Sulfasalazine (patient information)

Why is this medication prescribed
Sulfasalazine is used to treat bowel inflammation, diarrhea (stool frequency), rectal bleeding, and abdominal pain in patients with ulcerative colitis, a condition in which the bowel is inflamed. 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. Sulfasalazine is in a class of medications called anti-inflammatory drugs. It works by reducing inflammation (swelling) inside the body.

How should this medicine be used
Sulfasalazine comes as regular and delayed-release (enteric-coated) tablets. It usually is taken four times a day in evenly spaced doses throughout the day so that no more than 8 hours separates any two doses, if possible. Take sulfasalazine after a meal or with a light snack, then drink a full glass of water. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sulfasalazine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow tablets whole; do not crush or chew them.

Drink plenty of fluids (at least six to eight glasses of water or other beverage per day) while taking sulfasalazine.

Continue to take sulfasalazine even if you feel well. Do not stop taking sulfasalazine without talking to your doctor.

Other uses for this medicine
Sulfasalazine is also used to treat bowel inflammation, diarrhea (stool frequency), rectal bleeding, and abdominal pain in Crohn's disease. Talk to your doctor about the possible risks of using this drug for your condition.

What special precautions should I follow
Before taking sulfasalazine:


 * 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.
 * tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially digoxin (Lanoxin), folic acid, and vitamins.
 * tell your doctor if you have or have ever had asthma, kidney or liver disease, porphyria, blood problems, or blockage in your intestine or urinary tract.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking sulfasalazine, call your doctor.
 * plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. *Sulfasalazine may make your skin sensitive to sunlight.

What should I do if I forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Mild side effects
Sulfasalazine may cause side effects. Sulfasalazine causes temporary infertility in males. Fertility returns when the medicine is stopped. It can also cause your urine or skin to turn yellowish-orange; this effect is harmless.

Tell your doctor if any of these symptoms are severe or do not go away:


 * diarrhea
 * headache
 * loss of appetite
 * upset stomach
 * vomiting
 * stomach pain

Severe side effects
If you have any of the following symptoms, stop taking sulfasalazine and call your doctor immediately:


 * skin rash
 * itching
 * hives
 * swelling
 * sore throat
 * fever
 * joint or muscle aches
 * pale or yellow skin
 * difficulty swallowing
 * tiredness
 * unusual bleeding or bruising
 * weakness

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to sulfasalazine.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

 * Azulfidine®
 * Azulfidine® EN-tabs®