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Results for sulfasalazine
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trade name: Asulfidine-EN-Tabs, Azulfidine; drug class: sulfonamide derivative with antiinflammatory action; action: acts as a prodrug to deliver sulfapyridine and mesalamine (5-aminosalicylic acid) to the colon; uses: treatment of ulcerative colitis, Crohn’s disease.
Brand names: Azulfidine®, Azulfidine® En-Tabs®, Sulfazine®, Sulfazine® EC
Chemical formula:
Sulfasalazine tablets or enteric-coated tablets
What are sulfasalazine tablets or enteric-coated tablets?
SULFASALAZINE (Azulfidine®) is an anti-inflammatory agent. It is used to prevent and treat inflammatory bowel disease such as ulcerative colitis. It is also used to improve symptoms of rheumatoid arthritis or juvenile rheumatoid arthritis (JRA). Sulfasalazine works to reduce inflammation and other symptoms of these diseases. Generic sulfasalazine tablets are available.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
• asthma
• blood disorders or anemia
• glucose-6-phosphate dehydrogenase (G6PD) deficiency
• intestinal obstruction
• kidney disease
• liver disease
• porphyria
• severe allergies
• urinary tract obstruction
• an unusual or allergic reaction to sulfasalazine, sulfonamides, salicylates, or other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding
How should I take this medicine?
Take sulfasalazine tablets or enteric-coated tablets by mouth. Follow the directions on the prescription label. Swallow the tablets whole with a drink of water; do not suck or chew enteric-coated tablets. If sulfasalazine upsets your stomach, take it with food or milk. Take your doses at regular intervals. Do not take your medicine more often than directed.
Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. In general, children less than 2 years of age should not receive sulfasalazine.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.What drug(s) may interact with sulfasalazine?
• digoxin
• female hormones, including contraceptives or birth control pills
• fosphenytoin
• medicines for diabetes
• methotrexate
• other medicines that make you sensitive to the sun including some antibiotics, retinoinds (vitamin A analogs), or certain kinds of water pills (diuretics)
• phenytoin
• voriconazole
• warfarin
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking sulfasalazine?
Tell your prescriber or health care professional if your symptoms do not improve. There is usually an improvement within a month. You may need about 6—12 weeks of treatment to get good results. It is important that you go on taking your medicine and only stop taking it on your prescriber's advice.
Sulfasalazine can make your skin more sensitive to sun or ultraviolet light. Keep out of the sun, or wear protective clothing outdoors and use a sunscreen (at least SPF 15). Do not use sun lamps or sun tanning beds or booths.
Sulfasalazine can cause blood problems. You will need to have your blood checked while you are taking sulfasalazine. Notify your health care provider if you notice sores that do not heal, unusual bleeding or bruising, or get a cold that does not improve.
Make sure to drink plenty of fluids while taking sulfasalazine.
What side effects may I notice from taking sulfasalazine?
Side effects that you should report to your prescriber or health care professional as soon as possible:
• bloody diarrhea
• chest pain
• difficulty breathing, wheezing
• difficulty swallowing
• fever, chills, or sore throat
• joint or muscle aches
• painful, difficult or reduced urination
• pale skin
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• skin rash, itching
• stomach cramps or pain
• unusual bleeding or bruising
• unusual weakness or tiredness
• yellowing of the eyes or skin
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• diarrhea
• discolored urine or skin (orange-yellow color)
• dizziness
• headache
• increased sensitivity of the skin to sun or ultraviolet light
• indigestion
• loss of appetite
• nausea, vomiting
• reduced sperm count (loss of male fertility)
Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot open.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.
Last updated: 7/1/2002
Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.
A combination of sulfapyridine and salicylic acid, used in the treatment and prophylaxis of ulcerative colitis. Previously called salicylazosulfapyridine.
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Sulfasalazine
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| Systematic (IUPAC) name | |
| 6-oxo-3-((4-(pyridin-2-ylsulfamoyl)phenyl) hydrazinylidene]cyclohexa-1,4-diene-1-carboxylic acid | |
| Identifiers | |
| CAS number | |
| ATC code | A07 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C18H14N4O5S |
| Mol. mass | 398.394 g/mol |
| Pharmacokinetic data | |
| Bioavailability | <15%
|
| Metabolism | ? |
| Half life | 5-10 hours |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
? |
| Legal status | |
| Routes | oral |
Sulfasalazine (brand name Azulfidine in the U.S., Salazopyrin in Europe) is a sulfa drug, a derivative of Mesalazine (5-aminosalicylic acid abbreviated as 5-ASA), used primarily as an anti-inflammatory agent in the treatment of inflammatory bowel disease as well as for rheumatoid arthritis. It is not a pain killer.
Sulfasalazine is mainly used for treatment of inflammatory bowel disease, including ulcerative colitis and Crohn's disease. It is also effective in several types of arthritis, particularly rheumatoid arthritis.
However, in recent British research involving animal studies, and more recently, human trials for the treatment of chronic alcoholics, sulfasalazine has been found to reverse the scarring associated with cirrhosis of the liver. Apparently, cells called myofibroblasts, that cause scar tissue to form in a diseased liver, also give off proteins that prevent the breakdown of the scar tissue. Sulfasalazine appears to retard the secretion of these proteins.
It is usually not given to children under 2 years of age.
The use of sulfasalazine has declined. 5-ASA, and other derivatives of 5-ASA, are now usually preferred, despite their increased cost, due to their more favourable side-effect profile (they do not yield the metabolite sulfapyridine - see below).
Sulfasalazine, and its metabolite 5-ASA, are poorly absorbed. Its main mode of action is therefore believed to be inside the intestine. In Crohn's disease and ulcerative colitis, it is thought to be an antinflammatory drug that is essentially providing topical relief inside the intestine.
When treatment for arthritis is successful, pain, joint swelling and stiffness will be reduced and this may slow down or stop the development of joint damage. The precise reasons why sulfasalazine is effective in various forms of arthritis is not clearly understood.
Because sulfasalazine and its metabolite 5-ASA are poorly absorbed into the bloodstream, it is surprising that the drug is effective against symptoms outside of the intestine. One possible explanation is that, given that ulcerative colitis produces arthritic symptoms, it is possible that, in some cases, the arthritic symptoms are actually a product of unrecognized ulcerative colitis, which is effectively treated with sulfazalazine.
Talk to your doctor if you have ulcerative colitis, as some patients that have both sets of symptoms of ulcerative colitis and arthritis may have ankylosing spondylitis, which is a genetic condition, and have the antigen HLA-B27. This is a genetic marker, and there is a test available for it. Sulfasalazine is also good for this.
The other metabolite, sulfapyridine, is absorbed into the blood, and is believed to be the source of the side-effects discussed below. It is possible that the sulfapyridine is responsible for some of the anti-arthritic effects of sulfasalazine.
The most common side effect is nausea but often this can be controlled by a reduction in dose. Sometimes other medications may be needed. Occasionally mouth ulcers, a sore mouth or loose bowel motions may occur. Certain patients may develop a headache or slight dizziness but adjusting the dosage may bring things under control.
A rash may develop which may be itchy, but usually resolves quite quickly once the drug is stopped. Sulfasalazine can in rare cases cause a drop in the numbers of white blood cells which are needed to fight infection. If the blood count is monitored closely, it is unusual for this to be serious. Sulfasalazine can decrease the numbers of platelets, cells which help to stop bleeding, but again it is rare for this to actually cause problems. If however you develop a sore mouth, mouth ulcers, easy bruising, nosebleeds or bleeding gums, your doctor should be notified immediately.
The other potential problem is that sulfasalazine can cause a type of hepatitis (liver inflammation). This is most commonly minor and does not cause symptoms. Most often we find that some of the blood tests which reflect liver function may become a little abnormal but these soon return to normal if the treatment is stopped. A study at University of Newcastle found that the drug may also act to aid the healing of cirrhosis of the liver.[1]
Sulfasalazine always causes some orange discolouration of the urine and your perspiration may be a little orange-tinged. This will generally wash out of clothes, but will damage some nylon fabrics. Contact lenses, particularly extended-wear soft lenses may be permanently stained. It also causes semen to turn orange.
Sulfasalazine in rare cases can cause severe depression in young males.
Lastly, sulfasalazine may cause a decrease in the sperm count in men which may result in temporary infertility. This reverses when the drug is stopped. Temporary infertility may also occur in women. Sulfasalazine is considered to be safe in pregnancy, but should you wish to become pregnant, you should discuss this with your rheumatologist.
Sulfsalazine metabolizes to sulfapyridine. Serum levels should monitored every three months, and more frequently at the outset. Serum levels above 50 micrograms/L are associated with side effects.
| Antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07) | |
|---|---|
| Intestinal anti-infectives | Antibiotics (Neomycin, Nystatin, Natamycin, Streptomycin, Polymyxin B, Paromomycin, Amphotericin B, Kanamycin, Vancomycin, Colistin, Rifaximin) - Sulfonamides (Phthalylsulfathiazole, Sulfaguanidine, Succinylsulfathiazole) - other (Miconazole, Broxyquinoline, Acetarsol, Nifuroxazide, Nifurzide) |
| Intestinal adsorbents | Charcoal - Bismuth - Pectin - Kaolin - Crospovidone - Attapulgite - Diosmectite |
| Antipropulsives | Diphenoxylate - Opium - Loperamide - Difenoxin - Loperamide oxide |
| Intestinal anti-inflammatory agents | corticosteroids acting locally (Prednisolone, Hydrocortisone, Prednisone, Betamethasone, Tixocortol, Budesonide, Beclometasone) - antiallergic agents, excluding corticosteroids (Cromoglicic acid) - aminosalicylic acid and similar agents (Sulfasalazine, Mesalazine, Olsalazine, Balsalazide) |
| Antidiarrheal micro-organisms | Saccharomyces boulardii |
| Other antidiarrheals | Albumin tannate - Ceratonia - Racecadotril |
This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)
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| Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved. Read more |
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| Wikipedia. This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Sulfasalazine". Read more |
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