New Medication Added - Asulfadine (Sulfasalazin 500 mg)

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Regular Member

Date Joined Nov 2006
Total Posts : 76
   Posted 2/2/2009 8:22 AM (GMT -6)   
Hello, I have not posted in a very long time but had some questions about this new medication that was added to my Plaquenil last week.  I went for my six month check up and my Rheumotologist thought I had been having too many flares and wanted to add this medication.  I am diagnosed with inflammatory arthritis and RA, both mild forms.
My question is has anyone taken this med before and what side effects if any have you experienced.  I'm starting it today.  It is a sulfa drug also used for Crohn's and RA.
I am always afraid to start anything new.  I have been on Plaquenil for three years now and it has done wonders.
I go back in three months and he will decide then if he wants to reduce the Plaquenil and stay with the Asulfadine.  Your comments would be very much appreciated.
Thank you  AnnieRae  
There Is Always Hope

Regular Member

Date Joined May 2007
Total Posts : 475
   Posted 2/2/2009 8:49 AM (GMT -6)   
My son was on this for psoriaitc arthritis. It did not seem to help with the pain, much. He is in the process of seeing a new rheumy (insurance necessity) and the new doc is going to stop the drug for awhile to see if it is really making a difference. This new doc seems to think that it's NOT psoriatc arthritis (surprise), but a combination of degenerative arthritis and fibromyalgia, The bones in my son's neck have begun to fuse together.
If I remember correctly, my son could not take any additional aspirin products while he was on the Sulphasalazine. And he became SUPER-EXTREMELY sensitive to the sun. More than the normal sensitivity.

I hope you feel better and this drug works for you. We are all so different - and we all react to the same things so differently.

I do seem to remember reading somewhere on this board that Sulfa drugs are usually avoided with lupus patients (not sure why), maybe someone else will chime in with more info.

Good Luck - Feel Better!
Take care,

Dx: Lupus, sjogren's, celiac, severe allergies.
Daily Meds: Plaquenil, Zyrtec. Aciphex, Nasacort, Prozac, Ambien CR.
Daily Supplements: Calcium, B-100 Complex.
As Needed Meds: Epinephrine, Benadryl, Proventil, Xopenex, Tylenal, Darvocet, Prednisone.

Veteran Member

Date Joined Feb 2003
Total Posts : 5514
   Posted 2/2/2009 11:43 AM (GMT -6)   
Hi AnnieRae,
Do you have Lupus?  Any sulfa based drugs are not supposed to be prescribed for anyone with Lupus. We tend to have allergic reactions to it, and it can actually make our Lupus worse.  I have sulfa based drugs listed in my medical chart as an allergy.
For use in RA and inflammatory arthritis, I"m not sure if it can have the same negative effects. Hopefully someone here can have an answer for you on that.
If you do take it, I sure hope it helps your flare ups to calm down! 
I can do anything through Jesus Christ who strengthens me. I have learned in whatever state I am in,to be content. Phillipians 4:11-13

34 years old. Diagnosed with Lupus in 2000. Fibromyalgia, Anti-phospholipid syndrome(APS)(stroke, 2002), Sjogren's, Raynaud's, Libman Sach's Endocarditis, vasculitis, sacroiliitis, arthritis (neck), anxiety. Prednisone, Imuran, Coumadin, Clobazam, Amitriptyline, Didrocal, Cozaar, Zoloft, Neurontin, calcium, multi-vitamin, vitamin D, Magnesium, vitamin B6, Acidophilus
Moderator for the Lupus and Fibromyalgia forums

Regular Member

Date Joined Nov 2006
Total Posts : 76
   Posted 2/2/2009 3:10 PM (GMT -6)   
Thank you Fran and Ginny, my diagnosis with Lupus is not down on paper, but inflammatory arthritis, along with RA, both mild.  I'm going to call the office and ask about the drug induced Lupus and making things worse.  I appreciate your input.  Will let you know what happens.  Thanks again  AnnieRae

There Is Always Hope

Forum Moderator

Date Joined May 2005
Total Posts : 6947
   Posted 2/2/2009 5:35 PM (GMT -6)   
My sulfa reaction consisted of a rash of little red dots all over -- most visible on the white white of my belly. Some people also having itching with it. I had the sulfa reaction for at least 25 years before I had any signs of lupus.

As others have said, it very often accompanies lupus -- it'll be interesting to see if it accompanies drug-induced lupus or not!

Lynnwood, Co-Moderator: Lupus Forum
SLE(’00), Sjogren's Syndrome, Raynaud's Syndrome, Seasonal Affective Disorder, Depression, Herpes Simplex 1
Plaquenil, Prednisone(15 6mg), Piroxicam, Xanax, Trazodone, Boniva, Wellbutrin, Valtrex

Links: DIAGNOSING LUPUS (4 of 11), LUPUS INFORMATION, LUPUS RESOURCES, Donate to HealingWell, Drug Interactions

"Life is far too important to be taken seriously." –Oscar Wilde, 1982


Audrey Ann
Veteran Member

Date Joined Jul 2005
Total Posts : 815
   Posted 2/2/2009 10:56 PM (GMT -6)   
Greetings! I started taking asulfadine (sulphasalazine is the generic form) last month and I am just starting to notice the benefits. My RA is considered severe right now and my rheumy has explained to me that she is trying what she labled as "the triple threat" by adding the asulfadine to my plaquenil and arava. She has me on the brand name of this drug because she worries about the impact it may have on my stomach because I tend to get nauseated easily from my meds. The asulfadine is coated and the sulphasalzine is not coated. Although I have lupus, I do not have alergic reactions to sulpha drugs. According to the Lupus Foundation research that I found, about 30% of lupus patients are allergic to sulpha-based medications. Also, I have not heard of asulfadine causing drug-induced lupus but I would certainly want to rule that out if you suspect it might. Most of my research on asulfadine is that it slow to take effect. My rheumy says that is an annoying thing about asulfadine. She says it might take as much as six months to be fully effective. Her hope is that the asulfadine will help me taper completely off of my prednisone. I have been able to taper down to 5 mg but I have been on and off prednisone for over three years now. I hate prednisone (but love the fast pain relief - of course) and I will try anything my rheumy suggests to taper off the prednisone.

As for side-effects, I have not noticed any. My first week on the medication, I was told to take half of the dose so I would adjust to the medication. I believe there is concern that it can really cause upset stomach at first if taken at full dose right away. I basically stay out of the sun, but, like with all sulpha-based medications, they do tend to caution against sun exposure. I suspect it would increase sun sensitivity in most cases since it is sulpha-based.

Good luck to you, AnnieRae, and try to be patient. The asulfadine may take awhile to really kick in and help you!

Prayers to you - Audrey Ann
Audrey Ann
Lupus, RA, and (Maybe) Fibromyalgia and LOTS of Medications!


Regular Member

Date Joined Aug 2006
Total Posts : 142
   Posted 2/3/2009 4:36 PM (GMT -6)   
Hi Annie-
I have been on sulfasalazine for a few months now. It took a few weeks to notice a difference but I feel better. I was on celebrex before and my doc wouldnt increase my dosage but said to try this. It doesnt work as well as the Celebrex but differently. With the Celebrex my stiffness was almost completely gone, but after about 8 hours it wore off. So I would take it in the evening and wake up stiff again. The sulfasalazine I still have stiffness but to a lesser degree, but its all the time. So like before if it was at a 7 and I took the celebrex I would go down to a 1 or 0. With the sulfasalazine I am constantly at a 3 or 4. I hope that makes sense..... I also noticed that Tylenol doesnt work anymore. I think they work on the same enzymes, so you might need to try ibuprofen. Just thought I would mention that in case you take anything with acetaminophen in it (Vicodin, Percocet, Ultracet, etc.). If you are on a lower dose you might be ok. check too. It has first person reviews on drugs. I love it. I check everytime I get a new Rx. Although, some people are like " I took this 15 mins ago and my stomach hurts. Im never taking it again!" Ok maybe it was something you ate...... try it again before you blame the drug!
Anyhow so far as stopping the Plaquenil, my doc tried that too. I was miserable after stopping the Plaq. After about 2 weeks I started getting symtoms I forgot that I had! I also started getting rashes and pain in my hips that was terrible. And I felt like I could sleep 15 hours/day. I stopped for about a month, and couldnt take it anymore and put myself back on it. I guess it made me realize how much the Plaq does help!
I hope that you have good results with the sulfasalazine! I had no reactions from it. It actually made my stomach feel better. I have been on the Plaq for about 2 years and I still get stomach cramps and loose stools (sorry if that was TMI) from it. Usually when I miss a dose, and double up on it. Since I started the sulfasalazine I can take both pills at once with no problems. Hope that helps give you some insight! And definately check out that website, its very informative.
Dx: UCTD vs autoimmune spondyloarthropathy vs psoriatic arthritis (ie Limbo x5 yrs) Raynaud's, proteinuria
Rx: Plaquenil 400mg, Ultram PRN, Sulfasalazine 2 gram

Regular Member

Date Joined Nov 2006
Total Posts : 76
   Posted 2/5/2009 4:52 PM (GMT -6)   

Thank you Lynnwood, Audrey Ann, and Snickerdoodle (my favorite cookie).  I haven't been online for the past few days and noticed that you had all posted.  Thank you for the information. 

But honestly I do think I am becoming allergic to this drug.  I feel like I did when I was first diagnosed three years ago.  I am joint and muscle achey all over and feel like I have a slight fever. 

I don't know if taking this drug for a week can cause you to feel worse.  I have called the doctor to see what he wants me to do.  I was so hoping this would work for me.   I will let you know what he says.  Thank you again  AnnieRae

There Is Always Hope

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