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 for sulfasalazine is the treatment of rheumatoid arthritis. This is one of the most common chronic diseases of the joints, 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.

Clinico-pharmacological group

Anti-inflammatory drug used to treat Crohn's disease and UC.

Terms of sale from pharmacies

You can buy by prescription.

Price

How much does Sulfasalazine in pharmacies? The average price is at the level of 245 rubles.

Composition and release form

Sulfasalazine can be found in powder form, in plastic bags of various weights, ranging from 50 g. Usually, these are film-coated tablets with a dosage of 500 mg, which are sealed in blisters on 10 tablets. and cardboard boxes, packs come in 10 or 50 tablets.

  • One tablet with a film coating contains 535 mg of the active compound, sulfasalazine, coated with povidone 3% with water (in terms of equivalent to 500 mg of sulfasalazine).

Pregelatinized starch, magnesium stearate and colloidal anhydrous silica are auxiliary substances, and hypromellose, propylene glycol - film coating.

Pharmachologic effect

The active ingredient Sulfasalazine has anti-inflammatory and antimicrobial effects, aimed at pathogens of intestinal diseases. The use of the drug in the treatment of non-specific colitis is quite effective.

The active component of this tool selectively accumulates in the tissues of the intestinal walls and promotes the release of acids, which 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 to treat exacerbations, maintenance therapy in remission, the drug greatly alleviates the condition in chronic forms of the disease.

What helps the drug Sulfasalazine:

  • nonspecific ulcerative colitis;
  • Crohn's disease;
  • rheumatoid arthritis;
  • ankylosing spondylitis

After taking the drug, its active ingredients penetrate the connective tissues, the thickness of the intestinal walls, serous fluid, the drug prevents the synthesis of prostaglandins, leukotrienes and other inflammatory provocateurs. The drug has a pronounced antimicrobial effect, destroys pathogenic and conditionally pathogenic microflora.

Contraindications

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

Diseases / conditions for which the administration of Sulfasalazine requires caution (relative contraindications):

  • juvenile rheumatoid arthritis in systemic forms (due to the likelihood of developing serum sickness);
  • atopic dermatitis;
  • burdened with an allergic history (due to the likelihood of cross-allergic reactions to carbonic anhydrase inhibitors, thiazide diuretics, sulfonylurea derivatives, furosemide);
  • bronchial asthma;
  • pregnancy.

Dosage and method of use

As indicated in the instructions for use of the drug sulfasalazin taken orally after meals.

Rheumatoid and juvenile rheumatoid arthritis

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

Therapeutic daily dose can vary from 3 to 6 tab.

As a rule, the clinical effect appears after 6-10 weeks of use. Course duration - 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 / 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 / from 50 kg: 2 tab. 2 times a day.

The maximum daily dose for children - 4 tab. or at the rate of 40-50 mg / kg.

Crohn's disease, ulcerative colitis

The drug is prescribed as follows:

  • children 10-16 years old and / or with a body weight of 35-50 kg: 4 times a day, 1 tab. (500 mg). Maintenance 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., on the second - 2 tab., then - 3-4 tab. After acute clinical symptoms subside, adolescents weighing 65 kg and adults are prescribed supportive therapy: 3-4 times a day, 1 tab. course of several months. Maximum - 16 tab. in a day.

Side effect

Sulfasalazine reviews may cause disturbances from various body systems:

  • Urogenital system - hematuria, proteinuria, nephrotic syndrome, crystalluria.
  • The digestive system - pancreatitis, vomiting, drug-induced hepatitis, nausea, abdominal pain, diarrhea, stomatitis, loss of appetite.
  • Respiratory system - infiltrates in the lung tissue, shortness of breath, interstitial fibrosing alveolitis, pneumonitis, cough.
  • Nervous system - peripheral neuropathy, headache, aseptic meningitis, hallucinations, dizziness, sleep disturbance, convulsions, depression, ataxia.

Disorders of the blood-forming organs when taking Sulfasalazine, according to reviews, most often manifest themselves as leukopenia, macrocytosis, megaloblastic anemia, neutropenia, aplastic, hemolytic and hemolytic anemia, agranulocytosis, methemoglobinemia, hypoprothrombinemia, thrombocytoma

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;
  • Pruritus;
  • Anaphylactic shock;
  • Malignant exudative erythema;
  • Photosensitization;
  • Eosinophilia.

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

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

Overdose

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

Special instructions

During the period of use of the drug is recommended to use an increased amount of liquid.

Precautions should be prescribed 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 consider the interaction with other drugs:

  1. With simultaneous use of sulfasalazine reduces the absorption of folic acid and digoxin.
  2. With simultaneous use of sulfasalazine enhances the action of anticoagulants and sulfonylurea derivatives.
  3. With the simultaneous use of sulfasalazine and antibiotics, the effectiveness of sulfasalazine may be reduced, since antibiotics inhibit the intestinal flora.

Reviews

We offer you to read the reviews of people who used the drug Sulfasalazin:

  1. Ruslan. I had to deal with this drug a couple of years ago, after I was hospitalized with a diagnosis of UC (total loss, moderate). Personally, I didn’t like Sulfasalazine. He helped weakly, a lot of side effects, his head ached constantly. Found an excellent substitute in the form of the drug with the active substance (mesalazine).
  2. Sasha. The son fell ill with Crohn's disease about a year ago, while doctors also tried sulfasalazine. But, unfortunately, sulfasalazine did not help us at all. We were looking for a suitable drug for a long time, but I had to agree to an operation ...
  3. Milan She took the drug for a year after the doctors told me that I had erosive colitis. The diagnosis did not cause any doubts, since I had a colonoscopy. Initially, an expensive drug, salofalk, was prescribed for treatment. But, oddly enough, he practically did not help, neither the pain in his stomach subsided, nor the diarrhea did not stop. A week later, the doctor made a replacement of salofalk for sulfasalazine. From the second day began to improve. I did not feel any side effects. So not everything is expensive.

Analogs

The closest analogues of Sulfasalazine by the method of action include drugs in the dosage form of tablets: Asakol, Mesacol, Samezil, Mezavant, Salofalk, Mesalazin, Pentas and Kansalazin.

In addition, produce analogues of Sulfasalazine in other dosage forms. These include:

  • Rectal suspension - Salofalk, Samesil;
  • Rectal suppositories - Pentas;
  • Suspension for oral administration - Salazopyridazin;
  • Rectal foam dosed - Salofalk.

Before buying an analogue, consult your doctor.

Shelf life and storage conditions

Sulfasalazine tablets have a shelf life of 5 years. It is important to keep them in intact original packaging, in a dark, dry, out of the reach of children place at an air temperature not higher than + 25 ° C.

Watch the video: Important things to know about taking sulfasalazine (November 2019).

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