

  • Sore throat
  • Fever
  • Joint or muscle pain
  • Pale or yellow skin
  • Unusual bleeding or bruising
  • Ringing ears ( tinnitus )
  • Mental disorders and moods
  • Urinating less frequently, painful urination, or bloody urine
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