Sulfasalazine is a drug from the group of sulfonamides. It has anti-inflammatory and immunosuppressive effects. Check the indications for the use of sulfasalazine and possible side effects.

Action of sulfasalazine

The anti-inflammatory effect is due to the formation of mesalazine in the gastrointestinal tract, while inhibition of the growth of lymphocytes and granulocytes is responsible for the immunosuppressive effect.

It also inhibits the synthesis of folic acid by bacteria, thereby preventing the growth and division of bacterial cells.

The indications for the use of sulfasalazine include the treatment of NSAID-resistant rheumatoid arthritis, treatment and maintenance of inflammatory bowel diseases in remission, including ulcerative colitis and proctitis and Crohn's disease.

Sulfasalazine dosage

Sulfasalazine comes in the form of gastro-resistant tablets / capsules, do not crush, divide, break or open them. The tablets should be taken whole with meals and washed down with plenty of liquid.

Dosage is determined individually and it is different depending on the indication for use. For the treatment of RA in adults, the dosage is 1 to 3 g per day, in divided doses (twice a day).

Increase the dose gradually. If side effects occur, the dose should not be increased further if it is possible to stay with the highest one that does not cause side effects.

In inflammatory bowel diseases, the dosage varies depending on whether the acute phase of the disease is being treated or it is maintenance therapy.

In the acute phase of adults, the daily dose ranges from 3 to 8 grams and should be divided into 3-4 single doses. In children, however, in the event of exacerbation of symptoms, daily 40-60 mg per kg of body weight is also used in divided doses.

Maintenance treatment is based on the use of lower doses, in adults it is 500 mg to 1 g 3-4 times a day, and in children 20-30 mg per kg of body weight daily.

Contraindications to the use of sulfasalazine

The main contraindications to the use of sulfasalazine are:

  • porphyrias, or disturbances in hemoglobin synthesis,
  • obstructionurinary tract or intestines,
  • granulocytopenia,
  • age under 2.

Sulfasalazine should also not be used in patients with renal or hepatic insufficiency.

Particular caution should be exercised when using it in patients with bronchial asthma and glucose-6-phosphate dehydrogenase deficiency.

During treatment, the patient should have regular blood tests to check the functions of the bone marrow, liver and kidneys.

It is possible to use sulfasalazine during pregnancy only if the benefits outweigh the risks (decreased absorption of folic acid may cause defects in the nervous system of the developing fetus).

Breastfeeding is also allowed with caution when feeding premature babies and newborns with physiological jaundice.

Sulfasalazine side effects

Common side effects are:

  • leukopenia,
  • loss of appetite,
  • headaches and dizziness,
  • taste disturbance,
  • tinnitus,
  • cough,
  • nausea and vomiting,
  • hemorrhagic diathesis,
  • joint pain,
  • fever,
  • proteinuria.

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