Sulfasalazine anyone??

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Regular Member

Date Joined Jul 2007
Total Posts : 60
   Posted 10/13/2007 10:50 AM (GMT -7)   
Just given this by GI for arthritis pain related to CD.  Anyone else have experience with this med?
32 yrs old - dx'd w/ Mild CD in 2004 after 5 yrs of IBS (I swear it's from food poisening - bad fish from McD's) 2 fistulas (1 recto-vag).  Asacol for a while at first - now on Flagyl and sulfasalazine, Activia w/ diet control and pain meds for really bad days. Getting ready for Had seton placement and partly successful fistulotomy.  Officially dx'd w/ peri-anal Crohn's. 

Regular Member

Date Joined Aug 2007
Total Posts : 65
   Posted 10/13/2007 6:43 PM (GMT -7)   

This was one of the first meds I was put on for my Crohn's way back when I was diagnosed (about 11 years ago). My Crohn's is severe, and this drug is only a mild anti-inflammatory agent, so I was on it for about a year before we realized it wasn't helping at all. If your arthritis is not too bad, sulfasalazine (aka azulfidine) may help.

What I recall: the pills were round, pretty big and not coated. That made them hard to swallow. Also, you usually have to take a lot of them (between 4-10) each day. Lastly, since they are yellow, they can turn your urine very bright yellow. I have also heard that it can cause your sweat to turn a bit yellow, staining your clothes (just areas of heavy sweating, like pits), and even stain soft contact lenses after awhile...! For me, the urine was the only thing I noticed (not a big deal). I had no other side effects at all.

One last thing, my doctor mentioned that this drug can (but does not always) cause temporary infertility in women (I was 16 at the time and that really didn't matter to me), but your fertility returns to normal shortly after stopping the drug. Just wanted to let you know in case that would matter for you.

Hope it works for you!! :-) :-)

Veteran Member

Date Joined Oct 2004
Total Posts : 3932
   Posted 10/13/2007 8:11 PM (GMT -7)   
I'll never touch the stuff again! I got the usual side effects & then had some kind of seizure after 2-3 weeks on it. The sulfa in it, I have compatability issues. so do many people unfortunately.


Regular Member

Date Joined May 2006
Total Posts : 260
   Posted 10/13/2007 11:09 PM (GMT -7)   
I'm from the UC board, but took sufasalazine nonetheless for that condition.  Personally, it tore me up.  Made the restroom visits dramatically more frequent at the time I was taking them (from an already high 20 a day to 30..40?).  I was even unable to make it to the restroom in time, even though I was never more then 20 feet from it.  I obviously quit the drug after a couple days and everthing went back to 'normal'...or the way it was before I started it.  Now on Asacol, never going back to Sulfa again.

---Nathan---  31 yr old male
Diagnosed May 2006 w/severe UC
Currently in mild/moderate flare
2 400mg Asacol 4X day
20 mg Prednisone
1 multivitamin/day
2 grams calcium/day
75mg Imuran/day
100mg Tramadol/day for abdominal pain (as needed)
1 Fioricet ever 4 hrs as needed for severe migraines

Veteran Member

Date Joined Sep 2005
Total Posts : 769
   Posted 10/15/2007 12:57 AM (GMT -7)   
it can also makes you burn more easily in the sun, something that might be useful to remember

Veteran Member

Date Joined Jan 2005
Total Posts : 1831
   Posted 10/15/2007 3:57 AM (GMT -7)   
I'm currently on this med as it's the only one that is really affective for me. I was on it first in 1982 after my initial diagnosis. I've never had any side effects other than it turns my urine a darker yellow.

As with any med, there are those people who don't tolerate it well. You do need to remember to drink the recommended amount of water per day.

Consideringabag --- you just taught me something! I was never told about the possibility of this med causing infertility. Makes sense now why I had such a hard time getting pregnant all those years ago.


Veteran Member

Date Joined Apr 2006
Total Posts : 1885
   Posted 10/15/2007 5:35 PM (GMT -7)   
This med is the precursor to the 5-ASA meds like Pentasa and Asacol. The latter two are supposedly easier to tolerate, but to this day some people still question whether they are as effective as sulfasalazine. Dr. Present at Mt Sinai was a pioneer using this med, and the following paragraph is taken from a 1984 discussion, so I don't know whether it is out of date with the dosage guidelines:
"In mild to moderate cases of Crohn's disease, sulfasalazine therapy should be instituted gradually, initially 1 to 2 tablets (500 mg) daily and increased by 500 mg doses to 2 to 4 g daily. Sulfasalazine should be administered in four divided doses, with meals and with a light snack at night. Although there are numerous clinicians who advise dosages up to 12 g each day, I have found that the evidence of side-effects precludes this level of medication in most patients."

Elite Member

Date Joined Apr 2005
Total Posts : 14995
   Posted 10/15/2007 5:43 PM (GMT -7)   
I used this med successfully when first diagnosed back some 32 years ago. I can't use it now because 1) I am allergic to sulfa drugs now, and 2) It gives me bad headaches now. My Rheumy wanted me to try it for my inflammatory arthritis but told her nope, I'm allergic.
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.

Veteran Member

Date Joined Jan 2003
Total Posts : 6131
   Posted 10/15/2007 8:17 PM (GMT -7)   
my first drug. back in 84. was sensitive to it. had rash and corneal ulcerations. never took it again.

Veteran Member

Date Joined Mar 2007
Total Posts : 900
   Posted 10/16/2007 12:11 AM (GMT -7)   
I have been on Sulfasalazine 500mgs qid for years now. It does give me bad headaches if I don't take it with food and drink enough fluids in the day. I have found that the side effects were only mild, turns my urine darker yellow, and some overall itching, but again that all depends on how much water I drink. I find that this med helps both with the CD and the arthritis. It hasn't made me completely symptom free but I am maintained adequately enough.
The other thing to remember about sulfasalazine is that it is broken down or excreted through the liver....all the more reason to drink enough therefore makes taking over the counter pain meds like tylenol more of a risk. Tylenol can "build up " in your liver if taken too frequently and combined with the sulfasalazine can lead to toxicity.
My tablets are big and yellow, enteric coated so are easy to swallow. If I do forget to take a bit of food with it, then I do get a headache and a tummy ache.
I have tried going without the medication from time to time but can't seem to last more than a 3-4 days before I end up in another flare.
Hope this info helps a little....everyone is different and not all meds work for is a trial and error kind of thing....I've opted to stay with this med altho I'm not all that crazy about it and althoug I still get bad abd. pains if I eat the wrong thing...but I don't want to go on the "bigger guns" if I can help it.
Good luck
50 yr.old retired RN,Crohn's D for last35 yrs..severe esophagitis, migraines,strictures,urethral stricture,depression,probable MS.

New Member

Date Joined Nov 2007
Total Posts : 11
   Posted 11/9/2007 6:30 AM (GMT -7)   
Hello every one, I am new to this site and have already realized the wealth of knowledge you all possess.  I was diagnosed with CD in May of this year and have begun experiencing inflammatory arthritis in my fingers, toes, and SI joint.  My Rheumy has just started me on Sulfasalazine for the arthritis.  I am currently taking Pentasa for the CD and am also on Zoloft and Trazodone for other issues.  I was wondering if any of you have experienced a fluttering fast paced heart beat.  I was at a friends birthday party the other day and was standing for most of it.  I then grew tired and decided to lean against the wall in a squatting position.  After about 2 minutes of doing that, I felt my heart begin to race.  Luckly for me, one of the ladies there was a nurse and took my pulse immediately.  It was at 160 beats/min!  I am usually at about 65 or 70, am a healthy 27-year-old, am a normal weight size and height for my age and do not have a family history of heart disease.  I had just started my Sulfasalazine routine the day before and was wondering if this could be a side effect.  Has anyone heard of or had this happen to them?  It only happened that one time, but I am worried about it happening again.  Please enlighten me with any knowledge you may have.  Thanks so much!
Dx'd in May 2007 with CD.  Also have inflammatory arthritis in fingers and toes and SI joint.  1 Fissure.  Rx'd Pentasa (4g), Sulfasalazine (2g), also on Zoloft (75mg) for depression and Trazadone (200mg) as a sleep aid.  Rheumy considering putting me on Remicade in January 2008. 

Regular Member

Date Joined Oct 2007
Total Posts : 82
   Posted 11/9/2007 10:25 AM (GMT -7)   
I don't know about the rapid heart beat side affect...?  Like others who have posted here, I was given Sulfasalazine about 20 years ago and got extremely nauseous, threw up, abdominal pain, burning, etc....felt horrible.  Gave up on it after 2 days.  A few months later, another doctor gave me Dipentum and it worked fine.   I've also been on Asacol, and now Colozal.  I will never take the old sulfa drug again....uugghhh.
DX: mild to moderate Crohn's for 34 years
Additional benefits: chronic anemia, B12 deficient, peripheral neuropathy, facial mylagsia, joint pain, underactive thyriod
Current meds: Colozal, Nexium, Entocort, Flagyl, steriod cream, monthly B12 injections, Neurontin, Synthroid, Effexor ER, pain meds as needed

New Member

Date Joined Nov 2007
Total Posts : 11
   Posted 11/9/2007 12:31 PM (GMT -7)   

Hey Clcaj,

Thanks for the response.  I called my Rheumatologist and it turns out that it was a combination of taking psudophedrine, having low blood sugar (from no appetite), and the position I was squatting in (raised my blood pressure too fast).  I am glad it is not a reaction to the Sulfasalazine thus far, but I have only been taking it for a few days now.  We will have to wait and see if the benefits outweight the side-effects for me.  Thanks again.... :-)



Dx'd in May 2007 with CD.  Also have inflammatory arthritis in fingers and toes and SI joint.  1 Fissure.  Rx'd Pentasa (4g), Sulfasalazine (2g), also on Zoloft (75mg) for depression and Trazadone (200mg) as a sleep aid.  Rheumy considering putting me on Remicade in January 2008. 

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