Azulfidine side effects

What side effects can Sulfasalazine have?

Below you will find the most important information about possible, known side effects of sulfasalazine.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).

Common side effects:
loss of appetite, abdominal pain, nausea and vomiting, bloating, diarrhea, itching, rashes, hives, generalized weakness, headache, fever, lack of white blood cells, anemia, enlargement of red blood cells (macrocytosis), elevated liver function tests .

Uncommon side effects:
depression, sleep disorders, psychosis, ringing in the ears (tinnitus), drowsiness, dizziness, blood pressure increases, asthma, tingling and “pins and needles” in the skin, agranulocytosis within the first three months after initiation of therapy.

Rare side effects:
nerve damage, meningitis, changes in blood cells during long-term treatment, pulmonary fibrosis, pneumonia, shortness of breath, coughing, pancreatitis, jaundice, cyanosis, Lyell Sydrom, Stevens-Johnson syndrome and other skin reactions, increased skin photosensitivity , joint pain, kidney problems, anaphylactic shock, angioedema, lupus erythematosus, taste and smell changes, hair loss.

Very rare side effects and individual cases:
pericarditis, exacerbation of a slowing disease nudge in ulcerative colitis, muscle pain, kidney inflammation


Special features:
The risk of occurrence of serious skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis is highest during the first weeks of treatment. If rash increases, often with blistering or accompanying mucosal wounds, therapy with sulfasalazine should be discontinued. The patient may never be treated with the drug again.

Sulphasalazine may cause folic acid deficiency, which may lead to blood disorders. Folic acid is a vital vitamin. Therefore, concomitant folic acid intake – especially before and during pregnancy – is recommended.

Sulphasalazine can reduce fertility in men without affecting sexual potency.

Some side effects such as nausea, vomiting, loss of appetite and headache are dose-related. They can often be avoided by a gradual dose at the start of treatment or by reducing the daily dose. You may also want to stop taking Sulfasalazine for some time.

If suppositories are taken in place of the tablets, irritation to the upper gastrointestinal tract is eliminated and the drug is less likely to enter the bloodstream. Nevertheless, it can also lead to side effects when using suppositories.

The urine may turn yellow. In very rare cases, it can also lead to a temporary, harmless yellowing of the skin.

What interactions does Sulfasalazine show?

Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).

Each antibiotic can cause a disturbance of the intestinal flora that sulfasalazine is not or only partially degraded by intestinal bacteria in its active ingredients. This has been proven so far for the antibiotics ampicillin, neomycin, rifampicin and ethambutol.

If iron sulfates are taken at the same time, the uptake of sulfasalazine in the intestine is inhibited.

Lipid-lowering drugs such as cholestipol and cholestyramine (against lipid metabolism disorders) bind sulfasalzin and its constituents in the intestine and thus reduce its effectiveness.

Sulfasalazine may inhibit the uptake of digoxin (in cardiac insufficiency), therefore, these two drugs should be taken with a time delay of two to three hours.

Taking sulfonylureas (in type 2 diabetes) may increase their blood sugar-lowering effect.

Potential Azulfidine side effects may include: