About sulfasalazine

Sulfasalazine has an anti-inflammatory effect. Although it is not clear exactly how it works, it is thought to block the way inflammation develops in your body. It is used to manage the symptoms of inflammatory bowel diseases such as ulcerative colitis and Crohn's disease, and also for some forms of arthritis.

Ulcerative colitis and Crohn's disease can both cause inflammation in the large intestine, leading to problems such as abdominal pain and diarrhoea. Sulfasalazine can help control these symptoms.

It is prescribed in rheumatoid arthritis to help reduce damage to your joints. It is likely to be prescribed alongside other medicines.

Before taking sulfasalazine

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking sulfasalazine it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have any allergies.
• If you have asthma.
• If you have any problems with your liver or kidneys.
• If you have ever had an allergic reaction to a medicine. It is particularly important that you tell your doctor if you have had a bad reaction to aspirin, salicylate, or sulfonamide. (Sulfonamide is contained in some diuretics and antibiotic medicines.)
• If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
• If you have been told you have G6PD deficiency (an enzyme deficiency), or porphyria (a blood pigment disorder). These are both rare inherited conditions.

How to take sulfasalazine

• Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about sulfasalazine and a full list of side-effects which you may experience from taking it.
• How much sulfasalazine you need to take will depend upon the reason you are prescribed it. Your doctor will tell you how much to take and when to take it. Your dose will also be on the label of the pack to remind you. As a guide, adults taking sulfasalazine for an inflammatory bowel problem are likely to be prescribed 500 mg-2 g (1-4 tablets) four times daily. If you are taking it for rheumatoid arthritis, you will be prescribed 500 mg (1 tablet) daily to begin with, and this will then be increased each week up to a maximum of 6 tablets daily if needed.
• Gastro-resistant tablets (these have 'EN' or 'EC' after the brand name) must be swallowed whole. Do not break, chew or crush the tablets to take them. This is because they are specially coated to pass through your stomach before they are absorbed. Also, do not take any indigestion remedies within two hours (before or after) of taking these tablets, as this will interfere with the coating on them.
• It is important that you drink plenty of water while you are taking sulfasalazine. This is to avoid any problems with your kidneys.
• If you forget to take a dose, don't worry but do remember to take your next dose when it is due. Do not take two doses together to make up for a missed dose.

How to use sulfasalazine suppositories:

1. Empty your bowel firstly, if possible.
2. Remove the suppository from the packaging.
3. Using your finger, gently push the suppository into your back passage, pointed end first. (Some people find it helps to lie down on one side and draw their knees up towards their chest to do this.)
4. Push the suppository in as far as possible. You may have the urge to pass the suppository out again but this should ease after a few minutes.
5. Wash your hands.

Getting the most from your treatment

• Try to keep your regular appointments with your doctor and clinic. This is so your doctor can check on your progress. Your doctor will want you to have regular blood tests during this treatment.
• Sulfasalazine may colour your urine. This is completely harmless and nothing to worry about.
• Treatment with sulfasalazine is often long-term unless you experience an adverse effect. Continue to take it unless you are advised otherwise.
• If you usually wear soft contact lenses, speak with your optician about this, as sulfasalazine may stain your lenses a yellow/orange colour. You may be advised not to wear certain types of lenses.

Can sulfasalazine cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Important: rarely, sulfasalazine can cause allergic problems or problems with your blood. You should contact your doctor immediately if you have any:

• Difficulty in breathing, and swelling of your face or tongue.
• Unexplained bleeding, bruising, red or purple discolorations of your skin, a sore throat, fever, or if you feel generally unwell during this treatment.

How to store sulfasalazine

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines