In this drug factsheet:
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- abdominal or stomach pain or upset
- increased sensitivity of skin to sunlight
- loss of appetite
- nausea or vomiting
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- aching of joints
- bloody diarrhea
- bluish fingernails, lips, or skin
- headache (continuing)
- symptoms of anemia (such as weakness, paleness, and fatigue)
- symptoms of arthritis (such as joint pain, stiffness)
- symptoms of infection (such as fever, chills, or a general feeling of being ill)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- aching of joints and muscles
- back, leg, or stomach pain
- chest pain
- chills or sore throat
- difficulty swallowing
- pale skin
- redness, blistering, peeling, or loosening of skin
- skin rash
- symptoms of a severe allergic reaction such as:
- difficulty breathing
- swelling of the face or throat
- symptoms of liver impairment such as:
- loss of appetite
- unusual fatigue
- yellow eyes and skin
- symptoms of kidney problems (such as blood in the urine or very low urine volume)
- unusual bleeding or bruising
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergies: If you are allergic to furosemide, thiazide water pills, or carbonic anhydrase inhibitors you may also be allergic to this medication.
Asthma: If you have asthma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Blood disorders: If you have a blood disorder, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
You will probably need to have regular tests while taking this medication to make sure that the medication is not causing serious changes to the numbers of different blood cells produced by your body.
Blood tests: Sulfasalazine may affect the numbers of white blood cells (blood cells that fight infection), platelets (blood cells that help the blood clot), and your liver function. You will probably need to have regular blood tests while using this medication. Stop taking the medication and contact your doctor as soon as possible if you notice easy bleeding or bruising, as this may be a sign of low platelets in your blood.
Fertility: Infertility has been observed for some men treated with sulfasalazine. Stopping the medication appears to reverse these effects.
Glucose-6-phosphate dehydrogenase enzyme deficiency: People without the G6PD enzyme should discuss with their doctor how this medication may affect the dosing and effectiveness of this medication.
Kidney disease: If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. You will probably need to have regular tests while taking this medication to make sure that your kidneys are working properly.
Liver disease: If you have liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. You will probably need to have regular liver tests while taking this medication.
Staining: Sulfasalazine may produce an orange-yellow colour in the urine. Similar discoloration of the skin and yellow staining of soft contact lenses have occasionally been reported.
Tablets in stool: If you notice intact enteric-coated tablets in your stool, contact your doctor.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking sulfasalazine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: This medication is not recommended for children with juvenile rheumatoid arthritis.
What other drugs could interact with this medication?
There may be an interaction between sulfasalazine and any of the following:
- antidiabetes medications (e.g., chlorpropamide, glyburide)
- folic acid
- medications that increase sensitivity to the sun
- other salicylates (e.g., ASA, salsalate)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.