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Sulfasalazine side effects

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Ulcerative Colitis
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Sand&Sparrow
New Member
Joined : Jan 2021
Posts : 7
Posted 2/4/2021 3:50 PM (GMT -6)
My husband was newly diagnosed over 2 weeks ago and has been in a bad flare since last summer. The doctor initially gave him a prescription for melasamine. When we found out we couldn't afford $500+ a month and a week of back and forth with someone in his office, the doctor finally put him on 4000 mg. of sulfasalazine. After a couple days of taking it, my husband has horrible stomach pain and nausea. Another few days of back and forth with people at the doctor's office, they told my husband that since he didn't want to be on the more expensive mesalamine the doctor says he needs to take the sulfasalazine for at least another week. I realize many side effects can ease up a bit after a couple weeks, but I don't know how a med can stop being hard on your gut if your gut doesn't tolerate it. I had previously asked about some of the rectal foam and didn't get any answers. We are so frustrated with this doctor and clinic and feel ignored and like we are a problem to them. In the meantime my husband has horrible stomach pain besides all the normal UC flare symptoms. Can anyone speak to their experience in switching meds? Is this typical behavior for doctors to be so impersonal and intractable?
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Jane974
Regular Member
Joined : Feb 2017
Posts : 418
Posted 2/4/2021 4:13 PM (GMT -6)
Get a GI you are comfortable with. I switched a few times till I found someone who is on top of things and responsive.

Regarding meds, you need to stay on it usually for some time to get the benefits and side effects can reduce. He can try a lower dose if that may ease for a bit. Rectal meds are important to get on as well and work very effectively with oral meds.

If sulfasalazine doesn't work, he can try balsalazide (cheap generic). It may have fewer side effects for him.
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Old Hat
Veteran Member
Joined : Feb 2007
Posts : 5709
Posted 2/4/2021 10:03 PM (GMT -6)
There is an enteric-coated tablet form of sulfasalazine that might help your husband to avoid stomach pain. I took that decades back and was spared stomach discomfort, but found that med irritating to my eyes, and it is known to increase photosensitivity, especially in midday glare outdoors. One needs to drink a lot of water while taking sulfasalazine to mitigate side effects.*** Did you check the Rx drug formulary of your husband's health insurance plan to see if it covers other forms of mesalamine? Some plans will cover at least part of the cost for Asacol-Delzicol or Lialda, if he has pan-colitis. For left-sided UC, check on coverage for Balsalazide (generic of Colazal), and also for coverage of generic mesalamine enemas that treat sigmoid, rectum-anal canal regions of colon. *** Depending on your location & health insurance network, try to link up with a medical center that has gastroenterologists treating IBD. Some of them might accept your insurance. You could also check Website ccfa.org for such physicians in your area. / Old Hat (40 yrs with left-sided UC; in remission taking Colazal)
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Sand&Sparrow
New Member
Joined : Jan 2021
Posts : 7
Posted 2/5/2021 9:14 AM (GMT -6)
The doctor didn't tell my husband what type of UC he has specifically but the biopsies taken showed moderate inflammation in the sigmoid colon and the ascending colon. Duodenum biopsy tissue was not inflamed. It feels like learning a whole new language and the doctor is not a great resource. He just said that my husband needs to be on medication for the rest of his life and prescribed him something and said call me in 3 or 4 weeks. We were left to look at his test results and figure it out on our own.
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 1482
Posted 2/5/2021 9:31 AM (GMT -6)
I second getting a new GI.
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Old Hat
Veteran Member
Joined : Feb 2007
Posts : 5709
Posted 2/5/2021 2:01 PM (GMT -6)
Did the doctor scope terminal ileum? Inflammation there is indicative of Crohn's disease. The usual inflammatory pattern for UC is contiguous= no breaks of healthy tissue between inflamed sections, except for a known variant involving the cecal patch + lower left colon, not too common but a few members posting on this forum have experienced it. Your husband definitely needs a gastroenterologist with experience treating IBD who is willing to follow up on his case. Additionally, you need to inform yourselves about prescription coverage/out-of-pocket costs. Sulfasalazine will be pushed at you as THE cheapest med, but its sulfa component makes it unsuitable for many UCers due to side effects. / Old Hat
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