Meds and you

30 September 2013


Sulfasalazine is an intestinal anti-inflammatory agent.


(Also known as Sulphasalazine)

Sulfasalazine is the active ingredient of Salazopyrin EN Tablets (Nappi Code: 762016-019) and Salazopyrin Tablets (Nappi Code: 762008-008).

General information
Sulfasalazine is an intestinal anti-inflammatory agent.

In South Africa sulfasalazine is registered for the treatment of Intestinal inflammatory disorders. These include both acute and chronic ulcerative colitis, a serious disease that causes ulcers and irritation in the inner lining of the colon and rectum; and Chrohn’s disease, an inflammatory disease of the small bowel. It is also effective in treating rheumatoid arthritis, a crippling form of arthritis in which the body's immune system attacks joints, causing hot, painful swelling and deformity.

This drug does not cure the underlying condition, but simply keeps the symptoms under control. For sulfasalazine to be effective it has to be taken regularly, even if you do not notice an immediate effect.

Sulfasalazine may reduce the absorption of folic acid into the body and an additional folic acid supplement may be needed.

This drug may colour your urine orange or yellow. Although this is not harmful at all, those wearing contact lenses should be aware that it may stain lenses permanently.

How does sulfasalazine work?
It reduces the actions of substances in the body that produce inflammation.

Fast facts

Drug schedule: schedule 4
Available as: sulfasalazine is available as tablets.
What does it do? Sulfasalazine has an anti-inflammatory action.
Overdose risk: low
Dependence risk: low
Is sulfasalazine available as a generic? no
Is sulfasalazine available on prescription only? yes

User information

Onset of effect: it may take several days for the full effect to be seen.
Duration of action: up to 24 hours
Dietary advice: sulfasalazine should best be taken with food. A folic acid supplement is also advised.
Stopping this medicine: do not withdraw treatment abruptly as this may cause a return of symptoms; consult you prescriber before discontinuing treatment.
Prolonged use: there is an increased risk of adverse effects with prolonged use; regular blood and liver tests are advised.

Special precautions
Consult your doctor before using this drug if:

  • you are allergic to aspirin

  • you are allergic to sulphonamide drugs

  • you have liver or kidney disease

  • you are taking other medication

  • you have been diagnosed with porphyria

Pregnancy: avoid. It is unknown how this medication may affect your baby. Consult your doctor before using this drug, or if you are planning to fall pregnant.
Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: avoid. This medication may cause serious adverse effects. Consult your doctor before use.
Infants and children: this medication is not intended for use in children under the age of 2 years.
The elderly: no special precautions need to be taken.
Driving and hazardous work: no special precautions need to be taken.
Alcohol: no special precautions need to be taken.

Possible side effects

Side Effect
Consult your doctor

Only if severe
In all cases
nausea and vomiting




loss of appetite


sun sensitivity




skin rash




sore throat


abnormal bruising/bleeding




warfarin prolonged effect of Warfarin
drugs for the treatment of diabetes prolonged effect of diabetic drugs
phenytoin risk of phenytoin toxicity
ciclosporin risk of kidney damage
methotrexate increased toxicity of methotrexate
oral contraceptives possible pill failure
pyrimethamine increased folic acid depletion
rifampicin increased risk of rifampicin toxicity

Disease interactions
Consult your doctor before using this drug if you are allergic to aspirin or sulphonamide drugs, or if you have liver or kidney disease or you have been diagnosed with porphyria.

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage
Adults, oral:
Ulcerative colitis/Chrohn's disease: 4-8 g/day, rheumatoid arthritis: 0.5-3 g/day

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

Read Health24’s Comments Policy

Comment on this story
Comments have been closed for this article.