Sulfasalazine
Administration
- Type: Salicylate
- Dosage Forms: Tab: 500mg; DR Tab: 500mg
- Routes of Administration: Oral
- Common Trade Names: Azulfidine, Azulfidine EN-tabs, Sulfazine
Adult Dosing
Ulcerative Colitis
- 500 mg PO q6h
- Max: 6 g/day
Rheumatoid arthritis
- 1 g PO q12h
- Max 4 g/day
Crohn's disease
- 500 mg PO q6h
- Max 6 g/day
Pediatric Dosing
Ulcerative Colitis
- 6+ years old
- 30-70 mg/kg/day PO divided q12h
- Max: 2 g/day
- 30-70 mg/kg/day PO divided q12h
Juvenile idiopathic arthritis
- 6+ years old
- 30-50 mg/kg/day PO divided q12h
- Max: 2 g/day
- 30-50 mg/kg/day PO divided q12h
Special Populations
- Pregnancy Rating: Category B, benefits outweigh risk during pregnancy; low risk
- Lactation risk: Caution advised; risk of infant diarrhea
Renal Dosing
- Adult: Not defined
- Pediatric: Not defined
Hepatic Dosing
- Adult: Not defined
- Pediatric: Not defined
Contraindications
- Allergy to class/drug
- Hypersensitivity to salicylates
- Hypersensitivity to sulfonamides
- Porphyria
- GI Obstruction, GU obstruction
- Febrile viral infection (pts <20 yo)
Adverse Reactions
Serious
- Hypersensitivity reaction, anaphylaxis
- Erythema multiforme
- Stevens-Johnson syndrome, Toxic epidermal necrolysis
- Pulmonary toxicity, hepatotoxicity, nephrotoxicity
- Pancreatitis
- Seizure
- Meningitis
- Agranulocytosis, Aplastic anemia, hemolytic anemia
- Infertility, Oligospermia
- Reye syndrome
- Hypoglycemia
Common
- Anorexia
- Headache, Nausea, Vomiting, Dizziness
- Dyspepsia, stomatitis
- Oligospermia
- Rash, Pruritus, Urticaria
- Abdominal pain
- Fever
- Leukopenia, hemolytic anemia
- Cyanosis
- Crystalluria, Hematuria
- Photosensitivity
Pharmacology
- Half-life: 7.6 h (Active metabolites 10.4-14.8h)
- Metabolism: GI tract, liver
- Excretion: Urine 37% (15% unchanged), feces
Mechanism of Action
- Blocks cyclooxygenase and inhibits prostaglandin production, producing anti-inflammatory effects