Sulphasalazine’s effect on the body
It can:
· reduce the symptoms, inflammation in your joints, and thereby reduce pain, swelling and stiffness.  
· slow the progression of rheumatoid arthritis and other types of arthritis, e.g  psoriatic arthritis
· it is specially coated so that it does not dissolve quickly in the stomach.
· It has beneficial effects in treating inflammatory bowel disease, and vice versa.

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Who can benefit from sulphasalazine?
· People with active synovitis e.g. rheumatoid, psoriatic arthritis, enteropathic arthritis
 People treated with sulphasalzine should be using contraceptive methods, drink less than 7 units of alcohol per week and have regular check-ups for liver function and blood counts.

When and how do I take sulphasalazine?
It should be taken with a glass of water, and swallowed whole. Do not crush or chew.

What dose do I take?
Your doctor will prescribe the dose. Usually you will start on a low dose, 500 mg (one tablet) daily, for one week. The dose might be increased every week by 500 mg per day, till a maximum dose of 3000 mg per day.
It is not a pain-killer. Continue to take your painkillers as well, unless your doctor advises otherwise.

How soon I will feel better?
It may be about 12 weeks before you notice any benefit.

What are the potential side-effects?
· More common side-effects include nausea, diarrhoea or abdominal pain,
· Dizziness and headache,
· Skin rashes and photosensitivity.
· These side-effects may occur during the first 3 months of treatment.
· In some cases sulphasalazine can suppress the bone marrow activity, and anaemia may occur as well. 
· This drug may cause liver damage.
· The colour of your urine may change from yellow to orange. It is nothing to worry about.
· Sulphasalazine may stain soft contact lenses yellow.
· RED ALERT: If you develop a sore throat, any other infection, a fever, unexplained bruising or any other new symptoms, you should contact your doctor.

Do I need any special monitoring while on sulphasalazine?
Yes.
· Your blood counts should be monitored carefully and regularly.
· Your liver function should be monitored carefully and regularly.

Can I take other medication while using sulphasalazine?
Yes. Most drugs are considered safe to use with sulphasalazine.

What about sulphasalazine and fertility, pregnancy and breastfeeding?
It may cause a temporary and reversible drop in sperm count. This will return to normal as soon as the drug is stopped.
Not recommended during pregnancy or breastfeeding.

What about alcohol intake?
As alcohol increases the risk for liver damage, doctors advise patients to keep their alcohol intake below 7 drinks per week.(A drink means one beer, 1 tot of spirits or one glass of wine.)

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