Sulfasalazine Arthritis Medication

What is it?

Sulfasalazine 500 mg size tabletsSulfasalazine is a Disease Modifying Anti Rheumatic Drug (DMARD). Originally used as a treatment for ulcerative colitis and other inflammatory bowel conditions. It was noted to
have the same inflammation reducing effect on inflammatory arthritis.

FDA approved:

June 1950

Average annual

$186.15 – 500mg 4 per day

Brand Names and International Availability:

Azaline (US);
Azulfidine (US);

How does it work?


It is not known exactly how sulfasalazine works in inflammatory arthritis. It appears to have a strong anti-inflammatory effect and also has immune suppressant actions.

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Sulfasalazine normally comes in 500mg tablets. Average maintenance dose is 2g (4 tablets) daily, although higher doses are not uncommon.

How should I take it?

Take sulfasalazine as ordered, usually with a full glass of water. If stomach upset occurs,
take after meals.



Do not take if you have a known sulfa drug allergy. Sulfasalazine should be avoided in pregnant and nursing mothers. Sulfasalazine should not be used in children under the age of two.

Drug Interactions:


Sulfasalazine may decrease the absorption of digoxin. Because of the potent nature of this medicine, be sure to tell your doctor about any other medicines you are taking, including nonprescription medicines and vitamins.

Possible side effects:


These side effects are not considered serious but are certainly annoying for those experiencing them. The most frequently reported side effects include fatigue, nausea, headache, dizziness, diarrhea, increased sensitivity to the sun, loss of appetite and orange/yellow skin or urine.

More serious side effects that you should report right away include itchy rash, sore throat, fever, blisters, reduced urine output, stomach cramps, unusual bleeding or bruising, bloody stools.

Sulfasalazine has the potential to cause kidney and liver problems and severe anemia.

Signs of a possible allergic reaction are rash, swelling and difficulty breathing. These symptoms should be reported immediately.


Precautions & Special Notes:


Due to the potential for sun sensitivity exposure to direct sunlight should be avoided. If you are in the sun please wear protective clothing and strong sun block.

You will be required to have frequent blood work while on this medication. It is very important that you keep all lab and doctors appointments.

Sulfasalazine can cause a decrease in male sperm count. This is usually reversible once
the drug is discontinued.

For more information:

Info Net Sulfasalzine

References: Mosby’s GenRx, 10th ed. Copyright  2000 Mosby, Inc. Complete Guide to Prescription and Nonprescription Drugs, H.
Winter Griffith, M.D. ,Copyright