How does sulfasalazine work?
Sulfasalazine works by reducing swelling (inflammation). This helps reduce the symptoms of inflammatory conditions such as inflammatory bowel disease and rheumatoid arthritis.
It’s thought that it stops your body from producing chemicals that cause redness and swelling in the gut (in Crohn's disease and ulcerative colitis) and in the joints (in rheumatoid arthritis).
Sulfasalazine has a similar effect to immunosuppressants. It can reduce the numbers of white cells in your blood, reducing your body's ability to fight infection.
When will I feel better?
Sulfasalazine does not work straight away.
If you're taking sulfasalazine for inflammatory bowel disease, you must continue taking it even if you feel well to remain well.
If you have rheumatoid arthritis it may take 1 to 3 months before you notice your symptoms get better.
It depends on how high your dose is and how severe your symptoms are.
Are there any long-term side effects?
Sulfasalazine can be taken long term. However, your doctor will want to check how your kidneys are working before and during treatment. In rare cases sulfasalazine can cause kidney problems.
These checks usually happen once every 3 months for the first year. You will usually need a check once a year after that or as often as your doctor recommends.
Can I stop taking sulfasalazine?
If you're thinking of stopping sulfasalazine, talk to your doctor first. If you stop, your symptoms may come back.
If you want to stop because of any side effects, your doctor may be able to review your treatment and prescribe something else.
Do not stop using sulfasalazine unless your doctor tells you to.
Are there other treatments for Crohn's disease and ulcerative colitis?
Other medicines used to treat Crohn's disease and ulcerative colitis include:
- immunosuppressants, such as azathioprine and methotrexate
- steroids, such as prednisolone and budesonide
- biological medicines, such as adalimumab and infliximab
Are there other treatments for rheumatoid arthritis?
Other medicines used to treat rheumatoid arthritis include:
- disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate (an immunosuppressant) and mesalazine
- a short course of steroids
- biological medicines, such as adalimumab
Can I take sulfasalazine before surgery or dental treatment?
If you're due to have any surgery or dental treatment, tell your doctor or dentist before your treatment that you’re taking sulfasalazine.
They will tell you if you need to stop taking it.
Can I take painkillers with sulfasalazine?
You can take paracetamol with sulfasalazine.
However, you should avoid non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. Like sulfasalazine, NSAIDs can cause problems with the way your kidneys work.
Sulfasalazine is used to treat ulcerative colitis, Crohn's disease and other inflammatory bowel diseases. NSAIDs can irritate the gut and increase the risk of ulceration and bleeding.
Ask a pharmacist or doctor for advice if paracetamol is not working for you.
Will sulfasalazine affect my contraception?
Sulfasalazine does not affect any type of contraception, including the combined pill, progestogen-only pill and emergency contraception.
However, if using sulfasalazine makes you vomit or have severe, watery diarrhoea, or any diarrhoea that lasts for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.
Find out more:
Can I drive or ride a bike?
Sulfasalazine can make you feel dizzy. If this happens to you, do not drive, cycle or use machinery or tools until you feel better.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking sulfasalazine. GOV.UK has more information on the law on drugs and driving.
Can I drink alcohol while taking sulfasalazine?
You can drink alcohol while taking sulfasalazine.
However, alcohol can irritate your gut so may make symptoms worse if you have inflammatory bowel disease.
It's best to stick to the national alcohol guidelines of no more than 14 units a week.
Is there any food or drink I need to avoid?
You can usually eat and drink normally while taking sulfasalazine.
If you have indigestion or feel sick, it's best to stick to simple meals, and avoid alcohol and spicy foods.
For inflammatory bowel disease, your doctor may advise you make some changes to your diet as part of your treatment. This can include following a special diet or adding a nutritional supplement.