Sulfasalazine

Sulfasalazine is an anti-inflammatory and antibacterial agent used in gastroenterology and rheumatology.

Inflammatory bowel diseases (Crohn's disease, ulcerative colitis) - are an actual problem in gastroenterological practice. Another area of application of sulfasalazine is the treatment of rheumatoid arthritis. This is one of the most common chronic joint diseases, which is based on the inflammatory process.

Sulfasalazine is available only in tablet form. The drug should be taken after meals. The dose and frequency of reception is established by the attending physician.

Clinical and pharmacological group

A drug with anti-inflammatory action, used to treat Crohn's disease and NUC.

Terms of sale from pharmacies

Can buyby prescription.

Price

How much does sulfasalazine cost in pharmacies? The average price is at the level of245 rubles.

Composition and form of release

Sulfasalazine can be found in the form of a powder, in polyethylene bags of various masses, starting from 50 g. Usually, these are tablets in a film coating, with a dosage of 500 mg, which are sealed in blisters of 10 tab. and cardboard boxes, packs are on 10 or 50 tablets.

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One film-coated tablet contains 535 mg of active compound-sulfasalazine, 3% povidone coated with water (equivalent to 500 mg of sulfasalazine).

Pregelatinized starch, magnesium stearate and colloidal anhydrous silicon dioxide are auxiliary substances, and hypromellose, propylene glycol is a film coat.

pharmachologic effect

The active substance of sulfasalazine has an anti-inflammatory and antimicrobial effect, directed at the causative agents of intestinal diseases. The use of the drug in the treatment of nonspecific colitis is quite effective.

The active component of this drug selectively accumulates in the tissues of the intestinal walls and promotes the release of acids that are characterized by anti-inflammatory activity.

The drug also has an antimicrobial effect against Streptococcus spp., Including Streptococcus pneumoniae, Neisseria gonorrhoeae and Escherichia coli.

Indications for use

Sulfasalazine is used for the treatment of exacerbations, maintenance therapy in remission, the drug greatly facilitates the state of chronic forms of diseases.

What helps the drug Sulfasalazine:

nonspecific ulcerative colitis;
Crohn's disease;
rheumatoid arthritis;
Bechterew's disease.

After taking the drug, its active ingredients penetrate into the connective tissue, the thickness of the intestinal wall, serous fluid, the drug interferes with the synthesis of prostaglandins, leukotrienes and other inflammatory provokers. The drug has a pronounced antimicrobial effect, destroys the pathogenic and conditionally pathogenic microflora.

Contraindications

congenital deficiency of glucose-6-phosphate dehydrogenase (due to the possibility of jaundice development);
renal / hepatic impairment;
obstruction of the intestine or urinary tract;
aplastic anemia;
granulocytopenia;
porphyria;
age to 6 years (with therapy of juvenile rheumatoid arthritis, for this group of patients efficacy and safety not studied) or 10 years with a body weight less than 35 kg with chronic inflammatory bowel disease;
lactation period;
individual intolerance of the drug components, as well as salicylates or sulfonamides.

Diseases / conditions, in which the prescription of sulfasalazine requires caution (relative contraindications):

juvenile rheumatoid arthritis in systemic forms (due to the probability of developing serum sickness);
atopic dermatitis;
weighed allergic anamnesis (because of the probability of developing cross-allergic reactions to inhibitors of carbonic anhydrase, thiazide diuretics, sulfonylurea derivatives, furosemide);
bronchial asthma;
pregnancy.

Dosage and route of administration

As indicated in the instructions for use, Sulfasalazine is taken orally after meals.

Rheumatoid and juvenile rheumatoid arthritis

Adults and children from 16 years of age Sulfasalazin is prescribed in a single dose of 1 tab. The recommended frequency of reception: during the first 7 days - 1 time per day; from the 8th day of therapy - 2 times a day; from the 15th and onwards - 3 times a day.

Therapeutic daily dose can vary from 3 to 6 tablets.

Typically, the clinical effect manifests itself after 6-10 weeks of use. The duration of the course is from 6 months.

Dosage for children (determined by age / weight):

6-8 years / 20-29 kg: 1 tab. 2 times a day;
8-12 years old / 30-39 kg: 1 tab. 2-3 times a day;
12-16 years / 40-50 kg: 1 tab. 3 times a day or 2 tab. 2 times a day;
from 16 years old / from 50 kg: 2 tab. 2 times a day.

The maximum daily dose for children is 4 tablets. or from the calculation of 40-50 mg / kg.

Crohn's disease, ulcerative colitis

The drug is prescribed as follows:

children 10-16 years and / or with a body weight of 35-50 kg: 4 times a day for 1 tab. (500 mg). Supportive therapy is not prescribed. Maximum - 4 tab. in a day;
adults and children from 16 years: 4 times a day; single dose on the first day - 1 tab., in the second - 2 tab., further - 3-4 tab. After the acute clinical symptoms subsided, adolescents with a weight of 65 kg and an adult are prescribed maintenance therapy: 3-4 times a day for 1 tab. course of several months. Maximum - 16 tab. in a day.

Side effect

Sulfasalazine according to reviews can cause violations from various body systems:

Genitourinary system - hematuria, proteinuria, nephrotic syndrome, crystalluria.
Digestive system - pancreatitis, vomiting, drug-induced hepatitis, nausea, abdominal pain, diarrhea, stomatitis, decreased appetite.
Respiratory system - infiltrates in the lung tissue, dyspnea, interstitial fibrosing alveolitis, pneumonitis, cough.
Nervous system - peripheral neuropathy, headache, aseptic meningitis, hallucinations, dizziness, sleep disturbances, convulsions, depression, ataxia.

Disturbances from the organs of hematopoiesis when taking Sulfasalazine are most often seen in the form of leukopenia, macrocytosis, megaloblastic anemia, neutropenia, aplastic, hemolytic and hemolytic anemia, agranulocytosis, methemoglobinemia, hypoprothrombinemia, thrombocytopenia.

The most common allergic reactions when using sulfasalazine are:

Toxic epidermal necrolysis (Lyell's syndrome);
Lymphadenopathy;
Fever;
Periorbital edema;
Serum sickness;
Nodular periarteritis;
Generalized skin rash;
Erythema;
Hives;
Exfoliative dermatitis;
Itching itch;
Anaphylactic shock;
Malignant exudative erythema;
Photosensitivity;
Eosinophilia.

In addition, taking Sulfasalazine on reviews can lead to the development of mumps, tinnitus, hyperthermia and hyperbilirubinemia.

The intake of large doses of sulfasalazine, as a rule, leads to an overdose, which is expressed as digestive disorders (vomiting, nausea, abdominal pain) and dizziness. The use of sulfasalazine in very high doses most often causes crystalluria, anuria, convulsions and hematuria.

Overdose

In the case of a significant excess of the recommended therapeutic dosage of sulfasalazine tablets, nausea occurs, accompanied by vomiting, abdominal pain, dizziness. Treatment of an overdose is symptomatic, since there is no specific antidote for the drug. It is conducted in the conditions of a medical hospital.

special instructions

During the period of application of the drug, the use of increased amounts of liquid is recommended.

With caution should prescribe the drug to patients with impaired liver and / or kidney function, patients with bronchial asthma, allergic reactions.

Interaction with other drugs

When prescribing the drug, it is necessary to take into account interactions with other drugs:

With the simultaneous use of sulfasalazine reduces the absorption of folic acid and digoxin.
With the simultaneous use of sulfasalazine enhances the effect of anticoagulants and sulfonylurea derivatives.
With the simultaneous use of sulfasalazine and antibiotics, the effectiveness of sulfasalazine may be reduced, since antibiotics exert a depressing effect on the intestinal flora.

Reviews

We offer you to familiarize yourself with the reviews of people who used the drug Sulfasalazine:

Ruslan. I had to deal with this drug a couple of years ago, after I got to the hospital with a diagnosis - NJA (total defeat, moderate severity). Personally, I did not like "Sulfasalazine". Helped weakly, a lot of pobochek, his head was constantly ill. Found an excellent substitute in the form of a drug with the active substance (mesalazine).
Sasha. The son fell ill with Crohn's disease about a year ago, the doctors tried including sulfasalazine. But to us, unfortunately, sulfasalazine did not help at all. They searched for a suitable drug for a long time, but they had to agree to an operation ...
Milan. I took the drug for a year after the doctors told me that I had erosive colitis. The diagnosis of doubt did not cause, as I underwent a colonoscopy. Initially, for treatment was appointed doroguschy drug - salofalk. But, strangely enough, he practically did not help, neither the abdominal pain did not pass, nor the diarrhea did not stop. And after a week the doctor made a substitute for salofalk for sulfasalazine. From the second day, an improvement began. She did not feel any of the pills. So not everything is expensive well.

Analogues

The closest analogues of Sulfasalazine according to the mode of action are drugs in the dosage form of tablets: Asakol, Mesakol, Samesil, Mezavant, Salofalk, Mesalazine, Pentasa and Kansalazine.

In addition, analogues of sulfasalazine are released in other dosage forms. These include:

Rectal suspension - Salofalk, Samesil;
Suppositories rectal - Pentas;
Suspension for oral administration - Salazopyridazine;
Foam rectal dosed - Salofalk.

Before buying an analogue, consult your doctor.

Shelf life and storage conditions

Shelf life of sulfasalazine tablets is 5 years. It is important to keep them in intact original packaging, dark, dry, inaccessible to children at an air temperature of no more than + 25 ° C.