Sulfasalazine

In Aotearoa New Zealand, sulfasalazine is available as 500 mg tablets. There are 2 types of tablets – plain and enteric coated. The enteric coated tablets (Salazopyrin EN) are specially coated to release the medicine in your bowel rather than your stomach and may have fewer side effects.

The dose of sulfasalazine will be different for different people, depending on why you're taking it and your response to treatment

• Ulcerative colitis and Crohn's disease: The usual dose of sulfasalazine is one tablet 4 times a day. Some people may need a lower dose of 1 tablet twice a day. If you have a ‘flare-up’ your dose may be increased for a short time.
• Rheumatoid arthritis: The usual dose of sulfasalazine is two tablets 2 to 3 times a day. Your doctor will start you on a low dose (1 tablet once a day) and increase your dose slowly over a few weeks. This is so your body can get used to the medicine and it reduces side effects.

Always take your sulfasalazine exactly as your doctor has told you. The pharmacy label will tell you how much sulfasalazine to take, how often to take it, and any special instructions.

• Timing: Take sulfasalazine at the same times each day, with a full glass of water. Take your dose with food.
• Swallow the tablets whole: Don't crush, break or chew the Salazopyrin EN tablets. 
• Missed dose: If you forget to take your dose, take it as soon as you remember. But if it's nearly time for your next dose, just take the next dose at the right time. Don't take double the dose.
• Take regularly: Keep taking sulfasalazine every day. It may take a few months before you notice the full benefits.

Here are some things to know when you're taking sulfasalazine. Other things may be important as well, so ask your healthcare provider what you should know about.

Let your doctor know if you are allergic to medicines containing sulphur, or if you have asthma. Let your doctor know if you are pregnant or breastfeeding, or planning a pregnancy.

Sulfasalazine may affect the colour of your pee 

Sulfasalazine tablets are a yellow or orange colour. They can make your pee turn orange – this is harmless. Avoid wearing soft contact lenses as they may become stained.

Tests and monitoring

While you're taking sulfasalazine, you will need regular blood tests to monitor for side effects and to check whether the treatment is working. Blood tests are very important during the first few months of treatment. Over time, these tests are needed less often.

Other medicines

Sulfasalazine may interact with a few medicines and herbal supplements, so check with your doctor or pharmacist before starting sulfasalazine or before starting any new medicines, including those you may buy over-the-counter.

Sun protection

Sulfasalazine makes your skin more sensitive to the sun. Protect your skin when you're in the sun, especially between 10am and 3pm. Wear protective clothing and use a high factor sunscreen (SPF 30+) when you're outside.

Like all medicines, sulfasalazine can cause side effects, but not everyone gets them. Often side effects improve as your body gets used to the new medicine. 

Read more about medicines and side effects and reporting a reaction you think might be a side effect.