Medicines/Generics/Sulphasalazine

Sulphasalazine

Generic medicine reference

Not yet clinically reviewed

This entry was migrated from the earlier Pharmapedia app bundle and has not been reviewed by a named clinician on this site. It is provided for educational reference only — verify dosage and safety information against current, authoritative sources and a qualified healthcare professional before any clinical use.

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Overview

Sulphasalazine is a prodrug used in the treatment of ulcerative colitis. The drug is a combination of sulfapyridine and 5-aminosalicylic acid (mesalamine). Sulfasalazine is cleaved to these active components by bacteria in the colon. The subsequent local actions of mesalamine are believed to be responsible for the effectiveness of sulfasalazine in the treatment of inflammatory bowel disease. Mesalamine is also commercially available in oral and rectal preparations. Even though mesalamine is a metabolite of sulfasalazine, mesalamine blood levels are lower when administered as sulfasalazine. Side effects may be minimized by administering mesalamine as sulfasalazine. Sulfasalazine was approved by the FDA in 1950.

Indications

Sulphasalazine is primarily indicated in conditions like Assessment of thyroid function, Crohn's disease, Cyclical benign breast disease, Enhance permeation of SC or IM inj, Mild to moderate and severe ulcerative colitis, Premenstrual syndrome, Rheumatoid arthritis.

Contraindications

Sulphasalazine is contraindicated in conditions like Porphyrias.

Side Effects

The severe or irreversible adverse effects of Sulphasalazine, which give rise to further complications include Renal damage, Hepatitis, Hemolytic anemia, Stevens-Johnson syndrome, Serum sickness, Peripheral neuropathy, Exfoliative dermatitis, Systemic lupus erythematosus, Infertility, Fibrosing alveolitis, Lyell's syndrome, Oligospermia. Sulphasalazine produces potentially life-threatening effects which include Agranulocytosis, Thrombocytopenia. which are responsible for the discontinuation of Sulphasalazine therapy. The signs and symptoms that are produced after the acute overdosage of Sulphasalazine include Renal failure, Salicylate poisoning.

Warnings

Sulphasalazine should be used with caution in patients with liver or kidney diseases, blood disorders or of any drug allergy. This may make patient more prone to sunburn, wear protective clothing and (PABA-free) sunscreen when outdoors. It should be used with caution during pregnancy or lactation.

High Risk Groups

Drug should not be given to Pregnant Mothers.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

Adult Dosage

2 g (2 (2)) 24 hourly PO —

Child Dosage

10 to 15 mg/kg (12 (12.5)) 6 hourly Oral — Initially for acute attack 5 to 7.5 mg/kg (6.2 (6.25)) 6 hourly Oral — Maintenance

Neonatal Dosage

10 to 15 mg/kg (12 (12.5)) 6 hourly Oral — Initially for acute attack 5 to 7.5 mg/kg (6.2 (6.25)) 6 hourly Oral — Maintenance

Drug Interactions

Sulphasalazine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementCholestyramineDigoxinAbsorption of digoxin possibly reduced by sulphasalazine.ModerateRapidMonitor for decreased serum concentrations/therapeutic effects of digoxin if sulphasalazine is initiated/dose increased, or increased serum concentrations/effects if a sulphasalazine is discontinued/dose decreased.Ferrous SulphateFolic AcidRifampicin These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Storage

Susp Store Below 40°C. Do not Freeze. Tab Store in a well closed container, Below 40°C.