I would definitely ask your Doc about
the folic acid. You should also tell him about
the Iron supplements you are taking, if you haven't already. I believe Iron can decrease the absorption of Azulfadine. Perhaps you may want to look this up. This is what I have read: the site is: http://www.peacehealth.org/kbase/cam/hn-1504003.htm
Sulfasalazine decreases the absorption of folic acid.1 Biochemical evidence of depletion of folic acid has been reported in people taking this drug,2 although available evidence remains mixed.3, 4
Folic acid is needed for the normal healthy replication of cells. Perhaps as a result, there is evidence that folic acid can reverse precancerous changes in humans.5 Ulcerative colitis, a disease commonly treated with sulfasalazine, is associated with an increased risk of colon cancer. Folate deficiency has also been linked to an increased risk for colon cancer.6 It is plausible that some of the increased risk for colon cancer in people with ulcerative colitis may be related to folate depletion caused by sulfasalazine.
Folic acid supplementation may help protect against colon cancer.7 One study found that people who have ulcerative colitis and who supplement with folic acid have a 55% lower risk of getting colon cancer, compared with ulcerative colitis patients who do not supplement with folic acid (although this dramatic association with protection did not quite reach statistical significance).8 Researchers at the University of Chicago Medical Center reported a 62% lower risk of colon cancer in folic acid supplementers.9 They suggested that the link between folic acid supplementation and protection from colon cancer may well be due to overcoming the folic acid deficiency induced by sulfasalazine.
Many doctors believe that it is important for all people taking sulfasalazine to supplement with folic acid. Folic acid in the amount of 800 mcg can be found in many multivitamins and B-complex vitamins. People wishing to supplement with more-typically 1,000 mcg per day-should consult their doctor.
Iron can bind with sulfasalazine, decreasing sulfasalazine absorption and possibly decreasing iron absorption.10 This interaction can be minimized by taking iron-containing products two hours before or after sulfasalazine.
Hope this helps.....
diagnosed with uc 27 years ago. Enojoyed 20 year remission with just minor blips here and there (approximately 16 of those years without any meds)
In a flare for 2 very long years which Asacol didn't help at all. Finally in remission again since Jan 2008, can't believe it..............
currently on Sulfasalazine 2 tabs 3x day. Folic acid, mesalamine enema 2 x a week. Omega 3, Probiotics, multi vitamin, cacium supplement, Biotin....