The drug sulfasalazine is a 5-ASA compound, and is the combination of two substances: sulfapyridine and an aspirin-like compound. It works to reduce the inflammation in the colon caused by ulcerative colitis and then as a maintenance therapy to maintain remission. Sulfasalazine may also be used to treat Crohn's disease in some cases.
How is sulfasalazine taken?In order for sulfasalazine to be effective, the pills must be swallowed whole and not crushed or chewed. It is usually taken 4 times a day; this typically means at each mealtime and then before bed. Sulfasalazine should be taken with a meal or a snack with plenty of water.
Why is sulfasalazine prescribed?Sulfasalazine is used as a maintenance drug - it is helpful in retaining a remission but not in supressing a flare-up. It is typically, but not always, used for ulcerative colitis and ulcerative proctitis. The reason why sulfasalazine helps to treat intestinal inflammation is still poorly understood.
What do I do if I miss a dose?If you miss a dose, take it as soon as you remember. If your next dose should be taken soon, just take that dose. Don't double up, or take more than one dose at a time.
Who should not take sulfasalazine?Tell your doctor if you have ever had any of the following conditions:
- Allergy to other sulfa medications or aspirin
- An obstruction (blockage) of the intestine or urinary tract
- Asthma
- Blood problems
- Kidney disease
- Liver disease
- Porphyria
Side effects from sulfasalazine are not common. Minor side effects include diarrhea, headache, loss of appetite, upset stomach, vomiting, and stomach pain. Sulfasalazine may also cause urine to turn dark yellow or orange in color, but this is harmless. Serious side effects of sulfasalazine that should be reported to the prescribing physician include pale or jaundiced (yellow) skin or eyes, difficulty swallowing, unusual bleeding or bruising and weakness. See the azulfadine side effects page for a complete list.
Are there any sexual side effects?Sulfasalazine is associated with temporary infertility (oligospermia) in men, which abates after the drug is discontinued.
What medications can sulfasalazine interact with?Sulfasalazine is not known to interact with other medications. People who have had an adverse reaction to other sulfa drugs ay also be sensitive to sulfasalazine.
Sulfasalazine can interfere with the body's ability to absorb folic acid. The prescribing physician may recommend folic acid supplements.
Are there any food interactions?There are no known food interactions with sulfasalazine.
Is sulfasalazine safe during pregnancy?The FDA has classified sulfasalazine as a type B drug. The effect that sulfasalazine has on an unborn child has not been studied extensively. Sulfasalazine should only be used during pregnancy if clearly needed. Notify the prescribing doctor if you become pregnant while taking sulfasalazine. Sulfasalazine does pass into breast milk, and could affect a nursing infant.
How long can sulfasalazine be taken safely?Under the supervision of a physician, sulfasalazine can be safely used long-term.
