Does Sulfasalazine Suppress The Immune System
Sulfasalazine may suppress your immune system by lowering white blood cell counts. Serious or fatal infections can occur. If you come down with signs or symptoms of an infection such as fever, chills, shortness of breath, cough, paleness, sore throat, mouth sores, redness or swelling, contact your doctor right away.
What Are Warnings And Precautions For Sulfasalazine
Warnings
This medication contains sulfasalazine. Do not take Azulfidine or Azulfidine EN if you are allergic to sulfasalazine or any ingredients contained in this drug.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.
Contraindications
- Ensure adequate hydration to prevent crystalluria.
- May cause orange discoloration of the urine or skin.
Pregnancy and Lactation
- Sulfasalazine may be acceptable for use during pregnancy. Either animal studies show no risk but human studies are not available or animal studies showed minor risks and human studies were done and showed no risk.
- If used for prolonged periods or near term, use sulfasalazine only in LIFE-THREATENING emergencies during pregnancy when no safer drug is available. There is positive evidence of human fetal risk. There is increased potential for kernicterus in the newborn.
- Oral sulfasalazine inhibits the absorption and metabolism of folic acid, which may interfere with folic acid supplementation and protection from neural tube defects.
- Sulfasalazine is excreted into human breast milk. Use caution with breastfeeding. There are some reports of bloody stools or diarrhea in human milk fed infants of mothers taking sulfasalazine.
What Is Sulfasalazine Used For
Sulfasalazine is used to treat a certain type of bowel disease called ulcerative colitis. This medication does not cure this condition, but it helps decrease symptoms such as fever, stomach pain, diarrhea, and rectal bleeding. After an attack is treated, sulfasalazine is also used to increase the amount of time between attacks. Sulfasalazine works by reducing irritation and swelling in the large intestines. In addition, delayed-release tablets of sulfasalazine are used to treat rheumatoid arthritis. Sulfasalazine helps to reduce joint pain, swelling, and stiffness. Early treatment of rheumatoid arthritis with sulfasalazine helps to reduce/prevent further joint damage so you can do more of your normal daily activities. This medication is used with other drugs, rest, and physical therapy in patients who have not responded to other medications .
Sulfasalazine may also be used to treat another type of bowel disease called Crohn’s disease.
Sulfasalazine is available under the following different brand names: Azulfidine, and Azulfidine EN.
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What To Do In Case You Take Too Much Azulfidine Or Azulfidine En
Call your doctor right away if you think youve taken too much Azulfidine or Azulfidine EN-tabs. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, immediately call 911 or go to the nearest emergency room.
What Should I Ask My Doctor
The sections above describe the typical dosages provided by the drugs manufacturer. If your doctor recommends Azulfidine or Azulfidine EN-tabs for you, theyll prescribe the dosage thats right for you.
Remember, you should not change your dosage of Azulfidine or Azulfidine EN-tabs without your doctors recommendation. Only take Azulfidine or Azulfidine EN-tabs exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions you may want to ask your doctor:
- Will my dosage change if I switch from Azulfidine to Azulfidine EN-tabs?
- Will my dosage change the longer I take Azulfidine or Azulfidine EN-tabs?
- How often will you need to change my childs dosage as they grow?
If you have ulcerative colitis or rheumatoid arthritis , consider signing up for Healthlines IBD newsletter or RA newsletter for tips on managing these conditions.
You can also find support and advice from our Bezzy communities for IBD and RA.
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Common Questions About Sulfasalazine
Sulfasalazine works by reducing swelling . This helps reduce the symptoms of inflammatory conditions, such as inflammatory bowel disease and rheumatoid arthritis.
It’s not known exactly how sulfasalazine does this. It’s thought to stop your body producing chemicals that cause redness and swelling in the gut and in the joints .
Sulfasalazine has a similar effect to immunosuppressants. It can reduce the numbers of white cells in your blood, reducing your body’s ability to fight infection.
Sulfasalazine does not work straight away.
If you’re taking sulfasalazine for inflammatory bowel disease, you must continue taking it even if you feel well in order to remain well.
If you have rheumatoid arthritis it may take 1 to 3 months before you notice your symptoms get better.
It depends on how high your dose is and how severe your symptoms are.
Sulfasalazine can be used at a higher dose for a short time to treat flare-ups.
You can also take it long term to keep inflammation under control and prevent symptoms from flaring up again. How long you use it for will depend on your condition and how severe it is.
Do not stop using sulfasalazine unless your doctor tells you to.
Sulfasalazine can be taken long term. However, your doctor will want to check how your kidneys are working before and during treatment. In rare cases sulfasalazine can cause kidney problems.
If you are thinking of stopping sulfasalazine, discuss this with your doctor first as your symptoms may return.
Who Can And Cannot Take Sulfasalazine
Adults and children aged 2 years and older can take sulfasalazine.
Sulfasalazine is not suitable for some people. To make sure it’s safe for you, tell your doctor before starting the medicine if you:
- have ever had an allergic reaction to sulfasalazine, aspirin, or any other salicylates such as methyl salicylate or choline salicylate
- have ever had an allergic reaction to any other medicine
- have a rare blood condition called porphyria
- have any problems with your kidneys or liver
- are pregnant, trying to get pregnant or breastfeeding
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Will I Need To Take This Drug Long Term
Azulfidine and Azulfidine EN-tabs are meant to be used as a long-term treatment. If you and your doctor determine that Azulfidine or Azulfidine EN-tabs is safe and effective, youll likely take it long term.
The Food and Drug Administration approves prescription drugs such as Azulfidine and Azulfidine EN-tabs to treat certain conditions.
Whats The Dosage Of Azulfidine And Azulfidine En
In children ages 6 years and older, Azulfidine and Azulfidine EN-tabs are dosed based on body weight.
Dosage for ulcerative colitis
Both Azulfidine and Azulfidine EN-tabs are treatment options for UC in children. The daily starting dosage for children is 40 milligrams to 60 mg per kilogram * of body weight. The daily dosage is divided into three to six doses. Your childs doctor will calculate your childs dosage when prescribing this medication.
Your childs doctor may reduce your childs dose to a daily maintenance dosage of 30 mg/kg divided into four doses. This will depend on factors such as side effects your child may be having and how their UC is responding to Azulfidine.
* 1 kg is about 2.2 lbs.
Dosage for polyarticular juvenile idiopathic arthritis
Azulfidine EN-tabs are used to treat JIA in children ages 6 years and older. The recommended dose is 30 mg to 50 mg per kilogram of body weight. The daily dosage is divided into two doses.
Your childs doctor will calculate your childs dosage when prescribing this medication.
Your childs doctor may also start your child on a lower dosage and slowly increase it over the first month.
The maximum dosage for a child is usually 2 g per day.
* 1 kg is about 2.2 lbs.
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What Should Be Considered Before Taking Azulfidine And Azulfidine En
Before you start taking Azulfidine or Azulfidine EN-tabs, its important that you tell your doctor about any medical conditions you may have. You should also tell them about all medications you may take. This helps them determine whether Azulfidine or Azulfidine EN-tabs is the right treatment option for you.
Are There Any Other Precautions Or Warnings For This Medication
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergies: Some people who are allergic to furosemide, thiazide water pills, or carbonic anhydrase inhibitors also experience allergic reactions to this medication. Before you take sulfasalazine, inform your doctor about any previous adverse reactions you have had to medications, especially water pills or sulfonamide antibiotics. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.
Anemia: Sulfasalazine may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count such as shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible.
Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.
Asthma: Sulfasalazine can cause increased breathing difficulty for people with asthma. If you have asthma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
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Is Azulfidine Safe To Use During Pregnancy Or While Breastfeeding
In hundreds of pregnant women with ulcerative colitis or Crohn’s disease treated with sulfasalazine, there has been no increase in the risk of fetal malformations relative to other women with these illnesses who have not been treated with sulfasalazine. Additionally, there have not been ill effects on pregnant animals given high doses of sulfasalazine. Thus, sulfasalazine may be used during pregnancy if the physician feels the benefit outweighs the possible risk.
It should also be noted, however, that sulfasalazine may reduce sperm count and sperm function in men. These effects are reversible upon stopping the drug.
Caution should be exercised by women who are nursing their infants. Sulfasalazine and its constituents are secreted intobreast milk. There is a small risk that sulfapyridine may displace bilirubin from albumen in the blood of infants and causejaundice.
Dosage For Juvenile Idiopathic Arthritis
The dosage of Azulfidine EN-tabs for children ages 6 years and older with polyarticular* juvenile idiopathic arthritis is based on body weight. The recommended dosage is 30 mg to 50 mg per kilogram of body weight per day. This dose should be divided into two doses per day.
Heres an example for a child who weighs 40 kg, which is about 88 pounds . Their dosage would be between 1,200 mg and 2,000 mg per day. Their doctor may recommend a dose of 500 mg in the morning and 1,000 mg at night, or 1,000 mg twice per day.
The maximum dosage of Azulfidine EN-tabs in children with JIA is 2,000 mg per day.
Azulfidine is not approved to be used in children with JIA.
* Polyarticular arthritis affects five or more joints. 1 kg is about 2.2 lb.
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Azulfidine And Azulfidine En
Azulfidine and Azulfidine EN-tabs both come as oral tablets.
Azulfidine EN-tabs come as delayed-release enteric-coated tablets . These tablets help your intestines absorb the drug throughout the day. Your doctor may prescribe you Azulfidine EN-tabs if you have gastrointestinal side effects from Azulfidine.
What Are The Side Effects Of Sulfasalazine
Get emergency medical help if you have signs of an allergic reaction or a severe skin reaction .
Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.
You may get infections more easily, even serious or fatal infections. Call your doctor right away if you have signs of infection such as:
- fever, chills, sore throat
- mouth sores, red or swollen gums
- pale skin, easy bruising, unusual bleeding or
- chest discomfort, wheezing, dry cough or hack, rapid weight loss.
Also call your doctor at once if you have:
- fever with headache, rash, and vomiting
- a skin rash, no matter how mild
- severe nausea or vomiting when you first start taking sulfasalazine
- little or no urination, urine that looks foamy
- puffy eyes, swelling in your ankles or feet, weight gain or
- liver problems–loss of appetite, stomach pain , dark urine, jaundice .
Common side effects may include:
- nausea, vomiting, upset stomach, loss of appetite
- low sperm count in men.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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How To Take Sulfasalazine Tablets
Swallow the tablets whole, with a drink of water. Do not break, chew or crush them. This is because some tablets have a special coating to protect the medicine from the acids in your stomach.
You can take sulfasalazine tablets with or without food.
Try to space the doses evenly throughout the day and night, with a gap of no more than 8 hours between your bedtime and morning dose.
Drink plenty of fluids when taking this medicine to help prevent possible kidney problems.
Will Azulfidine Or Azulfidine En
No. Neither drug cures the autoimmune conditions theyre used to treat. There currently isnt a known cure for these conditions.
But drugs such as Azulfidine and Azulfidine EN-tabs can help treat symptoms of these conditions. This can make it easier for you to go about your daily activities.
Talk with your doctor or pharmacist if youd like to learn more about treatment options for your condition.
Your doctor will explain how you should take Azulfidine and Azulfidine EN-tabs. They will also explain how much to take and how often. Be sure to follow your doctors instructions.
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Common Side Effects And Adverse Reactions
- Sulfasalazine is considered to be generally safer than other DMARDS such as MTX and Leflunomide. It is one of the go to DMARDs when a patient is considering pregnancy.
- GI side-effects are most common: Nausea , dyspepsia , anorexia, gastric distress, vomiting
- Central nervous system: Headache , dizziness
- Dermatologic: Skin rash , pruritus, urticaria
- Genitourinary: Oligospermia
- Hematologic: can cause agranulocytosis. Leukopenia , thrombocytopenia , Heinz body anemia, hemolytic anemia
- Hepatic: Abnormal hepatic function tests
Im Taking An Azulfidine Or Azulfidine En
The side effects that are possible with Azulfidine and Azulfidine EN-tabs are the same regardless of the dose you take. These side effects are described throughout this article.
As with many medications, you may be more likely to get side effects if you take a high dose of Azulfidine or Azulfidine EN-tabs. Your doctor will always prescribe the lowest possible dose to manage your symptoms.
If youre concerned about side effects with the dosage of Azulfidine or Azulfidine EN-tabs youve been prescribed, talk with your doctor.
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What Are The Forms Of Azulfidine And Azulfidine En
Azulfidine and Azulfidine EN-tabs come as tablets that you swallow. They both have the same active ingredient but are released into the body differently. Azulfidine EN-tabs have a coating that delays the drugs release into your body. These tablets are broken down in your intestines instead of your stomach. This helps prevent stomach irritation.
What To Do In Case Of Overdose
If you think youve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.
When you get Azulfidine or Azulfidine EN-tabs from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.
The expiration date helps guarantee that the medication is effective during this time. The of the Food and Drug Administration is to avoid taking expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.
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Can I Switch From Azulfidine To Azulfidine En
Yes, in most cases your doctor can switch you from Azulfidine to Azulfidine EN-tabs, or vice versa.
Both drugs contain the same active medication, sulfasalazine. The difference between the drugs is the way the medication releases in your body. Azulfidine releases as soon as you take your dose. However, Azulfidine EN-tabs are delayed-release, so the medication releases in your body slowly over time. This can decrease nausea and vomiting that you may experience from Azulfidine.
Talk with your doctor about whether Azulfidine or Azulfidine EN-tabs is right for you.
More Common Side Effects Of Azulfidine And Azulfidine En
Azulfidine and Azulfidine EN-tabs can cause certain side effects , some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took Azulfidine or Azulfidine EN-tabs in clinical trials:
- reduced appetite
These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Azulfidine or Azulfidine EN-tabs and want to tell the FDA about it, visit MedWatch.
* For more information about this side effect, see Side effect specifics below.
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