Sulfasalazine
Sulfasalazine (Azulfidine)
Sulfasalazine
(sul-fah- SAL-ah-zeen)
Pregnancy Category: B Alti-Sulfasalazine Azulfidine Azulfidine EN-Tabs PMS Sulfasalazine Salazopyrin Salazopyrin-EN Tabs SAS-500 (Rx)

Classification: Sulfonamide

See Also: See also Sulfonamides .

Action/Kinetics: About one-third of the dose of sulfasalazine is absorbed from the small intestine while two-thirds passes to the colon, where it is split to 5-aminosalicylic acid and sulfapyridine. The drug does not affect the microflora.

Uses: Ulcerative colitis. Azulfidine EN-tabs are also used to treat rheumatoid arthritis in clients who do not respond well to NSAIDs. Investigational: Ankylosing spondylitis, collagenous colitis, Crohn's disease, psoriasis, juvenile chronic arthritis, psoriatic arthritis.

Additional Contraindications Children below 2 years. In persons with marked sulfonamide, salicylate, or related drug hypersensitivity. Intestinal or urinary obstruction.

Special Concerns: Use with caution during lactation.

Side Effects: Most common include anorexia, headache, N&V;, gastric distress, reversible oligospermia. Less frequently, pruritus, urticaria, fever, Heinz body anemia, hemolytic anemia, cyanosis.

Drug Interactions: Digoxin / Absorption of digoxin Folic acid / Absorption of folic acid

How Supplied: Enteric Coated Tablet: 500 mg; Tablet: 500 mg

Dosage
?Enteric-Coated Tablets, Tablets Ulcerative colitis.
Adults, initial: 3-4 g/day in divided doses (1-2 g/day may decrease side effects); maintenance: 500 mg q.i.d. Pediatric, over 2 years of age, initial: 40-60 mg/kg/day in 3 to 6 equally divided doses; maintenance: 30 mg/kg/day in 4 divided doses.
For desensitization to sulfasalazine.
Reinstitute at level of 50-250 mg/day; then, give double dose q 4-7 days until desired therapeutic level reached. Do not attempt in those with a history of agranulocytosis or who have experienced anaphylaxis previously with sulfasalazine.
Collagenous colitis.
2-3 g/day.
Psoriasis.
3-4 g/day.
Juvenile chronic arthritis.
50 mg/kg.
 Psoriatic arthritis.
2 g/day.