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Sulphasalazine/Nausea

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Posted 5/13/2010 11:06 PM (GMT 0)
I know it's hard to tell, but Asacol doesn't seem to be doing much for me these days.  I'm currently taking 12 a day and I've been flaring for almost a year now.  Azathioprine isn't an option as I showed elevated liver enzymes while on it.  Last week my GI mentioned Sulphasalazine.  He said we could try it, but he pretty much gauranteed it would make me sick to my stomach.  Is this the case for those of you who are on it?

John

Posted 5/13/2010 11:58 PM (GMT 0)
Yep it made me sick to my stomach. It also gave bad headaches too. Doctor did a blood test and said that I was allergic to it.
Posted 5/14/2010 12:25 AM (GMT 0)
i have taken it for 15 years with no problems at all
Posted 5/14/2010 12:50 AM (GMT 0)
No problem with it now. Seems like it gave me headaches initially like 10 years ago. I went off of it, but recently gave it another try and had no side affects at all.
Posted 5/14/2010 1:33 AM (GMT 0)
No real side effects to speak of.  You might start with a lower dose and work up.  I also understand there's an enteric coated version to avoid stomach upset.
Posted 5/14/2010 1:41 AM (GMT 0)
Thanks everyone! Have you found it to work better for you than Asacol?
Posted 5/14/2010 3:00 AM (GMT 0)
I just started taking sulfasalazine it hasnt given me any problems i switched from asacol only because i couldnt affod asacol anymore i dont have insurance to pay for it. I am taking 8 tablets a day and it seems to be working fine for me
Posted 5/14/2010 4:01 AM (GMT 0)

bunnies0507 said...
I just started taking sulfasalazine it hasnt given me any problems i switched from asacol only because i couldnt affod asacol anymore i dont have insurance to pay for it. I am taking 8 tablets a day and it seems to be working fine for me

How much is it costing you if you don't mind my asking?

Posted 5/14/2010 4:19 AM (GMT 0)
Generic is cheap less than $20 a month though Blue Cross discount, I get a discount, but I don't have prescription coverage, not sure what it would cost without the discount.
Doesn't really bother my stomach normally, but I take a very low dosage. Suppose to take it with food and or water.
Posted 5/14/2010 8:50 AM (GMT 0)
I switched over to sulfa nearly two months ago, as the GI hopes it will be more effective on my arthiritis.
I had horrible nausea when I started taking it, but it reduced after couple of weeks and now I get it only occasionally. Other than that, no side effects and it seems to work well on my UC.
Posted 5/14/2010 9:49 AM (GMT 0)
It worked far better for me than Asacol, and it's helped immensely with UC-related arthritis.

With BCBS I pay $10 for a 90-day supply.  Without insurance, I believe it's about $50 a month. 

Posted 5/14/2010 12:14 PM (GMT 0)
I was on a short stint of it back in the '90's because I couldn't afford my Asacol. It only gave me minor headaches but no other side effect - until I broke out in welts (it was thought at that time that I could possibly be allergic to it). The only thing that is highly recommended that you do while on it is to wear sunscreen because it can increase your sensitivity to the sun and make you burn easier.
Posted 5/14/2010 6:09 PM (GMT 0)
Why would a doctor say something like that? Yes, there are people who are allergic and respond poorly, but that happens with any drug.

I've been on sulfasalzine for years - maintenance dose now - and haven't had any problems. And yes, I did respond better to it than Asacol. Those who are sensitive to it may be able to start slowly and build up the dose as someone else mentioned.
Posted 5/14/2010 7:05 PM (GMT 0)
That doctor sounds under-informed. I've been taking it for a long time with no side effects at all. Is it helping? I dunno but am not stopping entirely (have reduced my dose to 6/day previously 9/day with 6mp which I dropped 3 months ago).

Since everything is getting better I don't want to stop and it's relatively inexpensive and as stated no side effects.

I think you should try it.
Posted 5/15/2010 2:14 AM (GMT 0)

imagardener2 said...


I think you should try it.

Yep, I think I should too.

Thanks for your input!

Posted 5/15/2010 4:45 AM (GMT 0)
Ask your GI to prescribe you suppository and oral. It will be very inconvenient to use it during the day but should work well during the night. I used like it for 1.5 years. After that, he recommended me to use only during the night and switched me on Colazid. What you could do is, during the day, you go with oral administration and rectal administration during the night. This way, someone has it in his/her signature, treating it in both ends..

@NewShinyCD,
You mentioned of headache. May I ask what kind of headache you had/have? My diary was badly maintained in early days of condition but as far as I remember, my migraine-like headache started when I started with Sulphasalazine but my GI disagrees that it has anything to do with it. I am still taking once a day Sulphasalazine suppository and Neproxen twice a week (as and when required) for migraine.
Posted 5/15/2010 1:41 PM (GMT 0)
My previous post appears to have disappeared (Hmm..). In any event, I stated that when I first started using sulfasalazine some 20 years ago it made me quite nauseous. I then opted for the enteric version and things have been fine since. So my suggestion would be to go the enteric route to minimize any complications.
Posted 5/15/2010 6:43 PM (GMT 0)
@ickypoo,
Do they still sell regular sulphasalazine tablets/capsules? They have to be enteric coated. The reason for this is, the action of sulphasalazine is intended for your intestine and not suppose to release in the stomach. If it releases in the stomach, I won't be surprised of your nausea.
Posted 5/15/2010 7:42 PM (GMT 0)
Sulfasalazine is different than drugs like Asacol.  Whereas Asacol and other topical drugs like it use an pH-sensitive acrylic jacket that dissolves in the colon, sulfasalazine counts on bacteria to break it apart.  It's also systemic, which is why it is effective for UC-related arthritis and is sometimes prescribed for Chron's.

It does not need to be enteric coated.  It shouldn't cleave in the stomach, but the ingredients may cause stomach upset.  I don't take the enteric coated version, but it doesn't give me stomach upset.

Posted 5/16/2010 10:53 AM (GMT 0)
mindstyle - to my knowledge the two forms still remain under the brand names azulfidine and azulfidine EN-tabs, but I'm not 100% positive.

seconder - You're right, but for those of us sensitive to the drug, having the enteric option can make a huge difference in quality of life. For me, the problem wasn't stomach upset but profound nausea. I felt like I needed to vomit - all the time. No fun.
Posted 5/16/2010 12:46 PM (GMT 0)
No doubt.

Just pointing out to mindstyle that it need not be enteric coated to be effective, as his/her post led me to believe.

Posted 5/19/2010 11:15 AM (GMT 0)
I have to correct myself after looking at my pill bottle. I take a diff. version called Balsalazide and it has less side effects than Sulfasalazine.

My bad for not looking first. It's in a capsule form, orange sherbet color.
I often wonder if it's related to turmeric because when a pill opens on the way down that's kinda the aftertaste.
Posted 5/19/2010 5:18 PM (GMT 0)

imagardener2 said...
I have to correct myself after looking at my pill bottle. I take a diff. version called Balsalazide and it has less side effects than Sulfasalazine.

My bad for not looking first. It's in a capsule form, orange sherbet color.
I often wonder if it's related to turmeric because when a pill opens on the way down that's kinda the aftertaste.

 

Balsalazide is generic Colazol which I believe is a 5-ASA.  Curious why it's not in your signature.

Posted 5/19/2010 5:24 PM (GMT 0)

Durango Kid said...


Balsalazide is generic Colazol which I believe is a 5-ASA. Curious why it's not in your signature.

I was told I had too many lines in my sig. :-)
My only current med is Balsalazide 750 mg (6) per day (reduced from 9/day in 2009).
I do not know if I am getting benefit from it, just take it because I don't want to rock my remission boat.
In a couple months I will probably reduce/stop it totally.
Posted 5/19/2010 7:45 PM (GMT 0)
Gotcha!
We have to watch those sig lines. You can always reduce the font size to fit more in. I'm the same way with my Asacol, don't really know if it's working anymore. Thus my thoughts about getting on sulfa. I do however want to stay on one of the maintainence meds to reduce the risk of cancer.

John
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