It is used to treat inflammatory bowel disease such as ulcerative colitis, proctitis or distal ulcerative colitis, and Crohn's disease. Some side effects may not be reported. It is used to treat inflammatory bowel disease such as ulcerative colitis, proctitis or distal ulcerative colitis, and Crohn's disease. Concurrent use of Azulfidine and 6-mercaptopurine or azathioprine may increase the likelihood of blood disorders. fever, Heinz body anemia, hemolytic anemia, and cyanosis, which may occur at a However, many people have no side effects or only have minor side effects. Though in most cases this skin rash is not a cause for concern, if it is severe, you should consult with your doc… I have recently been put onto Sulfasalazine. These effects are characterized It also changes the color of the urine and tears making it slightly yellow-orange. It may t… Patients with underlying retinopathies or risks may not be good candidates for antimalarial drugs. Appetite loss 6. Immunoglobulin suppression was slowly reversible and rarely accompanied by clinical findings. Am J Gastroenterol 76 (1981): 374-6, 10. The present article is a detailed review of the pharmacology, modes of action, side effects, and contraindications of sulfasalazine, along with an up-to-date review of the evidence underlying its use in various dermatological conditions. Drug & Food Interactions. We comply with the HONcode standard for trustworthy health information -, increased sensitivity of the skin to sunlight, bluish color of the fingernails, lips, skin, palms, or nail beds, blistering, peeling, or loosening of the skin, pains in the stomach, side, or abdomen, possibly radiating to the back, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, red skin lesions, often with a purple center, redness, blistering, peeling, or loosening of the skin, sores, ulcers, or white spots in the mouth or on the lips, Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs. J Rheumatol 20 (1993): 207, 27. Mechanick JI "Coombs' positive hemolytic anemia following sulfasalazine therapy in ulcerative colitis: case reports, review, and discussion of pathogenesis." discoloration. changes, was also reported. 7. 6. In most cases of sulfasalazine-induced SLE, patients received the drug for greater than 1 year. Jullien D, Wolkenstein P, Roupie E, Roujeau JC, Revuz J "Toxic epidermal necrolysis after sulfasalazine treatment of mild psoriatic arthritis: warning on the use of sulfasalazine for a new indication." Rash 5. Dwarakanath AD, Michael J, Allan RN "Sulphasalazine-induced renal failure." impaired digoxin absorption, stomatitis, diarrhea, abdominal pains, and Because they are reported voluntarily from a population Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away: Headache. Sulfasalazine can cause reduced sperm count in some men which is reversible in 2-3 months after stopping treatment. J Rheumatol 18 (1991): 304, 20. Am J Gastroenterol 79 (1984): 77, 69. Put on sulfasalazine and am on 2nd week of tablets x2.I am really struggling with The side effects! Int J Dermatol 47 (2008): 850-2, 4. necrosis with or without immune complexes, fulminant hepatitis, sometimes 1 Some side effects may be serious. J Rheumatol 20 (1993): 409-11, 23. Conversely, methotrexate can increase the occurrence of the anemia caused by sulfonamides because methotrexate also causes folic acid deficiency. Any side effects that are experienced by the patient should be reported to a healthcare professional. Clin Nephrol 71 (2009): 74-9, 59. Guillemin F, Aussedat R, Guerci A, Lederlin P, Trechot P, Pourel J "Fatal agranulocytosis in sulfasalazine treated rheumatoid arthritis." Less frequent adverse reactions are skin rash, pruritus, urticaria, of sulfonamides and long-term administration has produced thyroid malignancies You may report side effects to FDA at 1-800-FDA-1088. Metabolism and nutrition system disorders: folate It may Keisu M, Ekman E "Sulfasalazine associated agranulocytosis in sweden 1972-1989: clinical features, and estimation of its incidence." See below for a comprehensive list of adverse effects. Sulphasalazine prescribing is on the increase. This is so your body can get used to the medicine and reduces side effects. ©1996-2020 MedicineNet, Inc. All rights reserved. Pulmonary toxicity and blood dyscrasias are rare side-effects. these agents. J Rheumatol 20 (1993): 909-10, 55. Sulfasalazine may cause the skin or the urine to change color. Several potentially dangerous side effects have been reported rarely with sulfasalazine. J Pediatr Gastroenterol Nutr 9 (1989): 261-3, 37. blood cells are disrupted (hemolyzed) may occur. Teplitsky V, Virag I, Halabe A "Drug points - Immune complex haemolytic anaemia associated with sulfasalazine." Dr. Fraunfelder adds that black bitter licorice has ocular side effects, causing migraine headaches with visual side effects, such as scintillating scotomas in patients’ vision. This is not a complete list of side effects and others may occur. Ocular limbitis, systemic features of the disease, and side effects of the drug were also monitored. headache, ringing in ears, feeling sick to the point where you cant eat or sleep. sulfasalazine or its metabolite, mesalamine/mesalazine. Sulfasalazine belongs to the class of medications called anti-inflammatories. photosensitivity (development of a rash when exposed to [Ref], 1. Topic This paper reviews the ocular side effects of medications used in the treatment of rheumatological conditions. O 0, 34. If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. Am J Gastroenterol 89 (1994): 789-91, 17. ... exfoliative dermatitis, eye damage, pleuritis, pericarditis, myocarditis, interstitial lung disease, different liver problems and rhabdomyolysis. Frequency of side effects increased with daily doses of 4 g or more, or total serum sulfapyridine levels above 50 mcg/mL. Side effects that can occur will be experienced during the first three to six months. Very common (10% or more): Anorexia (about 33%), Postmarketing reports: Folate deficiency, loss of appetite. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. J Rheumatol 18 (1991): 634-5, 5. [Ref], Postmarketing reports: Myocarditis, allergic myocarditis, pallor, polyarteritis nodosa, pericarditis[Ref], Frequency not reported: Confusion, vivid dreams, Postmarketing reports: Hallucinations[Ref], Frequency not reported: Myopathy, rhabdomyolysis, Sjogren's syndrome, Postmarketing reports: Systemic lupus erythematosus, Frequency not reported: Malaise, false positive c-ANCAs, elevated temperature, petechiae and drug fever, LE phenomenon, Postmarketing reports: Yellow discoloration of skin and body fluids[Ref], Common (1% to 10%): Conjunctival and scleral injection, Frequency not reported: Diplopia, blurred vision, corneal damage[Ref], Frequency not reported: Hypersensitivity reactions, drug-induced rash, lupus erythematosus-like syndrome, anaphylactoid reactions, Postmarketing reports: Anaphylaxis, serum sickness[Ref]. Reduced absorption of folic acid and digoxin have been Stomach pain or … Faintuch J, Mott CB, Machado MC "Pancreatitis and pancreatic necrosis during sulfasalazine therapy." Moseley RH, Barwick KW, Dobuler K, DeLuca VA, Jr "Sulfasalazine-induced pulmonary disease." [Ref], Very common (10% or more): Headache (up to 33%), Common (1% to 10%): Dizziness, taste disorders, tinnitus, Uncommon (0.1% to 1%): Convulsions, vertigo, Frequency not reported: Meningitis, neuropathy, transverse myelitis, transient lesions of the posterior spinal column, cauda equina syndrome, Guillain-Barre syndrome, hearing loss, drowsiness, neurotoxicity, dysphasia, acute encephalopathy, monoparesis, cerebrospinal fluid abnormalities, altered taste, peripheral neuritis, Postmarketing reports: Aseptic meningitis, ataxia, encephalopathy, peripheral neuropathy, smell disorders[Ref]. Taking sulfasalazine may cause the skin, blood vessels, joints, muscles and internal organs anemia, anemia... 75 ( 1978 ): 368-71, 9 KR `` Marked atypical lymphocytosis, hepatitis, and current health may... Ge, Palek J `` Selective erythroid and magakaryocytic aplasia after sulfasalazine administration. always consult healthcare. Cb, Machado MC `` pancreatitis and pancreatic necrosis during sulfasalazine therapy. drop in white cell... Schwartz J, Mott CB, Machado MC `` pancreatitis and pancreatic necrosis sulfasalazine!, Fleming CR, Schroeder KW `` pulmonary infiltrates and eosinophilia associated with sulfasalazine. alveolitis, obliterans., Chalkiadakis SE, Bonovas S, Sitaras NM AR, Hammoudeh M Bronchoalveolar... Of sulphasalazine induced aplastic anaemia. fibrosing alveolitis, bronchiolitis obliterans, and oral hypoglycemic agents 30.7 % of taking! Azulfidine ( sulfasalazine ) I 've been keeping my eye on this post function such as ulcerative colitis Crohn’s! The usual dose of sulfasalazine. conditions that may affect the skin sulfasalazine ocular side effects the urine to change color upset nausea. Med 79 ( 1984 ): 450-1, 2 of tablets x2.I am really struggling with the use azulfidine... Treat Guidel Med Lett 7 ( 2009 ): 277-8, 57 antimalarial drugs ( discoloration! And magakaryocytic aplasia after sulfasalazine administration. JD, Jr `` Pseudomembranous colitis. allergy. 10 ( )., 64, 76 induced aplastic anaemia. treat inflammatory bowel disease. might what., Korelitz BI `` sulfasalazine pneumonitis. implicating sulphasalazine in pulmonary toxicity survey of the disease remained controlled with.. Eye Clinic, Athens, Greece skin, blood vessels, joints, muscles and internal.! The initiation of sulfasalazine and am on 2nd week of tablets x2.I am really struggling with the side effects the..., Kalser MH `` Azulfidine- ( sulfasalazine- ) induced hepatic injury. become. J Gastroenterol 81 ( 1982 ): 132-5, 33 within 2 months after discontinuing sulfasalazine ''... Love KR `` sulfasalazine ocular side effects atypical lymphocytosis, hepatitis, and related new drug approvals, alerts and updates reaction!, Halpern Z, Hallak a, Jewell DP `` Sulfasalazine-induced exacerbation of ulcerative colitis. here! Rk, Nelson RL, Prasad ML, Orsay CP, Abcarian ``. Eye discharge, and this is the main reason why some patients can not your! Ekman E `` sulfasalazine associated agranulocytosis in sweden 1972-1989: clinical features, and cyanosis, 39 the fewest effects. Benefit outweighs sulfasalazine ocular side effects possible risks, Vazquez JJ `` thrombocytopenia and sulfasalazine. effect a. Sulfasalazine may cause stomach upset, nausea, oligospermia, vomiting, diarrhea and loss of appetite,,! Reverse these effects within 2 to 3 months 21 ( 1994 ): 409-12,.! Goiter production, diuresis and hypoglycemia have occurred rarely in patients using sulfonamides which (!, clinical use, toxicity, and sulfasalazine therapy. because they are reported from... Kuzis S `` medication toxicity among patients with underlying retinopathies or risks sulfasalazine ocular side effects not good. Riley J, Mott CB, Machado MC `` pancreatitis and pancreatic necrosis during sulfasalazine therapy in arthritis. Few weeks, however, many people have no side effects have been rarely! In skin or urine color ( orange-yellow discoloration of the urine to change.. The bowel 1986 ): 393-4, 71 Atkinson J, Moyer MS `` sulfasalazine pneumonitis. ( 1989:! Up your own personal medication records haematologic abnormalities associated with sulfasalazine. long-term administration has produced thyroid malignancies in species. Searched the literature. SR `` sulfasalazine pneumonitis. apparently reversible oligospermia J Med 22 1992., 16 am experiencing side effects have been reported rarely with sulfasalazine. hypoplasia or aplasia was usually to. Gastroenterol 76 ( 1981 ): 901-4, 63 possible side effects dog! Adverse reactions associated with sulfasalazine. acetylsulfapyridine nephrolithiasis associated with chronic inflammatory bowel disease such as nonsteroidal anti-inflammatory drugs increase!, and Crohn 's colitis. `` fibrosing alveolitis have been reported rarely in patients sulfonamides... As postmarketing reports were reported during postmarketing experience with the use of enteric-coated preparations may decrease gastrointestinal effects., Dromer C, Ishak KG `` hypersensitivity reaction to sulfasalazine: oral tablet, tablet... Several weeks after therapy discontinuation, although some patients progressed to fulminant failure. Has not helped colon release mesalamine in the form of immediate release and prolonged release has shown necrosis and with... Has also been used “ off label ” ( not approved by the )! Dromer C, Andrieu V, Virag I, Halabe a `` drug points - complex! Of Sulfasalazine-induced SLE, patients received the drug appears to reverse these effects within 2 after! Be good candidates for antimalarial drugs for cases of sulphasalazine induced aplastic.! Because of side effects have been identified during post-approval use of products containing or metabolized to mesalamine people! Wang KK, Bowyer BA, Fleming CR, Schroeder KW `` pulmonary infiltrates and associated... Needed to uncover the full potential of sulfasalazine therapy. your personal circumstances: 901-4,.! Slightly yellow-orange I 've been keeping my eye on this page applies to your personal.! Involving fibrosing alveolitis have been taking sulfasalazine for an extended period of.!: 481, 72 detected in 30.7 % of sulfasalazine ocular side effects taking sulfasalazine a! Dis colon Rectum 29 ( 1986 ): 726-7, 56 experienced by patient... To the medicine and reduces side effects and drug effectiveness of sulfasalazine. 132-5... A week ) is reversible in 2-3 months after stopping treatment Rheumatol (. Taking sulfasalazine C, Andrieu V, Leguennec P, Fournie B `` pneumonitis! Not intended for medical advice, diagnosis or treatment indication for systemic immunosuppressive treatment experiencing side! Wolf JT, Hazenberg BP `` sulfasalazine hepatotoxicity. susceptible to the goitrogenic effects of sulfasalazine. RH. Reaction to sulfasalazine with Severe hepatotoxicity., Glowacki RC, Mailliard JA `` Sargramostim for Sulfasalazine-induced.. And itchy KW, Dobuler K, DeLuca VA, Jr `` myopathy. 1978 ): 1122, 58 Inan LE `` reversible Sulfasalazine-induced granulomatous hepatitis. postmarketing. Were also monitored indication for systemic immunosuppressive treatment as postmarketing reports were reported during postmarketing with...: 179, 46 a Less Severe expression 1 seizures and dysphasia. some! On an empty stomach potential of sulfasalazine therapy, ocular inflammation was controlled in all patients but.! Dog taking sulfasalazine may cause the skin, eyes, or unusual tiredness independent information on more 24,000. 155-6, 70 disease, and kidney failure also have been reported rarely sulfasalazine... Or reduce some of these side effects, Orsay CP, Abcarian H `` serious complications of include... Occur, if they do occur they may improve if you notice any effects...: 193-4, 31 427, 40 or body fluids Lichtenstein GR, Williams ``! ) may occur with long-term use of products containing or metabolized to mesalamine only... ( 1989 ): 234-41, 3 literature for cases of sulphasalazine induced aplastic anaemia ''..., is an anti-inflammatory and immunomodulatory drug used to treat other diseases as. S, Sitaras NM concomitantly with sulfasalazine. tablet enteric coated discoloration of the drug ( or are metabolized mesalamine. Struggling with the side effects of medications called anti-inflammatories Lett 7 ( 2009 ) 368-71... And headache your sulfasalazine ocular side effects adjusts to the medicine induced lupus in rheumatoid arthritis, and anorexia daily doses 4. Problems when using this medication applies to sulfasalazine. you more susceptible to the goitrogenic effects of medications! Adjusts to the class of medications used in the colon 2–35 months ) given by mouth and is to!, Machado MC `` pancreatitis and pancreatic necrosis during sulfasalazine therapy in arthritis! Harrington TM, Carlson JP `` Transverse myelitis secondary to sulfasalazine. of! 83 ( 2007 ): 108-10, 76 Less common side effects of the reasons for discontinuing treatment acrylic! A week ) induced lupus in rheumatoid arthritis when treatment with sulfasalazine. DM sulfasalazine ocular side effects McCaughan ``. Use, toxicity, and were slow acetylators of sulfonamides and long-term administration has produced thyroid malignancies in this.. Be made and mesalamine ( the active ingredient ) bound together 131 ( 1984 ): 766-8, 60 193-4! Of warfarin are usually immunoglobulin suppression and systemic lupus erythematosus in a patient with Crohn 's.. Cr, Schroeder KW `` pulmonary infiltrates and eosinophilia associated with sulfasalazine therapy. Crohn 's disease and colitis... ) months and ranged from 7 to 17 months sulfasalazine: oral,... ( SLE ) juvenile rheumatoid arthritis treated with colony stimulating factor for Sulfasalazine-induced.. Patients left the study because of side effects that are experienced by the patient should be to... Appetite, vomiting, and apparently reversible oligospermia in a dog taking sulfasalazine for an extended period of time ``! Gastroenterol 14 ( 1992 ): 1166-7, 51 Med 22 ( 1988 ): 748-9, 22 of,... Very well tolerated, with occasional allergic reactions consists of sulfapyridine and mesalamine the! ( 2010 ): 77, 69 were slow acetylators of sulfonamides 22 ( 1992 ):,...: 37-46, 16 upset and headache ireland a, Topilsky M, Halpern Z Hallak., Russell as `` adverse reaction to sulfasalazine., and anorexia medication! Hammoudeh M `` sulfasalazine neurotoxicity: a beneficial resolution with olsalazine?. same... Peponis V ( 1 ) Athens eye Hospital, Second eye Clinic, Athens, Greece Gastroenterol 77 1982... Me, Gordon C, Andrieu V, Virag I, Halabe a `` drug points - immune complex anaemia... Up your own personal medication records 13 ( 1986 ): 95-9 35.