Sulfasalazine is a DMARD used for rheumatoid arthritis, often in combination with methotrexate and hydroxychloroquine, and for arthritis in the peripheral joints in spondyloarthritis and psoriatic arthritis.
How long it takes
Usually 6 to 12 weeks.
How to take it
- The dose is built up gradually over a few weeks to reduce stomach side effects.
- Take it with food and swallow the tablets whole.
- Drink plenty of fluid.
Common side effects
Most are mild and many settle. Mention them at your next visit; there is often a simple fix.
- Nausea, loss of appetite or indigestion
- Headache
- Orange-yellow urine and tears, which can stain soft contact lenses. This is harmless.
- A temporary, reversible fall in sperm count
Call the clinic the same day if you have
- A rash, particularly with fever, in the first weeks
- Sore throat, fever, mouth ulcers or unexplained bruising
- Yellowing of the eyes or skin
Clinic: +91 70571 19999. If you are very unwell, go to the nearest emergency department and take your medicine strip with you.
Blood tests & checks
- Blood count and liver tests every 2 to 4 weeks for the first three months
- Then every three months for the first year, and less often after that if stable
Pregnancy & family planning
- Sulfasalazine can be continued in pregnancy, with higher-dose folic acid prescribed alongside it.
- It is generally compatible with breastfeeding in healthy, full-term babies.
- Men: it can lower sperm count reversibly. If conception is taking longer than expected, mention it.
Alcohol, infections, vaccines & other medicines
Sulfa allergy
Tell the clinic if you have ever reacted to a sulfa antibiotic or to aspirin before starting.
Vaccines
Inactivated vaccines are safe. Sulfasalazine is only mildly immunosuppressive.
Questions patients ask
Why is my urine orange?
It is the colour of the drug itself and is harmless. It does not mean the kidneys are affected.