Sulfasalazine

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Information about Sulfasalazine

Sulfasalazine is an antiinflammatory agent used extensively in chronic, long term therapy of inflammatory bowel disease. Sulfasalazine is structurally composed of a sulfonamide (sulfapyridine) and 5-aminosalacyclic acid (5-ASA) joined by an azo bond.

Liver safety of Sulfasalazine

Sulfasalazine is a rare, but well known cause of idiosyncratic liver injury.

Mechanism of action of Sulfasalazine

Sulfasalazine is a modified sulfonamide composed of sulfapyridine that is covalently linked to 5-aminosalacyclic acid (5-ASA). Sulfasalazine is poorly absorbed, but its azo bond is broken by bacteria in the bowel lumen releasing sulfapyridine that is absorbed and 5-ASA, which reaches high levels and acts locally decreasing inflammation.

FDA approval information for Sulfasalazine

Sulfasalazine was approved for clinical use in the United States in 1950 and is still commonly used.

Clinical use of Sulfasalazine

Current indications are for treatment of active ulcerative colitis and prevention of relapses in disease, both in adults and children. Sulfasalazine is also used for juvenile or adult rheumatoid arthritis. Sulfasalazine is available in generic forms in 500 mg tablets and under the commercial name Azulfidine. Extended release forms are also available. The usual dose in adults is 3 to 4 grams daily initially, with maintenance dosage of 2 grams daily (4 divided doses).

Side effects of Sulfasalazine

Common side effects include anorexia, headache, nausea, gastrointestinal upset, fever, arthralgias and rash.

The following are sulfonamide drugs

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