From the Guidelines
Sulfasalazine (Salazopirine) is primarily used to treat inflammatory bowel diseases like ulcerative colitis and Crohn's disease, as well as rheumatoid arthritis, juvenile arthritis, and ankylosing spondylitis. The typical adult dosage starts at 500 mg daily, gradually increasing to 2-3 grams per day divided into multiple doses, though this varies based on the condition being treated 1. Treatment is usually long-term for chronic conditions, with maintenance doses determined by patient response. Sulfasalazine works by combining sulfapyridine (an antibiotic) with 5-aminosalicylic acid (an anti-inflammatory), which helps reduce inflammation in the intestines and joints. In the intestines, bacteria break down the medication, releasing the active anti-inflammatory component. Common side effects include nausea, headache, and stomach upset, which can be minimized by taking the medication with food and increasing the dose gradually. Patients should be aware that sulfasalazine can cause orange-yellow discoloration of urine and skin, and may reduce sperm count temporarily in men. Regular blood tests are necessary to monitor for potential adverse effects on liver function and blood cell counts 1.
Some key points to consider when using sulfasalazine include:
- It is effective for inducing and maintaining remission in patients with mild to moderate ulcerative colitis 1.
- It may be used in combination with other medications, such as rectal mesalamine, for patients with extensive or left-sided disease 1.
- Patients with a history of sulfa allergy or intolerance should use caution when taking sulfasalazine 1.
- Regular monitoring of liver function and blood cell counts is necessary to minimize the risk of adverse effects 1.
Overall, sulfasalazine is a useful medication for the treatment of inflammatory bowel diseases and other conditions, but it should be used under the guidance of a healthcare professional and with careful monitoring for potential side effects.
From the FDA Drug Label
INDICATIONS AND USAGE Sulfasalazine tablets, USP are indicated: in the treatment of mild to moderate ulcerative colitis, and as adjunctive therapy in severe ulcerative colitis; and for the prolongation of the remission period between acute attacks of ulcerative colitis.
Salazopirine (sulfasalazine) is used for:
- Treatment of mild to moderate ulcerative colitis
- Adjunctive therapy in severe ulcerative colitis
- Prolongation of the remission period between acute attacks of ulcerative colitis 2
From the Research
Salazopirine (Sulfasalazine) Overview
- Salazopirine, also known as sulfasalazine, is a medication used to treat inflammatory bowel disease (IBD) [(3,4)].
- It is commonly prescribed for mild to moderate attacks of ulcerative colitis and has been shown to be effective in preventing recurrence of the disease 4.
Uses of Salazopirine
- Sulfasalazine is used to treat ulcerative colitis, a type of IBD that affects the colon [(3,4)].
- It is also used to treat Crohn's disease, another type of IBD that can affect the colon and small intestine 4.
- The medication has been shown to be effective in reducing symptoms and inducing remission in patients with IBD [(3,4)].
Mechanism of Action
- The exact mechanism of action of sulfasalazine is not fully understood, but it is thought to involve the release of 5-aminosalicylic acid (5-ASA), which has anti-inflammatory properties 4.
- The sulfapyridine component of sulfasalazine may be related to most of the side effects associated with the medication 4.
Side Effects and Precautions
- Common side effects of sulfasalazine include gastrointestinal symptoms, such as nausea and diarrhea 5.
- The medication can also cause more serious side effects, such as hematologic abnormalities and liver damage 5.
- Patients with a history of allergic reactions to sulfasalazine or sulphonamides should be treated with caution 5.