$Unique_ID{BRK02139}
$Pretitle{}
$Title{SULFASALAZINE}
$Subject{Azaline (Major)
Azulfidine (Pharmacia)
Azulfidine EN-tabs (Pharmacia)
S.A.S.-500 (Rowell)
sulfasalazine (various manufacturers)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


SULFASALAZINE
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BRAND NAMES (Manufacturers):
     Azaline (Major)
     Azulfidine (Pharmacia)
     Azulfidine EN-tabs (Pharmacia)
     S.A.S.-500 (Rowell)
     sulfasalazine (various manufacturers)
TYPE OF DRUG:
     Sulfonamide and anti-inflammatory
INGREDIENT:
     sulfasalazine
DOSAGE FORMS:
     Tablets (500 mg)
     Enteric-coated tablets (500 mg)
     Oral suspension (250 mg per 5-ml spoonful)
STORAGE:
     Store at room temperature in a tightly closed, light-resistant container.
       This medication should never be frozen.

USES

     This medication is used to treat inflammatory bowel disease (regional
enteritis or ulcerative colitis).  In the intestine, sulfasalazine is
converted to 5-aminosalicylic acid, an aspirin-like drug, which acts to
relieve inflammation.

TREATMENT

     In order to avoid stomach irritation while you are being treated with
this medication, you should take your doses with a full glass of water, with
food, or after meals (unless your doctor directs you to do otherwise).
     The enteric-coated tablets should be swallowed whole.  The enteric
coating is added to lessen stomach irritation.  Chewing, breaking, or crushing
these tablets destroys the coating.
     The suspension form of this medication should be shaken well just before
measuring each dose.  The contents tend to settle on the bottom of the bottle,
so it is necessary to shake the container to distribute the ingredients evenly
and equalize the doses.  Each dose should then be measured carefully with a
specially designed 5-ml measuring spoon.  An ordinary kitchen teaspoon is not
accurate enough.
     If you miss a dose of this medication, take the missed dose as soon as
possible, unless it is almost time for the next dose.  In that case, do not
take the missed dose at all; just return to your regular dosing schedule.  Do
not double the next dose.

SIDE EFFECTS

     Minor.

     Diarrhea, dizziness, drowsiness, headache, insomnia, loss of appetite,
nausea, stomach upset, or vomiting.  These should disappear as your body
adjusts to the drug.
     This medication can increase your sensitivity to sunlight.  You should,
therefore, avoid prolonged exposure to sunlight and sunlamps.  Wear protective
clothing and sunglasses, and use an effective sunscreen.  However, a sunscreen
containing para-aminobenzoic acid (PABA) interferes with the action of this
drug and should not be used.
     Sulfasalazine can discolor contact lenses.  You may want to stop wearing
them while taking this medication.  Discuss this with your ophthalmologist.
     Sulfasalazine can cause your urine to change to an orange-yellow color.
This is a harmless effect.
     If you feel dizzy, sit or lie down for a while; get up slowly from a
sitting or reclining position, and be careful on stairs.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
blood in the urine, convulsions, depression, difficulty in swallowing,
difficult or painful urination, fatigue, fever, hallucinations, hearing loss,
itching, joint pain, lower back pain, mouth sores, pale skin, rash or peeling
skin, ringing in the ears, sore throat, swelling of the front part of the
neck, tingling sensations, unusual bleeding or bruising, or yellowing of the
eyes or skin.

INTERACTIONS

     Sulfasalazine interacts with several other types of drugs:
     1. It can increase the side effects of oral anticoagulants (blood
thinners, such as warfarin), oral antidiabetic agents, methotrexate, aspirin,
phenytoin, and thiopental.
     2. The blood levels and effectiveness of digoxin and folic acid are
decreased by concurrent use of sulfasalazine.
     3. Probenecid, oxyphenbutazone, phenylbutazone, methenamine, and
sulfinpyrazone can increase the blood levels and side effects of
sulfasalazine.
     Before starting to take sulfasalazine, BE SURE TO TELL YOUR DOCTOR about
any medications you are currently taking, especially any of those listed
above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to sulfasalazine, aspirin or other salicylates, or
any sulfa drug (diuretics, oral antidiabetic medications, sulfonamide
antibiotics, oral antiglaucoma medication, acetazolamide, sulfoxone, dapsone).
     * Before starting to take this medication, be sure to tell your doctor if
you now have or if you have ever had blood disorders, blockage of the urinary
tract or intestine, glucose-6-phosphate dehydrogenase (G6PD) deficiency,
kidney disease, liver disease, or porphyria.
     * To help prevent the formation of kidney stones, try to drink at least
eight to 12 glasses of water or fruit juice each day while you are taking this
medication (unless your doctor directs you to do otherwise).
     * Before having surgery or other medical or dental treatment, tell your
doctor or dentist you are taking this drug.
     * If your condition does not improve within a month or two after starting
to take sulfasalazine, check with your doctor.  It may be necessary to change
your medication.
     * Be sure to tell your doctor if you are pregnant.  Although
sulfasalazine appears to be safe during most of pregnancy, extensive studies
in humans have not been conducted.  There is also concern that if this drug is
taken during the ninth month of pregnancy, it may cause liver or brain
disorders in the newborn infant.  Also, tell your doctor if you are
breast-feeding an infant.  Small amounts of sulfasalazine pass into breast
milk.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
