Sulfasalazine

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• Sulfasalazine for Rheumatoid Arthritis

What is sulfasalzine?

• Sulfasalazine is in a class of medications called Disease Modifying Anti-Rheumatic Drugs, or DMARDs. DMARDs are a slow acting but effective treatment for rheumatoid arthritis and other forms of inflammatory arthritis.
• Sulfasalazine is a milder DMARD in regards to its benefit, but can be useful in mild or early cases of inflammatory arthritis. Commonly, it is used in combination with other DMARDs.

What is the typical dose for sulfasalazine?

• Most rheumatologists will dose sulfasalazine between 1 – 3 grams per day, split into a morning and evening dose. The dose may be higher or lower based on the condition being treated and other factors related to the individual patient’s disease or other medical conditions.

How does sulfasalazine work?

• The exact mechanism of action remains unclear; sulfasalazine, like other DMARDs, modulates the immmune system to have its effect.

How soon will I feel the effects of sulfasalazine?

• Like all DMARDs, sulfasalazine takes time to work. Most patients start to feel the positive effects of at 4-8 weeks, with maximum benefit at 3-6 months. Side effects can occur earlier.

What are the common or serious side effects of sulfasalazine?

• Stomach upset – nausea, abdominal pain or diarrhea
• An allergic reaction, including rash
• Liver irritation
• Lower blood counts

How can I lower the risk of having a side effect?

• Let your doctor know if you have a sulfa allergy – if you do, sulfasalazine is not for you
• Take your medication as directed
• Tell your doctor if you are having any problems
• Get your bloodwork done as instructed – patients on sulfasalazine need bloodwork for blood counts and liver tests anywhere between every 2 weeks to every 3months

What should I do if I miss a dose?

• If you miss your morning or evening dose, do not take double at your next scheduled dose; just skip the dose and resume your regular routine. As long as this does not happen regularly, you will likely not feel any ill effects.

How can I safely stop sulfasalazine?

• It is safe to just stop sulfasalazine; you do not need to slowly reduce the dose. However, keep in mind, if you were gaining any benefit, it will usually take at least 6 weeks to lose it.

For more information about Sulfasalazine, or for questions that are specific to your situation, always consult your physician.