User:Mr. Ibrahem/Sulfasalazine

Sulfasalazine (SSZ), sold under the trade name Azulfidine among others, is a medication used to treat rheumatoid arthritis, ulcerative colitis, and Crohn's disease. It is considered by some to be a first line treatment in rheumatoid arthritis. For ulcerative colitis, it is largely considered after mesalazine. It is taken by mouth.

Significant side effects occur in about 25% of people. Commonly these include loss of appetite, nausea, headache, and rash. Severe side effects include bone marrow suppression, liver problems, Stevens–Johnson syndrome, and kidney problems. It can stain body fluids and contact lenses yellow. It should not be used in people allergic to aspirin or sulfonamides. Use during pregnancy appears to be safe for the baby; though folic acid supplements are needed.

Sulfasalazine is in the disease-modifying antirheumatic drugs (DMARDs) family of medications. It is unclear exactly how it works. One proposed mechanism is the inhibition of prostaglandins, resulting in local anti-inflammatory effects in the colon. The medication is broken down in the colon by intestinal bacteria into 5-aminosalicylic acid, the active ingredient, and sulfapyridine, which is largely responsible for its side effects. Of the 10-20% that is absorbed, some is excreted by the kidneys and in the bile.

Sulfasalazine was approved for medical use in the United States in 1950. It is on the World Health Organization's List of Essential Medicines. Sulfasalazine is available as a generic medication and is cost effective with respect to inflammatory bowel disease as of 2017. Sulfadiazine is different and has in the past been prescribed in error.