tell your doctor if you are allergic to sulfasalazine, sulfapyridine, aspirin, choline magnesium trisalicylate (Triosal, Trilisate), choline salicylate (Arthropan), mesalamine (Asacol, Pentasa, Rowasa), salsalate (Argesic-SA, Disalcid, Salgesic, others), sulfa drugs, trisalicylate (Tricosal, Trilisate),or any other drugs. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. Sulfasalazine is a type of drug known as a disease-modifying anti-rheumatic drug (DMARD).It may be used on its own or with other drugs. The incidence of hepatocellular adenoma or carcinoma in male and female mice was significantly greater than the control at all doses tested. The calculated clearance of SSZ following intravenous administration was 1 L/hr. Renal clearance was estimated to account for 37% of total clearance. A single oral dose of 12 g/kg was not lethal to mice. Sulfasalazine oral tablet is a prescription medication that's used to treat rheumatoid arthritis, juvenile rheumatoid arthritis, and ulcerative colitis. Approximately 60% of the Caucasian population can be classified as belonging to the slow acetylator phenotype. The presence of clinical signs such as sore throat, fever, pallor, purpura, or jaundice may be indications of serious blood disorders or hepatotoxicity. Sulfasalazine is used to treat ulcerative colitis and to maintain remission. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. Some of these cases were fatal. Reproduction studies have been performed in rats and rabbits at doses up to 6 times the human maintenance dose of 2 g/day based on body surface area and have revealed no evidence of impaired female fertility or harm to the fetus due to Sulfasalazine. The low molecular weight of Sulfasalazine and its metabolites may facilitate their removal by dialysis. Sulfasalazine changes the way your condition affects you, and reduces inflammation, pain and swelling in your joints. Hypersensitivity reactions: erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, epidermal necrolysis (Lyell's syndrome) with corneal damage, drug rash with eosinophilia and systemic symptoms (DRESS), anaphylaxis, serum sickness syndrome, interstitial lung disease, pneumonitis with or without eosinophilia, vasculitis, fibrosing alveolitis, pleuritis, pericarditis with or without tamponade, allergic myocarditis, polyarteritis nodosa, lupus erythematosus-like syndrome, hepatitis and hepatic necrosis with or without immune complexes, fulminant hepatitis, sometimes leading to liver transplantation, parapsoriasis varioliformis acuta (Mucha-Haberman syndrome), rhabdomyolysis, photosensitization, arthralgia, periorbital edema, conjunctival and scleral injection, and alopecia. Drug Class. Sulfasalazine and its metabolite are also present in human milk. Duplication for commercial use must be authorized by ASHP. In the intestine, SSZ is metabolized by intestinal bacteria to SP and 5-ASA. In more advanced cases, central nervous system symptoms such as drowsiness, convulsions, etc., may be observed. Sulfasalazine (SSZ) Drug Name Sulfasalazine (SSZ) Brand Name(s) Salazopyrin®, generics. Sulfasalazine delayed-release (Azulfidine EN-tabs) is also used to treat rheumatoid arthritis in adults and children whose disease has not responded well to other medications. Ask your pharmacist any questions you have about refilling your prescription. Dosages. Information is also available online at https://www.poisonhelp.org/help. Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).. Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Side … • You will need to take the vitamin supplement called folic acid while on sulfasalazine • Sulfasalazine can decrease the effect of digoxin and iron • Sulfasalazine can increase the effects of oral anticoagulants (e.g.,Coumadin), oral hypoglycemic medications (e.g.,Glucophage, Avandia, Glucotrol, DiaBeta), and … Mogadam M, et al. It is the generic name of a drug that belongs to a class of drugs called sulfa drugs. Scand J Gastroenterol 1982;17:1–4. Do not take a double dose to make up for a missed one. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. In ulcerative colitis, clinical studies utilizing rectal administration of SSZ, SP, and 5-ASA have indicated that the major therapeutic action may reside in the 5-ASA moiety. Sulfasalazine Oral Tablet Drug Information, Side Effects, Faqs In the colon it is broken down by bacterial azo reductases that cleave the azo bond linking the sulfa and 5-ASA moieties (Figure 1)(Friedman & Blumberg, 2012). Patient Education. Alkalinize urine. Other brands: Azulfidine, Azulfidine EN-tabs, aspirin, prednisone, ibuprofen, meloxicam, naproxen, hydrocortisone topical, hydrocortisone, dexamethasone, methylprednisolone, hydroxychloroquine. In case of overdose, call the poison control helpline at 1-800-222-1222. Sulfasalazine should be discontinued if an alternative etiology for the signs or symptoms cannot be established. Sulfasalazine is known to inhibit the absorption and metabolism of folic acid and may diminish the effects of folic acid supplementation. Absorbed SP and 5-ASA and their metabolites are primarily eliminated in the urine either as free metabolites or as glucuronide conjugates. Metabolism and nutrition system disorders: Respiratory, thoracic and mediastinal disorders: We comply with the HONcode standard for trustworthy health information -, API MANUFACTURE(59762-5000), MANUFACTURE(59762-5000). Serious infections, including fatal sepsis and pneumonia, have been reported. It is often necessary to continue medication even when clinical symptoms, including diarrhea, have been controlled. Discontinue Sulfasalazine if a patient develops a serious infection. The clinical implication of this is unclear; however, in a small pharmacokinetic trial where acetylator status was determined, subjects who were slow acetylators of SP showed a higher incidence of adverse events. Birth defects and drugs during pregnancy. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Last updated on Aug 2, 2020. Sulfasalazine is a milder DMARD in regards to its benefit, but can be useful in mild or early cases of inflammatory arthritis. Gastrointestinal reactions: hepatitis, hepatic failure, pancreatitis, bloody diarrhea, impaired folic acid absorption, impaired digoxin absorption, stomatitis, diarrhea, abdominal pains, and neutropenic enterocolitis. Urinalysis and an assessment of renal function should also be done periodically during treatment with Sulfasalazine. The most common adverse reactions associated with Sulfasalazine are anorexia, headache, nausea, vomiting, gastric distress, and apparently reversible oligospermia. Sulfasalazine did not show mutagenicity in the bacterial reverse mutation assay (Ames test) and in L51784 mouse lymphoma cell assay at the HGPRT gene. Following intravenous injection, the calculated volume of distribution (Vdss) for SSZ was 7.5 ± 1.6 L. SSZ is highly bound to albumin (>99.3%) while SP is only about 70% bound to albumin. A national survey evaluated the outcome of pregnancies associated with inflammatory bowel disease (IBD). The sulfonamides bear certain chemical similarities to some goitrogens, diuretics (acetazolamide and the thiazides), and oral hypoglycemic agents. This reaction is frequently dose related. I stopped taking the drug and I was in a daze for a few days. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. D00448 Sulfasalazine (USP/INN); Salazosulfapyridine (JP17) Drugs listed in the Japanese Pharmacopoeia [BR:br08311] Chemicals D00448 Salazosulfapyridine Drug metabolizing enzymes and transporters [br08309.html] Drug transporters D00448 Pharmacogenomic biomarkers [br08341.html] Polymorphisms and mutations affecting drug response D00448 Patients should be informed of the possibility of adverse reactions and of the need for careful medical supervision. Symptoms of overdosage may include nausea, vomiting, gastric distress, and abdominal pains. Sulfasalazine should be discontinued at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity. When endoscopic examination confirms satisfactory improvement, the dosage of Sulfasalazine should be reduced to a maintenance level. ... Sulfasalazine decreases sperm count and therefore may cause infertility. Look up information on diseases, tests, and procedures; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms. In this same study, 5-ASA is much less well absorbed from the gastrointestinal tract with an estimated bioavailability of from 10 to 30%. If diarrhea recurs, the dosage should be increased to previously effective levels. Dosages for children: The dosages listed above are those typically prescribed for adults aged 18-65. These occur, the principal metabolite of SP to AcSP is mediated by polymorphic enzymes such that two distinct of. 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