Sulfasalazine - instructions for use, reviews, analogs and formulations (tablets 500 mg EH) of a medicament for the treatment of rheumatoid arthritis, ulcerative colitis and Crohn's disease in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Sulfasalazine. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of physicians specialists on the use of Sulfasalazine in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of sulfasalazine in the presence of existing structural analogues.Use for the treatment of rheumatoid arthritis, ulcerative colitis and Crohn's disease in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Sulfasalazine - a drug for the treatment of Crohn's disease and ulcerative colitis (NJC). Sulfasalazine selectively accumulates in the connective tissue of the intestine with the release of 5-aminosalicylic acid, which has anti-inflammatory activity, and sulfapyridine, which has an antimicrobial effect against diplococci, streptococci, gonococci, E. coli.

Composition

Sulfasalazine + auxiliary substances.

Pharmacokinetics

Sulfasalazine is poorly absorbed in the intestine (no more than 10%). It is cleaved by intestinal microflora with the formation of 60-80% sulfapyridine and 25% 5-aminosalicylic acid (5-ASA). Binding to plasma proteins is 99% for sulfasalazine, 50% for sulfapyridine, 43% for 5-ASA. In the liver, sulfapyridine is biotransformed mainly by hydroxylation with the formation of inactive metabolites, 5-ASA by acetylation. With feces 5% of sulfapyridine and 67% of 5-ASA are excreted; 75-91% of the absorbed sulfasalazine is excreted by the kidneys within 3 days.

Indications

• nonspecific ulcerative colitis (treatment of exacerbations and maintenance therapy in the phase of remission);
• Crohn's disease (mild and moderate forms in the phase of exacerbation);
• rheumatoid arthritis;
• juvenile rheumatoid arthritis.

Forms of release

Tablets coated with 500 mg (EH).

Other dosage forms, whether candles or solution, at the time of drug description in the directory did not exist.

Instructions for use and dosing regimen

With NNC and Crohn's disease, adults on the first day of treatment are prescribed 500 mg 4 times a day; in the second day - 1 g 4 times a day; in the third and subsequent days - 1.5-2 g 4 times a day. After the acute clinical symptoms subsided, the drug is prescribed in a maintenance dose of 500 mg 3-4 times a day for several months.

Children aged 5-7 years are prescribed 250-500 mg 3-6 times a day, children older than 7 years - 500 mg 3-6 times a day.

With rheumatoid arthritis, adults are prescribed 500 mg once a day for the first week; within 2 weeks - 500 mg twice a day; for 3 weeks - 500 mg 3 times a day. The therapeutic daily dose of sulfasalazine can be from 1.5 to 3 g. The course of treatment - 6 months or more.

For children over the age of 6, the drug is prescribed in a dose of 30-50 mg / kg of body weight per day,divided into 2-4 admission; for children over 16 years the maximum daily dose is 2 g.

The drug should be taken after meals.

Side effect

• headache;
• dizziness;
• noise in ears;
• convulsions;
• sleep disorders;
• hallucinations;
• peripheral neuropathy;
• impaired renal function;
• interstitial nephritis;
• nausea, vomiting;
• diarrhea;
• abdominal pain;
• anorexia;
• hepatitis;
• pancreatitis;
• interstitial pneumonitis and other pulmonary tissue lesions;
• Anemia, leukopenia, thrombocytopenia, agranulocytosis;
• oligospermia;
• infertility;
• skin rash;
• toxic epidermal necrolysis (Lyell's syndrome);
• malignant exudative erythema (Stevens-Johnson syndrome);
• fever;
• anaphylactic shock;
• yellowing of the skin, urine, soft contact lenses.

Contraindications

• porphyria;
• anemia;
• severe liver dysfunction;
• severe renal dysfunction;
• deficiency of the enzyme glucose-6-phosphate dehydrogenase;
• children under 5 years;
• lactation period;
• hypersensitivity to sulfonamides and derivatives of salicylic acid.

Application in pregnancy and lactation

The use of sulfasalazine in pregnancy is possible only on strict indications in the minimum effective dose. If the course of the disease allows, it is recommended to cancel the drug in the 3rd trimester of pregnancy.

If you need to use the drug during lactation, you should decide whether to stop breastfeeding.

Use in children

The drug is contraindicated for children under 5 years.

Children aged 5-7 years are prescribed 250-500 mg 3-6 times a day, children older than 7 years - 500 mg 3-6 times a day.

special instructions

With caution should prescribe the drug to patients with impaired liver and / or kidney function, patients with bronchial asthma, allergic reactions.

During the period of application of the drug, the use of increased amounts of liquid is recommended.

During the period of application of the drug it is necessary to monitor the level of hepatic enzymes, a general analysis of blood and urine.

Drug Interactions

With the simultaneous use of sulfasalazine reduces the absorption of folic acid and digoxin.

With simultaneous use of Sulfasalazin increases the effect of anticoagulants, antiepileptic and oral hypoglycemic drugs.

With simultaneous application increases the side effect of cytostatics, immunosuppressants, hepato- and nephrotoxic agents.

With the simultaneous use of sulfasalazine and antibiotics, the effectiveness of sulfasalazine may be reduced in ulcerative colitis, since antibiotics exert a depressant effect on the intestinal flora.

Analogues of the drug Sulfasalazine

Structural analogs for the active substance:

• Sulfasalazine EH.

Analogues on the curative effect (agents for the treatment of ulcerative colitis):

• 5 ASA;
• Azathioprine;
• Alginatol;
• Hydrocortisone;
• Dexamethasone;
• Diprospan;
• Irmalax (dietary fiber with vitamin C and citrus flavor);
• Yogulact;
• Yogulact forte;
• Lactobacterin in powder;
• Lemodus;
• Maltofer;
• Mesakol;
• Methyluracil;
• Neonatrix;
• Pentasa;
• Prednisolone;
• Rheopolyglucin with glucose;
• Salosinol;
• Salofalk;
• Triamcinolone;
• Urbazon;
• Fortecortin;
• Fortecortin Mono;
• Celeston;
• Eglonyl;
• Enterosan.

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