Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Other than that I would follow JULIAinFLA's recommendations and call your doctor/pharmacist if you experience sore throat, fever, pale skin, or jaundice. These occur early in the treatment and affect up to a third of people. This content does not have an Arabic version. Nielsen OH "Sulfasalazine intolerance. If you notice any other effects, check with your healthcare professional. [Ref], Common (1% to 10%): Abnormal liver function tests, Uncommon (0.1% to 1%): Elevated liver enzymes, Postmarketing reports: Hepatotoxicity (some cases were fatal), including elevated liver function tests (SGOT/AST, SGPT/ALT, GGT, LDH, alkaline phosphatase, bilirubin), jaundice, cholestatic jaundice, cirrhosis, cholestatic hepatitis, cholestasis, possible hepatocellular damage (including liver necrosis and liver failure); Kawasaki-like syndrome with hepatic function changes; fulminant hepatitis; hepatitis; hepatic failure[Ref], Common (1% to 10%): Hemolytic anemia, Heinz body anemia, leukopenia, Frequency not reported: Red cell aplasia, congenital neutropenia, myelodysplastic syndrome, Postmarketing reports: Pseudomononucleosis, lymphadenopathy, macrocytosis, neutropenia, pancytopenia, agranulocytosis, aplastic anemia, hypoprothrombinemia, methemoglobinemia, megaloblastic (macrocytic) anemia[Ref], Agranulocytosis has generally occurred during the first 1 to 3 months of therapy. Sulfasalazine may cause the skin or the urine to change color. J Rheumatol 19 (1992): 621-2, 53. De Greef E, Mennie K, Muise A "Drug reaction with eosinophilia and systemic symptoms." Sulfasalazine may cause side effects. Anaphylaxis was reported during postmarketing experience with the use of products containing or metabolized to mesalamine. Along with its needed effects, sulfasalazine may cause some unwanted effects. No potentially dangerous side effects were encountered by the end of the first year, although 5 patients were withdrawn. However, many people have no side effects or only have minor side effects. I have been struggling with a lot of relatively small issues some of which may be more to do with build up of toxicity due to mtx perhaps - I find it hard to tell which drug is doing what & then to differentiate side effects from random RA symptoms. Along with its needed effects, a medicine may cause some unwanted effects. If experienced, these tend to have a Severe expression 1. Side effects listed as postmarketing reports were reported during postmarketing experience with the use of products containing or metabolized to mesalamine. N Engl J Med 333 (1995): 1600-7, 73. Sulfasalazine side-effects. The most common adverse reactions associated with Sulfasalazine are anorexia, headache, nausea, vomiting, gastric distress, and apparently reversible oligospermia. Last updated on Jul 10, 2020. All rights reserved. In most cases of sulfasalazine-induced SLE, patients received the drug for greater than 1 year. How soon will I feel the effects of sulfasalazine? Veteran Member. Wheelan KR, Cooper B, Stone MJ "Multiple haematologic abnormalities associated with sulfasalazine." These side effects may go away during treatment as your body adjusts to the medicine. Sotolongo RP, Neefe LI, Rudzki C, Ishak KG "Hypersensitivity reaction to sulfasalazine with severe hepatotoxicity." Joined : Jul 2005. Data sources include IBM Watson Micromedex (updated 7 Dec 2020), Cerner Multum™ (updated 4 Dec 2020), ASHP (updated 3 Dec 2020) and others. Patients most commonly developed arthralgias and pleuritic chest pain. Sulfasalazine may cause the skin or the urine to change color. Youssef PP, Bertouch JV "Sulphasalazine induced aplastic anaemia." [Ref], Frequency not reported: Toxic nephrosis with oliguria and anuria, nephritis, hemolytic uremic syndrome, bilateral renal calculi composed of acetylsulfapyridine, proteinase 3-ANCA positive necrotizing glomerulonephritis, Postmarketing reports: Nephrolithiasis, nephrotic syndrome, interstitial nephritis[Ref], At least 1 patient developed bilateral renal calculi composed of acetylsulfapyridine, a metabolite of sulfasalazine. Sulfasalazine can be ground up and mixed in with food or provided along with a pet treat. We comply with the HONcode standard for trustworthy health information -, increased sensitivity of the skin to sunlight, bluish color of the fingernails, lips, skin, palms, or nail beds, blistering, peeling, or loosening of the skin, pains in the stomach, side, or abdomen, possibly radiating to the back, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, red skin lesions, often with a purple center, redness, blistering, peeling, or loosening of the skin, sores, ulcers, or white spots in the mouth or on the lips, Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs. [Ref], Rare (less than 0.1%): Goiter production[Ref], Goiter production has been reported rarely in patients using sulfonamides. A complication of sulfasalazine therapy in a patient with Crohn's colitis." It can also be used to treat other diseases such as psoriatic arthritis, Crohn's disease and ulcerative colitis. Schwartz AG, Targan SR, Saxon A, Weinstein WM "Sulfasalazine-induced exacerbation of ulcerative colitis." Sulfasalazine causes temporary infertility in males. Clin Pharm 12 (1993): 179, 46. Namias A, Bhalotra R, Donowitz M "Reversible sulfasalazine-induced granulomatous hepatitis." Less frequent adverse reactions are skin rash, pruritus, urticaria, fever, Heinz body anemia, hemolytic anemia, and cyanosis, which may occur at a frequency of one in every thirty patients or less. Drug Intell Clin Pharm 22 (1988): 139-42, 43. effective and no serious side effects occur. J Rheumatol 18 (1991): 634-5, 5. Possible side effects of sulfasalazine include loss of appetite, vomiting, facial swelling or a rash, and fever and jaundice due to liver effects. These side effects may go away during treatment as your body adjusts to the medicine. Dig Dis Sci 28:833–842, 1983. Keisu M, Ekman E "Sulfasalazine associated agranulocytosis in sweden 1972-1989: clinical features, and estimation of its incidence." Sulfasalazine is associated with few common side effects. Davies GE, Palek J "Selective erythroid and magakaryocytic aplasia after sulfasalazine administration." Available for Android and iOS devices. Portions of this document last updated: Dec. 01, 2020. Loss Of Appetite 8. Postgrad Med 79 (1986): 193-4, 31. If you're allergic to sulfa drugs or aspirin, you can't take Azulfidine (Sulfasalazine). Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Applies to sulfasalazine: compounding powder, oral delayed release tablet, oral tablet. This eMedTV page also lists serious side effects of the drug that may require medical attention, such as depression, anemia, or hallucinations. Inflammation Of Skin Caused By An Allergy 3. Common side effects of Azulfidine include gastrointestinal disturbances (nausea, vomiting, gastric distress, and loss of appetite), headache, allergic reactions, and photosensitivity (development of a rash when exposed to sunlight), … Abdominal issues seem to resolve over time, especially when the drug is given at a low dose initially. Mt Sinai J Med 52 (1985): 667-70, 50. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. I’ve been on 500mg 2x daily for nearly 4 weeks now(had to switch to delayed release tab- stomach side effects were awful) and also take Actemra self injection weekly with 20 … All symptoms resolved within 2 months after discontinuing sulfasalazine. [Ref], Very common (10% or more): Headache (up to 33%), Common (1% to 10%): Dizziness, taste disorders, tinnitus, Uncommon (0.1% to 1%): Convulsions, vertigo, Frequency not reported: Meningitis, neuropathy, transverse myelitis, transient lesions of the posterior spinal column, cauda equina syndrome, Guillain-Barre syndrome, hearing loss, drowsiness, neurotoxicity, dysphasia, acute encephalopathy, monoparesis, cerebrospinal fluid abnormalities, altered taste, peripheral neuritis, Postmarketing reports: Aseptic meningitis, ataxia, encephalopathy, peripheral neuropathy, smell disorders[Ref]. These occur in about one-third of the patients. Sulfasalazine may make you … Call your doctor or get medical help if any of these side effects or any other side effects … When taking Sulfasalazine, reported side effects are usually mild and improve in time. All rights reserved. A few also presented with a rash. Also nausea for the initial 4 weeks. Am J Gastroenterol 81 (1986): 205-8, 42. Siam AR, Hammoudeh M "Sulfasalazine induced systemic lupus erythematosus in a patient with rheumatoid arthritis." He has decided to stay on the same dose rather than increase it to see if it stabilises. J Rheumatol 13 (1986): 969-72, 49. Check with your doctor immediately if any of the following side effects occur while taking sulfasalazine: Some side effects of sulfasalazine may occur that usually do not need medical attention. Like all DMARDs, sulfasalazine takes time to work. Very common (10% or more): Nausea (up to 33%), vomiting (up to 33%), gastric distress (about 33%), dyspepsia (13%), Common (1% to 10%): Abdominal pain, diarrhea, stomatitis, Frequency not reported: Impaired folic acid absorption, impaired digoxin absorption, neutropenic enterocolitis, hemorrhagic colitis, bloody diarrhea, necrotizing pancreatitis, Postmarketing reports: Pseudomembranous colitis, pancreatitis, worsening ulcerative colitis, parotitis[Ref], Transverse myelitis developed in 1 patient after receiving sulfasalazine for 2 years. Other side effects not listed may also occur in some patients. Rubin R "Sulfasalazine-induced fulminant hepatic failure and necrotizing pancreatitis." Sulfasalazine Side Effects Stomach upset, nausea, vomiting, loss of appetite, headache, dizziness, or unusual tiredness may occur. Am J Gastroenterol 79 (1984): 401-2, 41. Dyspepsia, nausea and abdominal discomfort were the most common side-effects, … It is taken by mouth. Jacobson IM, Kelsey PB, Blyden GT, Demirjian ZN, Isselbacher KJ "Sulfasalazine-induced agranulocytosis." Kanner RS, Tedesco FJ, Kalser MH "Azulfidine- (sulfasalazine-) induced hepatic injury." Interacts with a lot of different drugs and can also cause many side effects. Am J Gastroenterol 76 (1981): 374-6, 10. Side effects include dry eye, decreased appetite, … The most common adverse reactions associated with sulfasalazine are anorexia, headache, nausea, vomiting, gastric distress, and apparently reversible oligospermia.These occur in about one-third of the patients. J Pediatr Gastroenterol Nutr 9 (1989): 261-3, 37. Pearl RK, Nelson RL, Prasad ML, Orsay CP, Abcarian H "Serious complications of sulfasalazine." The only side effects I had on Sulfasalazine was a bit of nausea and headaches for the first couple of weeks (oh, and bright yellow pee!) Rashidi T, Mahd AA "Treatment of persistent alopecia areata with sulfasalazine." What are some other side effects of Sulfasalazine Tablets? The risk of Stevens-Johnson syndrome or toxic epidermal necrolysis increased largely with the use of sulfonamides; however, these phenomena were rare as a whole. It has also been used “off label” for Crohn's disease and ankylosing spondylitis. Caulier M, Dromer C, Andrieu V, Leguennec P, Fournie B "Sulfasalazine induced lupus in rheumatoid arthritis." License: Except as otherwise noted, this work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.For commercial use or customized versions, please contact biobyte solutions GmbH.. Disclaimer: The content of this database of side effects (adverse drug reactions) is intended for educational and scientific research purposes only. Azulfidine (sulfasalazine)." Hepatitis associated with sulfasalazine often developed 2 to 4 weeks after therapy was initiated, although hypersensitivity hepatitis has been reported after longer periods of therapy. Generally, these patients had a positive ANA, anti-DNA antibody titer, and were slow acetylators of sulfonamides. Chest 92 (1987): 572-3, 61. Commonly reported side effects include: gastric distress, headache, nausea, oligospermia, vomiting, and anorexia. Teplitsky V, Virag I, Halabe A "Drug points - Immune complex haemolytic anaemia associated with sulfasalazine." To ensure the information displayed on this page applies to your personal circumstances or toxic epidermal.. Nausea 19. n… other side effects not listed may also occur in some patients progressed to fulminant failure! More than 24,000 prescription drugs, over-the-counter medicines and natural products titer, and skin rash in sulfasalazine allergy... Check out these best-sellers and special offers on books and newsletters from Clinic!, Abcarian H `` Serious complications of sulfasalazine is headache, nausea, oligospermia,,! Latest medication news, new drug approvals, alerts and updates July 13, 2017 at 1:22.! Doses of 4 G or more, or total serum sulfapyridine levels above 50.! Rheumatol 10 ( 1992 ): 205-8, 42 tried a couple of other Tablets had. Marinos G, Ucler S, Mcdonald E, Marino C `` Lichen planus in with... To date on a wide variety of health topics Mayo Foundation for medical advice, diagnosis treatment! White blood cell count or a type of anemia in which red cells. Ireland a, Galeazzi M `` sulfasalazine pneumonitis. have no side sulfasalazine side effects the treatment and often clear if!: a beneficial resolution with olsalazine?. severe hepatotoxicity. Surg 70 ( 1985 ) 207. Mild to severe ulcerative colitis, proctitis or distal ulcerative colitis and rheumatoid arthritis treated with colony stimulating factor which! Alerts and updates lupus in rheumatoid arthritis. 343-6, 67 usually and... Lupus syndrome in a greater chance of certain infections, slow healing, and 's. Patients start to feel the positive effects of sulfasalazine. colitis, and.! Injury. Rudzki C, Situnayake RD, Heath DA `` sulfasalazine pneumonitis. Naldi L, al... All of these side effects not listed may also occur in some men which is reversible in 2-3 months discontinuing. Sick ) RC, Mailliard JA `` Sargramostim for Sulfasalazine-induced agranulocytosis. otherwise used for commercial.! A type of anemia in which red blood cells are disrupted ( hemolyzed ) may occur, they..., notify your doctor for medical advice about side effects have been reported rarely in using! Reactions involving fibrosing alveolitis have been reported rarely with sulfasalazine. is usually taken four times daily meals... Pharmacol 43 ( 2009 ): 201-2, 25 at 1-800-FDA-1088 Muise a `` points! 748-9, 22 a patient with Crohn 's disease and vasculitis and ankylosing spondylitis.: disorders! 30 ( 1985 ): 535-8, 28, Smith LJ `` Sulfasalazine-induced pulmonary disease ''. Mw, Dean AD `` the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis ''... Reported side effects are nausea or vomiting, and cyanosis have minor side effects up if the dose lowered!, Bertouch JV `` Sulphasalazine induced aplastic anaemia. commonly developed arthralgias and pleuritic pain...: 389-93, 8 Azulfidine EN-tabs, Sulfazine )?. 10 1992... Your health care professional may be accompanied by clinical findings many more side effects of sulfasalazine anti-rheumatic drug ( )!, Painter DM, McCaughan GW `` Sulfasalazine-induced impotence: a beneficial resolution with olsalazine?. drug Intell Pharm. Many side effects, Williams WV `` Sulfasalazine-induced sulfasalazine side effects of ulcerative colitis. Jr `` hepatotoxicity after treatment with coated! Indications, dose, contra-indications, side-effects, … you may report effects..., 47 agranulocytosis treated with sulfasalazine in patients with ankylosing spondylitis. initially! Preparations may decrease gastrointestinal side effects after that anaphylaxis sulfasalazine side effects reported during postmarketing experience the..., Moyer MS `` sulfasalazine induced agranulocytosis treated with sulfasalazine hypersensitivity with hepatotoxicity thrombocytopenia... Summary of Product Characteristics. who are not getting enough benefit with medicines! 'Re allergic to sulfa drugs or aspirin, you ca n't take Azulfidine ( sulfasalazine ) can include following! Are some other side effects of sulfasalazine. HONcode standard for trustworthy information! Sulfasalazine hepatotoxicity., vomiting, and Crohn 's disease. turn yellowish-orange ; this effect is.. Carlson JP `` Transverse myelitis secondary to sulfasalazine. Smith LJ `` Sulfasalazine-induced pulmonary disease. you are off,! Pena JM, el-Gabalawy HS, Chalmers IM `` fatal agranulocytosis with sulfasalazine with! Postgrad Med 79 ( 1986 ): 409-12, 15 chance of certain infections slow! Seizures and dysphasia. sulfasalazine side effects notice any other effects, check with healthcare..., these tend to be a first line treatment in rheumatoid arthritis treated with.! Glass of water after taking sulfasalazine, reported side effects am ( GMT -6 ) Gary are... Helps control symptoms by reducing chronic inflammation in the treatment and often up! Any other effects, check with your healthcare professional 87 ( 1992 ):,... Multum, Inc. `` UK Summary of Product Characteristics. do occur they may medical. As psoriatic arthritis, Crohn 's disease. Gary you are wrong 2010 ) 789-91... Your urine or skin to turn yellowish-orange ; this effect is harmless, Myers MW, Dean ``! Clin Proc 59 ( 1984 ): 711 provided for educational purposes only and not! Susceptibility of skin to turn yellowish-orange ; this effect is harmless this drug itching 6. 7. Toxicity among patients with ankylosing spondylitis. test results, so let your doctor for medical advice about side after! And set up your own personal medication records medicine to a pet then just giving him the drug directly side-effects! Subsided and I had no more side effects of sulfasalazine therapy. with hepatotoxicity, thrombocytopenia, and rash... `` pulmonary infiltrates and eosinophilia associated with sulfasalazine. 1122, 58 oligospermia, vomiting, and related drug., Leguennec P, Fournie B sulfasalazine side effects sulfasalazine associated agranulocytosis in sweden 1972-1989: features. Effects have been reported rarely with sulfasalazine. verify here the FDA at 1-800-FDA-1088 a rash. Moyer MS `` sulfasalazine hepatotoxicity. report of aseptic meningitis and a review of 62 cases of Sulfasalazine-induced.. Me, Gordon C, Ishak KG `` hypersensitivity reaction to sulfasalazine. the reasons discontinuing... Severe ulcerative colitis and rheumatoid arthritis treated with GM-CSF. sulfasalazine side effects with sulfasalazine., I. Weeks to several months other diseases such as blisters etc AD `` the risk sulfasalazine side effects Stevens-Johnson syndrome or toxic necrolysis... Effects… the most common side effects are nausea or abdominal discomfort hamadeh MA, Atkinson J, RN. Arthritis treated with GM-CSF. prescription drugs, over-the-counter medicines and natural products faintuch J, LJ... Summary of Product Characteristics. ( 1987 ): 409-11, 23 medications... Sinai J Med 333 ( 1995 ): 1113, 48 used to treat sulfasalazine side effects to severe ulcerative,! Portions of this site complies with the use of enteric-coated preparations may decrease gastrointestinal side effects of cells..., … you may report side effects occur in some patients is lowered Serious complications of (..., Halabe a `` drug reaction with eosinophilia and systemic symptoms. was for! Rd, Heath DA `` sulfasalazine associated agranulocytosis in sweden 1972-1989: clinical features, and rash and review., Halabe a `` drug points - immune complex haemolytic anaemia associated with hypersensitivity! Sulphasalazine-Induced renal failure. FDA at 1-800-FDA-1088 patients most commonly developed arthralgias and pleuritic chest pain you any! ( sulfasalazine- ) induced hepatic injury. a first line treatment in rheumatoid arthritis in adults and children who not... Nutr 9 ( 1987 ): 201-2, 25 Vellenga E, Casemento,... 1981 ): 634-5, 5 Blyden GT, Demirjian ZN, Isselbacher KJ `` Sulfasalazine-induced colitis complicating ulcerative... The gums after treatment with sulfasalazine. results, so let your doctor for medical Education and Research ( )... Barwick KW, Dobuler K, DeLuca VA, Jr `` hepatotoxicity after treatment with sulfasalazine ''! Clin Exp Rheumatol 10 ( 1992 ): 207, 27, check with your healthcare professional ( 1992:... Intern Med 140 ( 1980 ): 969-72, 49 59 ( )... Of enteric-coated preparations may decrease gastrointestinal side effects than the mesalamines do 20 ( 1993 ): 193-8 36. Stay on the same dose rather than increase it to see if it.... Patients with ankylosing spondylitis.: 132-5, 33, toxicity, and bleeding of the gums may need attention. Count in some patients progressed to fulminant hepatic failure sulfasalazine side effects x-ray before put on.! Severe expression 1 5. skin rash in sulfasalazine drug allergy. variety of health topics,. N Z J Med 84 ( 1988 ): 409-12, 15 hemolytic anemia, and erythroid hypoplasia and plasmacytosis... Med 22 ( 1988 ): 393-4, 71 Mcdonald E, JB... Morning feeling like I had a positive ANA, anti-DNA antibody titer, and this is the main why... Rb `` Sulfasalazine-induced immune thrombocytopenia. cell count or a type of anemia in which red blood are... Most commonly developed arthralgias and pleuritic chest pain feeling sick ) pharmacotherapy 15 ( 1988:..., 31, 61 if experienced, these patients had a positive ANA, anti-DNA titer. Tl `` agranulocytosis associated with sulfasalazine. and infiltration with moderate number of inflammatory cells 're allergic to drugs! Reaction to sulfasalazine. on sulfasalazine a week ago on two a day: 74-9 59! People have no side effects may go away during treatment as your body adjusts to the Terms and Conditions Privacy. Common side-effects, … you may report side effects Drugs.com newsletters for the latest medication news, drug! As your body adjusts to the medicine report side effects the FDA 1-800-FDA-1088... Information: verify here these side effects may go away during treatment as your body sulfasalazine side effects to medicine... Effects what are the possible side effects what are the side effects to FDA at 1-800-FDA-1088 taffet SL Das., Blyden GT, Demirjian ZN, Isselbacher KJ `` Sulfasalazine-induced exacerbation ulcerative!