Sulfasalazine - anti-inflammatory drug used to treat relapses of ulcerative colitis, rheumatoid arthritis and Crohn's disease.
Sulfasalazine drug released as a yellow-brown film-coated tablets containing 500 mg of active substance of the same name (azo sulfapyridine salicylic acid). 10 pieces per pack.
Analogues of sulfasalazine
To closest analogues of sulfasalazine mode of action include drugs in the dosage form of tablets: Asacol, Mesakol, Samezil, Mezavant, Salofalk, Mesalazin, Pentas and Kansalazin.
Moreover, sulfasalazine analogs produced in other dosage forms. These include:
- Rectal suspension - salofalk, Samezil;
- Rectal suppositories - Pentas;
- Oral suspension - salazopiridazina;
- Foam rectal dosage - Salofalk.
Mode of action of sulfasalazine
Active ingredient Sulfasalazine has both anti-inflammatory and antimicrobial activity against pathogens of intestinal diseases.
The use of sulfasalazine when treating nonspecific colitis effectively due to the ability of the active ingredient of the drug selectively accumulates in the tissues of the intestinal walls and release acids which have anti-inflammatory activity and have antimicrobial activity against Streptococcus spp., Including Neisseria gonorrhoeae, Streptococcus pneumoniae and Escherichia coli.
According to the instructions of sulfasalazine is prescribed for the treatment of:
- Relapses of ulcerative colitis, as well as maintenance therapy in remission;
- Rheumatoid arthritis and juvenile rheumatoid arthritis in cases where standard therapy with nonsteroidal anti-inflammatory drugs proved ineffective;
- Crohn's disease is mild and moderate forms of exacerbation.
The use of sulfasalazine is contraindicated in the following cases:
- When aplastic anemia;
- In hepatic and renal failure;
- In congenital deficiency of glucose-6-phosphate dehydrogenase;
- During the period of lactation;
- When Porfirio;
- At the age of 5;
- When bowel obstruction or urinary tract;
- When granulocytopenia;
- If hypersensitivity to the active or auxiliary components sulfasalazine.
In addition, sulfasalazine for reviews should be taken with caution in:
- Atopic dermatitis;
- Bronchial asthma;
- Allergic reactions to sulfonamide derivatives in history;
- Systemic form of juvenile rheumatoid arthritis (due to the increased risk of serum sickness).
Sulfasalazine according to the instructions recommended to take after a meal.
Adults and children from 16 years in the treatment of ulcerative colitis and Crohn's disease:
- On the first day of treatment take one tablet sulfasalazine 4 times a day;
- On the second day - increase the dosage twice;
- In the third and subsequent days - 3-4 tablet 4 times a day.
Supportive therapy with sulfasalazine administered after reduction of acute clinical symptoms in a dose of 2 g, divided into four portions, lasting at least several months.
The maximum daily dose of sulfasalazine for adults is 16 tablets per day for children up to 16 years - 2 grams per day.
In the treatment of juvenile rheumatoid arthritis and rheumatoid arthritis in adults and children of 16 years prescribed:
- During the first week - one tablet once per day;
- During the second week - 1 tablet twice a day;
- During the third week - one tablet three times a day.
By this scheme gradually over 5-6 weeks of therapy, the dose received was adjusted to 1, 5-3 grams per day. As a rule, stable clinical effect appears within a few months. The average duration of treatment - from six months.
Sulfasalazine dosage for children is calculated physician, and depends upon the age and body weight, but the daily dose should not exceed 40-50 mg / kg body weight, or 2 grams of the drug.
Side effects of sulfasalazine
Review sulfasalazine can cause disorders of the various organ systems:
- Urogenital - haematuria, proteinuria, nephrotic syndrome, crystalluria;
- The nervous system - peripheral neuropathy, headache, aseptic meningitis, hallucinations, dizziness, insomnia, seizures, depression, ataxia;
- Respiratory system - infiltration in the lung tissue, dyspnea, interstitial fibrosing alveolitis, pneumonia, cough;
- Digestive system - pancreatitis, vomiting, drug-induced hepatitis, nausea, abdominal pain, diarrhea, stomatitis, decreased appetite.
Violations by the side of blood when taking sulfasalazine for reviews often manifested as leukopenia, macrocytosis, megaloblastic anemia, neutropenia, aplastic, hemolytic and hemolytic anemia, agranulocytosis, methemoglobinemia, hypoprothrombinemia, thrombocytopenia.
The most common allergic reactions when using sulfasalazine are:
- Generalized skin rash;
- Exfoliative dermatitis;
- Malignant erythema;
- Toxic epidermal necrolysis (Lyell's syndrome);
- Periorbital edema;
- Serum sickness;
- Periarteritis nodosa;
In addition, sulfasalazine Review may lead to the development of mumps, tinnitus, hyperthermia and hyperbilirubinemia.
Taking large doses Sulfasalazine usually leads to overdose, which is expressed in the form of digestive disorders (nausea, vomiting, abdominal pain), and dizziness. The use of sulfasalazine in very high doses often cause crystalluria, anuria, convulsions and hematuria.
The simultaneous use of sulfasalazine with anticoagulants, antiepileptic and oral hypoglycemic drugs increases the effect of the latter.
The risk of developing myelosuppression is increased by simultaneous use of drugs that suppress bone marrow hemopoiesis.
Increased severity of side effects possible with the combined use of sulfasalazine with cytostatics, immunosuppressive and nephrotoxic drugs.
The effectiveness of sulfasalazine in the treatment of ulcerative colitis reduce antimicrobial drugs, due to the dampening effect on the intestinal microflora.
Sulfasalazine according to the instructions available on medical prescription. Shelf life at temperature conditions (25 ° C) shall not exceed five years.