SULFASALAZINE

Sulfasalazine is an anti-inflammatory and immunomodulatory medication commonly used for treating inflammatory bowel diseases and rheumatoid arthritis. It works by reducing inflammation and suppressing the immune response.

Indications

-Treatment of ulcerative colitis. -Management of Crohn’s disease. -Rheumatoid arthritis, particularly in patients unresponsive to first-line therapies.

Dosage

-Ulcerative Colitis: Initial dose of 1-2 g orally daily in divided doses; maintenance dose of 500 mg to 1 g twice daily. -Rheumatoid Arthritis: Starting dose of 500 mg daily, gradually increased to 2-3 g/day in divided doses. -Adjust dosage based on medical advice and patient response.

Contra-Indications

-Hypersensitivity to sulfasalazine, sulfa drugs, or salicylates. -Intestinal or urinary obstruction. -Severe liver or kidney impairment.

Special Precautions

Use with caution in patients with G6PD deficiency due to risk of hemolysis. -Monitor for blood dyscrasias, hepatotoxicity, and severe skin reactions. -Ensure adequate hydration to prevent crystalluria and kidney stones. -Regular blood tests are recommended to monitor liver and renal function.

Side Effects

-Common: Nausea, headache, rash, diarrhea, abdominal pain. -Rare but serious: Stevens-Johnson syndrome, liver damage, bone marrow suppression.

Drug Interactions

-May reduce the efficacy of digoxin and folic acid. -Concurrent use with methotrexate or azathioprine may increase risk of toxicity. -Interaction with anticoagulants may increase bleeding risk.