Sulfasalazine
- Atc Codes:A07EC01
- CAS Codes:599-79-1
- PHARMGKB ID:599-79-1
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Salazopyrin, Sulfasalazin; Belgium: Salazopyrine; Bulgaria: Salazopyrin, Sulsalazin; Czech Republic: Salazopyrin, Sulfasalazin; Denmark: Salazopyrin, Sulfasalazin; Estonia: Salazopyrin; Finland: Salazopyrin, Sulfasalzin; France: Salazopyrine, Sulfasalazin; Germany: Azulfidine, Colo-Pleon, Pleon RA, Salazopyrin, Salazopyrine; Greece: Salopyrine; Hungary: Salazopyrin; Ireland: Salazopyrin, Salazopyrine; Italy: Salazopyrin; Latvia: Salazopyrin, Sulfasalazin; Lithuania: Salazopyrin, Sulfasalazin; Luxembourg: Salazopyrine; Malta: Salazopyrin, Sulfasalazin; Netherlands: Sulfasalazyne; Poland: Salazopyrin, Sulfasalazin; Portugal: Salazopirina; Romania: Salacidin, Salazopyrin, Sulfasalazin; Slovakia: Sulfasalazin; Slovenia: Sulfasalazin; Spain: Salazopyrina; Sweden: Salazopyrin, Sulfasalazin; UK: Salazopyrin, Sulfasalazine.
North America
Canada: Salazopyrin, Sulfasalazine; USA: Azulfidine, Sulfasalazine.
Latin America
Argentina: Azulfidine, Flogostop-Ivax; Brazil: Azulfin; Mexico: Azulfidina.
Asia
Japan: Asasurfan, Azulfidine, Eminapyrin, Lanofen, Safildine-EN, Salazopyrin, Slama, Soaresin.
Drug combinations
Chemistry
Sulfasalazine: C~18~H~14~N~4~O~5~S. Mw: 398.39. (1) Benzoic acid, 2-hydroxy-5-[[4-[(2-pyridinylamino)sulfonyl]phenyl]azo]-; (2) 5-[[p-(2-Pyridylsulfamoyl)phenyl]azo]salicylic acid. CAS-599-79-1 (1975).
Pharmacologic Category
Antibacterials; Sulfonamides. Gastrointestinal Drugs; Anti-inflammatory Agents. Biologic Response Modifiers. Disease-modifying Antirheumatic Drugs. 5-Aminosalicylic Acid Derivative. (ATC-Code: A07EC01).
Mechanism of action
May serve as a vehicle to deliver sulfapyridine and 5-aminosalicylic acid (5-ASA)(mesalamine) to colon in higher concentrations than can be achieved by oral administration of these metabolites alone. Therapeutic effect may result from antibacterial action of sulfapyridine and/or topical anti-inflammatory action of 5-ASA and interfering with secretion by inhibiting prostaglandin synthesis.
Therapeutic use
Ulcerative colitis. Rheumatoid arthritis in patients who respond inadequately to analgesics and NSAIDs.
Pregnancy and lactiation implications
Enters breast milk (use with caution in nursing women). Sulfonamides are excreted in human breast milk and may cause kernicterus in newborn.
Unlabeled use
Ankylosing spondylitis. Collagenous colitis. Crohn’s disease. Psoriasis. Psoriatic arthritis. Juvenile chronic arthritis.
Contraindications
Hypersensitivity to sulfasalazine, its metabolites, sulfonamides, or salicylates. Intestinal or urinary tract obstruction. Porphyria. Pregnancy.
Warnings and precautions
Deaths from irreversible neuromuscular and CNS effects reported. Deaths from fibrosing alveolitis reported. May cause folate deficiency (consider providing 1 mg/day folate supplement). In males, oligospermia (rare) reported. Chemical similarities are present among sulfonamides, sulfonylureas, carbonic anhydrase inhibitors, thiazides, and loop diuretics (except ethacrynic acid). Risk of cross-reaction exists in allergy to any of these compounds (avoid use when previous reaction severe). Use with caution in severe allergies or asthma, in blood dyscrasias (deaths from agranulocytosis, aplastic anemia, and other blood dyscrasias reported), in G6PD deficiency, in impaired hepatic/renal function, and in urinary obstruction.