Kickas.org Forums Treatments, Drugs and Alternatives NSD and diet-related; sulfasalzine

I had a very mild flare recently and took some sulfasalazine to make sure it didn't turn into something more nasty. In order to get the prescription for it, I had to go and see my Doctor (a nice enough fellow, but not exactly at the cutting edge of medicine). He said that sulfasalzine was an aspirin derivative - is that true? And further to that, is anyone aware of any negative effects of sulfasalzine? Is it best to avoid it if possible, or do you think I am right to take it at the first signs of trouble? If it is an aspirin derivative, doesn't it follow that it may have some aggressive effects on the gut?

I really don't need to take it, but use it more as an insurance policy, so I would be quite happy to never take it again if needs be.

Charlie

Hi, Charlie:

Yes, SSZ is an aspirin derivative, but it has two components that it breaks into: The 5-ASA is aspirin (acetalsalicylic acid), but a very mild one when broken down from the SSZ. Next is the sulfa radical that acts as an antibiotic.

If you got the enteric-coated SSZ (salazopyrin-EN), you should have little problem with the aspirin portion and the EN variety is many times more effective than the non-coated.

Best Regards,
John

Hi Charlie,

Side effects... folic acid defeciency (so supplement), possible nausea and elevated liver enzymes (which is what I eventually experienced).

Have you trialed any alternatives? MSM, rutin (others seem to have good results with rutin), ginger root (I have good results with ginger root).

Just a thought.

Tim

Our greatest glory is not in never falling, but in rising every time we fall - Confucius

Hi Charlie,

I think the 2 things that you should get regular blood tests for on SSZ are for liver enzymes and WBC. I have been taking it for 4 months now. So far liver enzymes are fine but I noticed my WBC count is down to 3.5. I will talk to my Dr and see if this is significant or not. I know it is a little low. Are you planning on going on it long term? If so be sure to get regular blood work done.

Deborah

Deborah,

I won't take it long term, just if I feel a bit achey. What is WBC?
Thanks,
Charlie

Hi Charlie,

WBC is white blood cell count. It can go quite low on sulfasalazine and a reason to stop taking it I believe. Not positive though and will have to go talk to my dr about it and find out how low it has to go before going off it.

Deborah

Hi Charlie ,I take sulphasalazine and no other medication and I have lowered the dose to 1gram am and the same at night .The drug is seems to be used more for people with crohns ( no surprise there then) so i would think as John suggests that the aspirin part of the drug is pretty harmless, as you would expect, if it is being used to treat guts with lesions.The old story with me is too much alcohol and too much food and I go bad.To eat little and often is the key for me as I'm sure you know well enough now .It's almost a monks story .All the best ,Tim. ps. I take Rutin,flax oil and lipoic acid supplements as well as ...........endless list .

Hi Charlie!

I was on Sulfasalazine once....... made me so ill I had to continue that also . However, my Rheumy told me that it took a while to work, so I am not sure if this drug is the one to use for the occasional flare. You might want to find something a little more fast acting.

My doc just gave me Bextra to use for the occasional flare. They are supposed to me very mild on the stomach (hold on a mo!.... didn't he say that same thing for the last three or four different ones I tried? ) but fast acting. The sulfasalazine has to build up in your system before you see any improvement in your condition I beleieve.

Let us know how it goes.

Maxine

May the roof above us never fall in, and the many friends gathered below it never fall out.

I agree with Maxine. I heard it took a while to work and not something that if you take one or two you will feel it within and hour.

My Rheumy said Sulfasalazine was a really potent anti-inflammatory. I am on the maximum dosage right now. I have to get my blood drawn every 6 weeks. I believe he said it could cause the lining of my stomach to bleed (among other things)...

Sulfasalazine really helped me a lot but I finally stopped taking it because it gave me macrocytic anemia and made me very fatigued. I was taking folic acid too, but I still had the anemia.

My doctor had me start it gradually, first 1 pill twice daily for a few weeks, then 2 pills 2 times a day, then 2 pills 3x a day. I had no trouble tolerating it and the mild anti-inflammatory was great for me. The only issue was the anemia.

He did a CBC panel on me every 4 months, that's how I knew I was getting anemic.