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What is it prescribed for?

Sulfasalazine is an oral anti-inflammatory medication that reduces inflammation and swelling. It is usually prescribed for the treatment of diarrhea, bowel inflammation and rectal bleeding. It can also be recommended for treating abdominal pain in patients with a condition known as ulcerative colitis. Sulfasalazine is also a second-choice drug for the treatment of rheumatoid arthritis that did not respond to the first-choice treatment.

Taking Sulfasalazine

You need to consult a qualified medical professional before starting to take this medicine. Sulfasalazine is usually taken four times a day at evenly spaced intervals so that there would be 8 hours between every two doses. You should try to avoid missing any doses, as this will affect the efficiency of your treatment. It's best to take Sulfasalazine after having a meal or a snack of some kind, drinking a full glass of water right after. That way, you can avoid stomach upset that's quite common. Make sure you get plenty of fluids during the course of the treatment. Keep taking Sulfasalazine even if your condition improves, until you are supposed to stop per your doctor's directions.

Information about Sulfasalazine

Side Effects

From the nervous system and sensory organs:

  • headache
  • weakness
  • sleep disturbances
  • dizziness
  • fatigue
  • hallucinations
  • convulsions
  • peripheral neuropathy
  • tinnitus

From the side of cardiovascular system and blood:

  • agranulocytosis
  • leukopenia
  • thrombocytopenia
  • hemolytic anemia

On the part of the digestive tract:

  • nausea
  • diarrhea
  • vomiting
  • abdominal pain
  • flatulence
  • anorexia
  • blood in feces
  • pancreatitis

On the part of the urogenital system:

  • renal dysfunction
  • interstitial nephritis
  • transient oligospermia and infertility

Allergic reactions:

  • skin rash
  • Lyell's syndrome
  • Stevens-Johnson syndrome
  • anaphylactic shock


Read more about dosages of medicines for specific diseases on the page on dosages of sulfasalazine. The following is general information when taking.

Inside, after eating.

Ulcerative colitis / Crohn's disease

Adults. On the first day, 500 mg 4 times a day; on the 2nd day, 1 g 4 times a day; in the 3rd and following days, 1.5-2 g 4 times a day. After subsiding of the acute clinical symptoms of ulcerative colitis, a maintenance dose of 500 mg 3-4 times a day for several months is prescribed.

Children. At the age of 5-7 years, 250-500 mg 3-6 times a day; older than 7 years, 500 mg 3-6 times a day.

Rheumatoid arthritis

Adults. During the first week, 500 mg is administered once a day, during the second, 500 mg 2 times a day, during the third, 500 mg 3 times a day, etc. The therapeutic dose can range from 1.5 g to 3 g per day. The course of treatment is 6 months or more.

Children. At the age of over 6 years in a dose of 30-50 mg / kg of body weight per day, divided into 2-4 doses. For children over the age of 16, the maximum daily dose is 2 g.

Mechanism of action

In connective tissue, the intestinal wall dissociates into 5-aminosalicylic acid, which causes the anti-inflammatory properties of sulfasalazine, and sulfapyridine, a competitive para-aminobenzoic acid antagonist, which stops folate synthesis in microbial cells and causes antibacterial activity. Affects diplococci, streptococci, gonococci, Escherichia coli.

Poorly absorbed from the digestive tract (no more than 10%). Subjected to intestinal microflora splitting to form 60–80% sulfapyridine and 25% 5-aminosalicylic acid (5-ASA). Plasma protein binding of sulfasalazine - 99%, sulfapyridine - 50%, 5-ASA - 43%. Sulfapyridine undergoes biotransformation in the liver by hydroxylation to form inactive metabolites, 5-ASA is acetylated. T1 / 2: sulfasalazine - 5–10 hours, sulfapyridine - 6–14 hours, 5-ASA - 0.6–1.4 hours. With feces 5% sulfapyridine and 67% 5-ASA are eliminated, and kidneys - 75–91% sulfasalazine (within 3 days).

Use during pregnancy and lactation

In pregnancy, it is possible only under strict indications and in the minimum effective dose.

Category of action on the fetus by the FDA - B.

At the time of treatment should stop breastfeeding.


Caution is prescribed to patients with impaired renal or liver function, bronchial asthma, and allergic reactions. During the period of treatment it is necessary to systematically monitor the blood picture and the level of liver enzymes.

Possible staining in orange-yellow skin, urine, soft contact lenses.

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