Sulfasalazine (Systemic)

Brand Names : Salazopyrin EN-Tabs, S.A.S.-500, S.A.S. Enteric-500, salazosulfapyridine, salicylazosulfapyridine, sulphasalazine, Azulfidine, Azulfidine EN-Tabs, Alti-Sulfasalazine, PMS-Sulfasalazine, PMS-Sulfasalazine E.C., Salazopyrin

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sulfasalazine, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to any of the sulfa medicines, furosemide (e.g., Lasix) or thiazide diuretics (water pills), oral antidiabetics (diabetes medicine you take by mouth), glaucoma medicine you take by mouth (for example, acetazolamide [e.g., Diamox], dichlorphenamide [e.g., Daranide], methazolamide [e.g., Neptazane]), or salicylates (for example, aspirin). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Sulfasalazine has not been studied in pregnant women. However, reports on women who took sulfasalazine during pregnancy have not shown that it causes birth defects or other problems. In addition, sulfasalazine has not been shown to cause birth defects in studies in rats and rabbits given doses of up to 6 times the human dose.

Breast-feeding - Sulfa medicines pass into the breast milk in small amounts and have been shown to cause unwanted effects in nursing babies with glucose-6-phosphate dehydrogenase (G6PD) deficiency. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children - Sulfasalazine should not be used in children up to 2 years of age because it may cause brain problems. However, sulfasalazine has not been shown to cause different side effects or problems in children over the age of 2 years than it does in adults.

Older adults - This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sulfasalazine, it is especially important that your health care professional know if you are taking any of the following:

• Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
• Amiodarone (e.g., Cordarone) or
• Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
• Androgens (male hormones) or
• Carbamazepine (e.g., Tegretol) or
• Carmustine (e.g., BiCNU) or
• Dantrolene (e.g., Dantrium) or
• Daunorubicin (e.g., Cerubidine) or
• Disulfiram (e.g., Antabuse) or
• Divalproex (e.g., Depakote) or
• Estrogens (female hormones) or
• Ethionamide (e.g., Trecator-SC) or
• Etretinate (e.g., Tegison) or
• Fat emulsions, intravenous (e.g., Intralipid) (with prolonged use) or
• Fluconazole (e.g., Diflucan) or
• Gold salts (medicine for arthritis) or
• Inflammation or pain medicine, except narcotics or
• Iron (with overdose) or
• Labetalol (e.g., Normodyne) or
• Lovastatin (e.g., Mevacor) or
• Mercaptopurine (e.g., Purinethol) or
• Methimazole (e.g., Tapazole) or
• Naltrexone (e.g., ReVia) (with long-term, high-dose use) or
• Niacin (with high doses, sustained release, and antihyperlipidemic use) or
• Nitrofurans or
• Other anti-infectives by mouth or by injection (medicine for infection) or
• Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
• Plicamycin (e.g., Mithracin) or
• Pravastatin (e.g., Pravachol) or
• Propylthiouracil (e.g., Propyl-Thyracil) or
• Simvastatin (e.g., Zocor) or
• Troleandomycin or
• Valproic acid (e.g., Depakene) or
• Vitamin A (with chronic overdose) - Use of sulfasalazine with these medicines may increase the chance of side effects affecting the liver

• Acetohydroxamic acid (e.g., Lithostat) or
• Dapsone or
• Furazolidone (e.g., Furoxone) or
• Menadiol (e.g., Synkavite) or
• Nitrofurantoin (e.g., Furadantin) or
• Primaquine or
• Procainamide (e.g., Pronestyl) or
• Quinidine (e.g., Quinidex) or
• Quinine (e.g., Quinamm) or
• Sulfoxone (e.g., Diasone) - Use of sulfasalazine with these medicines may increase the chance of side effects affecting the blood

• Anticoagulants (blood thinners) or
• Ethotoin (e.g., Peganone) or
• Mephenytoin (e.g., Mesantoin) - Use of sulfasalazine with these medicines may increase the chance of side effects of these medicines

• Antidiabetics, oral (diabetes medicine you take by mouth) - Use of oral antidiabetics with sulfasalazine may increase the chance of side effects affecting the blood and/or increase the side effects of oral antidiabetics

• Methotrexate (e.g., Mexate) - Use of methotrexate with sulfasalazine may increase the chance of side effects affecting the liver and/or increase the side effects of methotrexate

• Methyldopa (e.g., Aldomet) - Use of methyldopa with sulfasalazine may increase the chance of side effects affecting the liver and/or the blood

• Phenytoin (e.g., Dilantin) - Use of phenytoin with sulfasalazine may increase the chance of side effects affecting the liver and/or increase the side effects of phenytoin

Other medical problems - The presence of other medical problems may affect the use of sulfasalazine. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergies, severe or
• Asthma, bronchial - The risk of an allergic reaction to sulfasalazine may be increased
• Blood problems or
• Glucose-6-phosphate dehydrogenase deficiency (lack of G6PD enzyme) - Patients with these problems may have an increase in side effects affecting the blood

• Intestinal blockage - Sulfasalazine will not reach the site of action in the bowel

• Kidney disease or
• Liver disease - Patients with kidney disease or liver disease may have an increased chance of side effects

• Porphyria - Use of sulfasalazine may cause an attack of porphyria

• Urinary blockage - Sulfasalazine may not be eliminated properly, causing an increased risk of side effects