Sulfasalazine - Anyone had success with it?

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expecting226
Regular Member


Date Joined Jul 2007
Total Posts : 402
   Posted 6/21/2010 10:29 AM (GMT -7)   
Giving it a last ditch effort while going through the Remicade pre-approval and testing process and while simultaneously having a surgical consult for a j-pouch (trying to make a decision between Remicade or surgery)... and am going to start Sulfasalazine tomorrow.  My GI thinks it could work, and although it may be a long shot, why not give it a try while I pursue these other courses.
 
Have any of you had any success with it?  Side effects?  Issues?  I know it's an older drug and not really prescribed much anymore, so I'm not certain if I will get any responses to this.

Thanks in advance!
Current Medications:
- 6 mp (100 mg per day)
- Asacol (4 pills, 3x per day)
- Prednisone (40 mg)
- Rowasa (1 enema daily, as needed)
- Folic Acid (1 mg, 1x per day)
- Calcium (600 mg, 2x per day)
- Multi-Vitamin (1x per day)


seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 610
   Posted 6/21/2010 10:37 AM (GMT -7)   
It has worked very well for me, much better than Asacol.  I noticed an improvement within three days; I don't know whether it was the sulfasalazine kicking in or not taking Asacol any more.
 
Drink plenty of water and try to eat a little something with it if it upsets your stomach (or request enteric coated tabs).
 
I've had very few side effects.  My eyes and skin are a bit more photosensitive. 

wrxBRAH
Regular Member


Date Joined Mar 2008
Total Posts : 312
   Posted 6/21/2010 11:10 AM (GMT -7)   
I was put on Sulf + Pred at my initial diagnosis and had 1 year of remission where I only had to take Sulfa but during the next flare, it didnt work. Also Sulfa caused me nasty migraines every few months. I was eventually put on Asacol because my doctor told me it was the same thing as Sulfa without the toxic component which was causing my headaches. The cost of Asacol is pretty high though as well.
Male 30yrs old Bay Area, California

Currently taking:
Prednisone - 0mg <== ohhhh yea!!!!!!
Asacol - 4800mg
Remicade since Feb 2010


sirenshooter
Veteran Member


Date Joined Jun 2009
Total Posts : 2009
   Posted 6/21/2010 11:34 AM (GMT -7)   
I was wondering if like, say I can't get through this flare or something, if I could add sulfa in with my Imuran? My old doctors told me not to take Asacol and Imuran at the same time. So I wonder if sulfa would be safer? Just curious.
20yr old female diagnosed with UC in 2005 at age 15
Flaring (and away from home)
125mg Azathioprine 1xday
450mg Boswellia 1xday
Arthritis
Also: asthma, acid reflux, and Raynaud's Syndrome


chcl
Regular Member


Date Joined Jun 2010
Total Posts : 92
   Posted 6/21/2010 11:43 AM (GMT -7)   
Very odd that they said not taking Imuran and Asacol at the same time. My guess is that an absolute majority who uses Imuran is on a 5-asa at the same time. Did you have any odd reactions to the combination or bad blood values?
29 year old Swedish man, diagnosed 2003.

Colazal: 9 * 750mg
Remicade: 10 mg/kg every 8 week (just upped this last one due to heavy flare)
6mp: 100mg
Prednisone: 30mg - tapering 5mg every week.
Looking for good probiotic (more than what is avaliable in yoghurt form) in Sweden.

Flare almost completely gone after latest Prednisone/Remicade. Still some D but no urgency.


sirenshooter
Veteran Member


Date Joined Jun 2009
Total Posts : 2009
   Posted 6/21/2010 12:57 PM (GMT -7)   
No. They didn't say outright not to, but when I was afraid to go off my Asacol after getting on Imuran, they told me it could cause liver problems. Or maybe they were just trying to scare me off the Asacol lol
20yr old female diagnosed with UC in 2005 at age 15
Flaring (and away from home)
125mg Azathioprine 1xday
450mg Boswellia 1xday
Arthritis
Also: asthma, acid reflux, and Raynaud's Syndrome


sirenshooter
Veteran Member


Date Joined Jun 2009
Total Posts : 2009
   Posted 6/21/2010 12:58 PM (GMT -7)   
I was also thinking about adding sulfa if I need more meds because it's supposed to be good for arthritis.
20yr old female diagnosed with UC in 2005 at age 15
Flaring (and away from home)
125mg Azathioprine 1xday
450mg Boswellia 1xday
Arthritis
Also: asthma, acid reflux, and Raynaud's Syndrome


seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 610
   Posted 6/21/2010 2:34 PM (GMT -7)   

Sulfasalazine worked great for my joint pain, first time in many, many years the joint pain went away.  It took about two months to notice it.

For some reason, up until about a week ago, I had unremitting joint pain in my hands, hips, neck, and knees for about two months.  Then, it went away -- as usual with this stupid disease.  I've upped my dose of sulfa and I hope that did the trick for now.


s_morgana
Regular Member


Date Joined Jun 2010
Total Posts : 83
   Posted 6/21/2010 2:45 PM (GMT -7)   
sulfa definitely improved things for me. I'm in Australia and it is the first and so far only medication I am taking for this. The only side effect I noticed was orange urine which stopped after a while. I was told to take it with meals.
Diagnosed UC 2010 and mild reflux
gall bladder removed mid 2009
medication: sulfasalazine 500mg 4 pills daily
also on medication for longstanding depression/anxiety and asthma
almost 40


wrxBRAH
Regular Member


Date Joined Mar 2008
Total Posts : 312
   Posted 6/21/2010 2:52 PM (GMT -7)   
ElephantPipe said...
No. They didn't say outright not to, but when I was afraid to go off my Asacol after getting on Imuran, they told me it could cause liver problems. Or maybe they were just trying to scare me off the Asacol lol


I was on Asacol and Imuran for about a year. My doctor or pharmacist didnt warn me of any extra dangers regarding taking those meds. I was told that Imuran is an antisuppressant and so is pred so I should be careful as far as that goes but nothing else.

Also as another poster mentioned, your urine will be extremely yellow or orange while on sulf.
Male 30yrs old Bay Area, California

Currently taking:
Prednisone - 25mg (started flaring again)
Asacol - 4800mg
Remicade since Feb 2010


expecting226
Regular Member


Date Joined Jul 2007
Total Posts : 402
   Posted 6/21/2010 6:38 PM (GMT -7)   
Thanks for your help! My surgical consult is scheduled for August 2nd, so I am going to give this Sulfa a try while I wait and while I taper off the Prednisone since it is no longer helping. Keeping my fingers crossed.

Regarding the Asacol and Imuran/6mp at the same time... My GI said that the research has shown that with some people (*not all*), the Asacol can prevent the 6mp from being metabolized correctly. They actually think that is what happened with me, and why I had the serious side effects from the 6mp. Apparently, it's emerging research and it only applies to a certain subset of people.
Current Medications:
- 6 mp (100 mg per day)
- Asacol (4 pills, 3x per day)
- Prednisone (40 mg)
- Rowasa (1 enema daily, as needed)
- Folic Acid (1 mg, 1x per day)
- Calcium (600 mg, 2x per day)
- Multi-Vitamin (1x per day)


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5142
   Posted 6/21/2010 7:51 PM (GMT -7)   
Expecting, I know from past posts that some members do well on sulfasalazine-- Princesa & Munchkindd are among them, & also Jjic, as I recall. If you do go on it, try the enteric-coated tablets, drink plenty of water daily, and also ask your gastro to Rx a folic acid supplement-- because steady sulfa can interfere with the body's absorption of folic acid. I tried sulfasalazine early in my UC career, but got off it within a yr due to photosensitivity issues. Best wishes and please keep us posted as your time permits. / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)

Zippy123
Veteran Member


Date Joined Feb 2009
Total Posts : 735
   Posted 6/21/2010 9:22 PM (GMT -7)   
Asacol and Colazal just made things worse for me Sulfa seems to help I think.

quincy
Elite Member


Date Joined May 2003
Total Posts : 29945
   Posted 6/21/2010 9:31 PM (GMT -7)   
Zippy...you do realise that sulfasalazine does have mesalasine in it (same as asacol)? it's not the sulfa, per se, that helps the UC....Maybe it's a better delivery system for you, however...whereas the ASacol and Colazal aren't delivered as effectively?

q

CheesePuff
Regular Member


Date Joined Oct 2007
Total Posts : 92
   Posted 6/22/2010 1:37 AM (GMT -7)   

I have been on the sulfa for the past two months and it seems to be working for me. I have bene on Asacol since my initial diagnosis, but due to arthiritis my doc wanted me to try the sulfa based to help with the pain.

I'm on 6mp as well and seem to do quite well at the moment.


UC since 1995, PanColitis diagnosed May 2007
Multiple Gallstones
4 * 800mg Asacol
Imuran 100 mg
6mp 50mg a day
Salzopyrin 4*500mg - hopefully will help with my back!
Provisional Diagnosis of AS - Jan 2009
Baby Boy born in June 2009


quincy
Elite Member


Date Joined May 2003
Total Posts : 29945
   Posted 6/22/2010 7:00 AM (GMT -7)   
It's definitely an option and I recently read that the sulfasalazine is good for liver problems as well (forget what exactly, however). There are plusses to it for sure, unless the side effects get you...sigh.

q

expecting226
Regular Member


Date Joined Jul 2007
Total Posts : 402
   Posted 6/22/2010 10:25 AM (GMT -7)   
Well, I started the Sulfa today. We'll see! Keeping my fingers crossed.
Current Medications:
- 6 mp (100 mg per day)
- Asacol (4 pills, 3x per day)
- Prednisone (40 mg)
- Rowasa (1 enema daily, as needed)
- Folic Acid (1 mg, 1x per day)
- Calcium (600 mg, 2x per day)
- Multi-Vitamin (1x per day)


sirenshooter
Veteran Member


Date Joined Jun 2009
Total Posts : 2009
   Posted 6/22/2010 10:38 AM (GMT -7)   
Good luck!
20yr old female diagnosed with UC in 2005 at age 15
Flaring (and away from home)
125mg Azathioprine 1xday
450mg Boswellia 1xday
Arthritis
Also: asthma, acid reflux, and Raynaud's Syndrome


Malkavian
Veteran Member


Date Joined Mar 2009
Total Posts : 1439
   Posted 6/22/2010 5:44 PM (GMT -7)   
I have sulfa allergies so I can't take it. Wish I could though, it's much cheaper than lialda or asacol.
Heather, 22/Female/NJ
Ulcerative colitis from rectum to mid transverse colon, diagnosed 3/6/2009, symptoms for 2 years beforehand
Remission?!?!?!
Currently on lialda 4x/day, azithioprine 150 mg/day, calcium and d, B12. Enemas make things WORSE
Allergies: penicillin, sulfa, bee stings, environmental (especially ragweed!), OTC meds as needed


polishdan
Veteran Member


Date Joined Mar 2010
Total Posts : 1595
   Posted 6/22/2010 6:59 PM (GMT -7)   
expecting226

I was diagnosed with UC about 1974 at age 30. Prednisone and Sulfasalazine put it into remission. Took two Sulfa tabs twice a day for 30 years with no side effects. UC in total remission until about 2004 when I stopped drinking coffee. I had no idea that caffeine and nicotine help keep UC in remission. I have never smoked. Tried all the UC medications to no avail. In 2007 I had a total colectomy and ileostomy. Hope you have good results with Sulfasalazine.

Dan

munchkindd
Regular Member


Date Joined Oct 2007
Total Posts : 348
   Posted 6/24/2010 6:46 AM (GMT -7)   
Expecting......... I am one of the lucky ones that has had nothing but success with Azulfidine/Sulfasalazine.  I have had colitis since 1982.  This is really the only drug that works for me, and of course it doesn't hurt that it is so affordable.  Good luck, I hope it works for you.

*******Donna*******
 
South of Boston, Ma
 
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,  Omega 3, Probiotics, multi vitamin, calcium supplement, Biotin 5000mcg, Fibercon.
 


AZYooper
Veteran Member


Date Joined Mar 2010
Total Posts : 1180
   Posted 6/24/2010 9:22 AM (GMT -7)   
Interesting GUT article comparing Sulfasalzine and mesalamine drugs.

www.ncbi.nlm.nih.gov/pmc/articles/PMC1773399/
Diagnosed with proctosigmoiditis as my 50th birthday present Dec 2009
4.8 grams Asacol HD plus 1000mg canasa daily for 8 weeks

Now on 1.6 gr Asacol HD daily,fish oil, homemade yogurt(VSL#3/Mountain high cultures), pscillium husk,glucosamine sulfate,turmeric and Mutaflor(e. coli nissle).

Will begin fazing in boswellia,s. boulardii, and bromelain for both UC and/or back/joint inflammation soon.


quincy
Elite Member


Date Joined May 2003
Total Posts : 29945
   Posted 6/24/2010 9:32 AM (GMT -7)   
Yes, it is a good article, and although written in 2002, some doctors still aren't on the 5ASA band wagon.

Interesting about the 1g optimum dosage for rectal, but I dont see that it says to combine oral/rectal.

One most interesting point is the osalazine induced diarrhea for low limited UC...treats and helps stool consistency for easier exit.

q

songlady
Veteran Member


Date Joined Aug 2009
Total Posts : 3586
   Posted 6/24/2010 9:34 AM (GMT -7)   
Wow, what a great article! I am going to put it above in our article thread so we have ready access to it, OK?
I loved the statement, ostensibly backed by research, that the continual taking of 5-ASA meds decreases long-term cancer risk by 75%!!!!!!!!!
That's more than enough to keep me packin'my pills!
Co-Moderator, UC Forum
Age 54. Diagnosed UP 1983, UC 1986
Prednisone 2 years! 86-88
Now:Asacol - 16 pills/day, Rowasa 2x/week
Metamucil - 2 doses/day since '86
VSL#3DS, Multivitamin, Calcium and D
homemade yogurt each day
hip replacement 4/5/10
Son, 16, dx pancolitis 2007
Both in remission since April!


quincy
Elite Member


Date Joined May 2003
Total Posts : 29945
   Posted 6/24/2010 9:49 AM (GMT -7)   
[img]/community/emoticons/turn.gif[/img] Now there's a hopeful and optimistic statistic!!!!!
q
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