Sulfasalazine

Synonym

SalazosulfapyridineSulfasalazine is an anti-inflammatory drug that is used to treat various diseases. In the intestine, sulfasalazine is metabolized to its two cleavage products mesalazine and sulfapyridine. The drug is available only on prescription.

Fields of application

Sulfasalazine is used to treat chronic inflammatory bowel diseases (e.g. Crohn’s disease and ulcerative colitis), as well as in the treatment of chronic polyarthritis. The drug is suitable both for the treatment of acute flare-ups and for long-term use.

Contraindication

Sulfasalazine should not be used in patients who have an allergy to sulfonamides or salicylates. Also, the drug should not be used in case of intestinal obstruction, porphyria (congenital blood formation disorder), white blood cell deficiency (leukopenia), platelet deficiency (thrombopenia), disorders of blood-forming organs, and severe liver and kidney dysfunction. Special caution is also required in patients who have a tendency to allergies or asthma or who suffer from mild liver or kidney dysfunction. These patients may only take Sulfasalazine under close medical supervision and weighing of the risks.

Mode of action

Sulfasalazine is difficult to be absorbed by the organism when taken orally. Therefore it reaches the large intestine in almost unchanged form. There it is finally metabolised by the body’s own intestinal bacteria and split into its effective end products.

In this form it can then unfold its effect. By inhibiting the arachidonic acid metabolism, sulfasalazine has an anti-inflammatory effect, since arachidonic acid is normally used to form inflammation mediating substances. In addition, sulfasalazine has an immunosuppressive effect. In most patients there is a significant improvement of the symptoms after about three months of therapy.

Dosage

Usually the dose of the drug is slowly increased and adjusted to the needs of the patient. This is decided by the treating physician. The therapy must be long-term in order to achieve a good clinical result. If the treatment is discontinued prematurely, a further deterioration of the clinical picture can be expected.