Sulfasalazine(sul fa sal’ a zeen)
Azulfidine, Azulfidine EN-TabsDNC, PMS-Sulfasalazine (CAN), PMS-Sulfasalazine EC (CAN)DNC, Salazopyrin EN-Tabs (CAN)DNC
PREGNANCY CATEGORY B
Drug Classes
Anti-inflammatory
Antirheumatic
Sulfonamide
Therapeutic Actions
Bacteriostatic: Competitively antagonizes PABA, an essential component of folic acid synthesis in susceptible gram-negative and gram-positive bacteria; one-third of the oral dose is absorbed from the small intestine; remaining two-thirds passes into the colon where it is split into 5-aminosalicylic acid and sulfapyridine; most of the sulfapyridine is absorbed; the 5-aminosalicylic acid acts locally as an anti-inflammatory agent.
Indications
Treatment of ulcerative colitis
Delayed-release: Treatment of rheumatoid arthritis (RA) in patients intolerant or unresponsive to other anti-inflammatories
Azulfidine EN-Tabs: Treatment of children 6–16 yr with juvenile rheumatoid arthritis, (JRA) involving five joints, who have not responded adequately to salicylates or other NSAIDs
Unlabeled uses: Crohn’s disease, ankylosing spondylitis, psoriatic arthritis, regional enteritis, granulomatous colitis
Contraindications and Cautions
Contraindicated with allergy to sulfonamides, sulfonylureas, thiazides, salicylates; lactation (risk of kernicterus, diarrhea, rash); intestinal or urinary obstruction; porphyria; and in pediatric patients younger than 2 yr.
Use cautiously with impaired renal or hepatic function, G6PD deficiency, blood dyscrasias, pregnancy.
Available Forms
Tablets—500 mg; DR tabletsDNC—500 mg
Dosages
Administer around-the-clock; dosage intervals should not exceed 8 hr. Give after meals.
Adults
Ulcerative colitis: Initial therapy, 3–4 g/day PO in evenly divided doses. Initial doses of 1–2 g/day PO may lessen adverse GI effects. Doses of more than 4 g/day increase risk of toxicity. Maintenance, 2 g/day PO in evenly spaced doses (500 mg qid).
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