Sulfasalazine for ankylosing spondylitis

Examples

Generic Name	Brand Name
sulfasalazine	Azulfidine, Azulfidine EN-tabs,

Sulfasalazine is a medicine made from salicylic acid—the same active ingredient found in aspirin—plus an antibiotic called sulfapyridine. The medicine comes in time-release tablets taken by mouth.

How It Works

Sulfasalazine reduces inflammation, but the exact way this happens is not known. It has been used to decrease bowel inflammation in inflammatory bowel diseases such as Crohn's and joint inflammation in rheumatoid arthritis. More recently, it has been used to fight inflammation in ankylosing spondylitis, but it does not seem to work on the spine. It is more effective if ankylosing spondylitis is causing symptoms in other areas such as the shoulders and the heels.

Why It Is Used

Ankylosing spondylitis causes pain, stiffness, and swelling of the spine and sometimes other areas such as the hips, chest wall, and heels. Many people who have ankylosing spondylitis also have inflammatory bowel disease. Sulfasalazine helps by decreasing bowel inflammation and abdominal pain.

How Well It Works

Sulfasalazine may help control pain and inflammation for some people in areas other than the spine. Its effectiveness is still being studied.¹

Side Effects

Sulfasalazine is usually well tolerated. Side effects are usually temporary and may include:

• Diarrhea.
• Headache.
• Loss of appetite.
• Upset stomach.
• Vomiting.
• Stomach pain.
• Temporary infertility in men, but only while the medicine is being taken.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Talk to your doctor before taking this medicine if you are pregnant or thinking about becoming pregnant. Do not take sulfasalazine if you are breast-feeding.

Tell your doctor if you are allergic to aspirin, sulfa drugs, or any other drug, and be sure he or she knows about any other medicines, vitamins, or other supplements you are taking.

Make sure your doctor knows whether you have ever had asthma, kidney or liver disease, blood problems, or blockage in your intestine or urinary tract.

You could be sensitive to sunlight while taking sulfasalazine. Wear sunglasses and sunscreen.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Author:	Shannon Erstad, MBA/MPH	Last Updated: May 14, 2009
Medical Review:	Anne C. Poinier, MD - Internal Medicine E. Gregory Thompson, MD - Internal Medicine Richa Dhawan, MD - Rheumatology
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