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Arthritis and immune medicines

Sulfasalazine

Also sold as: Salazopyrin, Azulfidine

Prescription neededArthritis and immune medicines
Comes as:Tablet

Usual adult dose

Dose is set by your doctor. It is usually started at 500 mg a day and increased weekly to 2 to 3 g a day in divided doses with food. Regular blood tests are needed in the first months.

Your doctor may give you a different dose. Children's doses depend on weight.

Side effects

Common

  • nausea
  • loss of appetite
  • headache
  • orange-yellow urine (harmless)
  • rash

Serious — get help

Stop taking it and see a doctor straight away if you notice:

  • sore throat
  • fever or mouth ulcers
  • unusual bleeding or bruising

Do not take it, or take care, if

  • Allergy to sulfa medicines or to aspirin
  • Porphyria
  • Serious liver or kidney disease, or G6PD deficiency (use with caution)

Interactions

Medicines that can react with this one.

Moderate1 medicineTake together only with care. Ask your doctor or pharmacist.
  • Azathioprine

    Together they increase the risk of low blood counts; blood tests are needed.

Pregnancy

  1. A
  2. B
  3. C
  4. D
  5. X

Category B

No risk seen in animal studies, but there are few studies in pregnant women. Usually considered safe when needed.

Generic alternatives

Similar medicines your doctor or pharmacist may offer instead.

severe skin rash
  • yellow eyes or skin
  • Minor1 medicineUsually not a problem, but tell your doctor.
    • Folic acid

      Sulfasalazine reduces folic acid absorption; a supplement may be advised.

    Methotrexate
  • Hydroxychloroquine
  • Mesalazine
  • Check with my other medicines

    Always follow your doctor or pharmacistThis page is general information, not a prescription. Do not start, stop or change a medicine on your own.