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Sulfasalazine - Anyone had success with it?

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Posted 6/21/2010 5:29 PM (GMT 0)
Giving it a last ditch effort while going through the Remicade pre-approval and testing process and while simultaneously having a surgical consult for a j-pouch (trying to make a decision between Remicade or surgery)... and am going to start Sulfasalazine tomorrow.  My GI thinks it could work, and although it may be a long shot, why not give it a try while I pursue these other courses.

Have any of you had any success with it?  Side effects?  Issues?  I know it's an older drug and not really prescribed much anymore, so I'm not certain if I will get any responses to this.


Thanks in advance!

Posted 6/21/2010 5:37 PM (GMT 0)
It has worked very well for me, much better than Asacol.  I noticed an improvement within three days; I don't know whether it was the sulfasalazine kicking in or not taking Asacol any more.

Drink plenty of water and try to eat a little something with it if it upsets your stomach (or request enteric coated tabs).

I've had very few side effects.  My eyes and skin are a bit more photosensitive. 

Posted 6/21/2010 6:10 PM (GMT 0)
I was put on Sulf + Pred at my initial diagnosis and had 1 year of remission where I only had to take Sulfa but during the next flare, it didnt work. Also Sulfa caused me nasty migraines every few months. I was eventually put on Asacol because my doctor told me it was the same thing as Sulfa without the toxic component which was causing my headaches. The cost of Asacol is pretty high though as well.
Posted 6/21/2010 6:34 PM (GMT 0)
I was wondering if like, say I can't get through this flare or something, if I could add sulfa in with my Imuran? My old doctors told me not to take Asacol and Imuran at the same time. So I wonder if sulfa would be safer? Just curious.
Posted 6/21/2010 6:43 PM (GMT 0)
Very odd that they said not taking Imuran and Asacol at the same time. My guess is that an absolute majority who uses Imuran is on a 5-asa at the same time. Did you have any odd reactions to the combination or bad blood values?
Posted 6/21/2010 7:57 PM (GMT 0)
No. They didn't say outright not to, but when I was afraid to go off my Asacol after getting on Imuran, they told me it could cause liver problems. Or maybe they were just trying to scare me off the Asacol lol
Posted 6/21/2010 7:58 PM (GMT 0)
I was also thinking about adding sulfa if I need more meds because it's supposed to be good for arthritis.
Posted 6/21/2010 9:34 PM (GMT 0)

Sulfasalazine worked great for my joint pain, first time in many, many years the joint pain went away.  It took about two months to notice it.

For some reason, up until about a week ago, I had unremitting joint pain in my hands, hips, neck, and knees for about two months.  Then, it went away -- as usual with this stupid disease.  I've upped my dose of sulfa and I hope that did the trick for now.

Posted 6/21/2010 9:45 PM (GMT 0)
sulfa definitely improved things for me. I'm in Australia and it is the first and so far only medication I am taking for this. The only side effect I noticed was orange urine which stopped after a while. I was told to take it with meals.
Posted 6/21/2010 9:52 PM (GMT 0)

ElephantPipe said...
No. They didn't say outright not to, but when I was afraid to go off my Asacol after getting on Imuran, they told me it could cause liver problems. Or maybe they were just trying to scare me off the Asacol lol

I was on Asacol and Imuran for about a year. My doctor or pharmacist didnt warn me of any extra dangers regarding taking those meds. I was told that Imuran is an antisuppressant and so is pred so I should be careful as far as that goes but nothing else.

Also as another poster mentioned, your urine will be extremely yellow or orange while on sulf.
Posted 6/22/2010 1:38 AM (GMT 0)
Thanks for your help! My surgical consult is scheduled for August 2nd, so I am going to give this Sulfa a try while I wait and while I taper off the Prednisone since it is no longer helping. Keeping my fingers crossed.

Regarding the Asacol and Imuran/6mp at the same time... My GI said that the research has shown that with some people (*not all*), the Asacol can prevent the 6mp from being metabolized correctly. They actually think that is what happened with me, and why I had the serious side effects from the 6mp. Apparently, it's emerging research and it only applies to a certain subset of people.
Posted 6/22/2010 2:51 AM (GMT 0)
Expecting, I know from past posts that some members do well on sulfasalazine-- Princesa & Munchkindd are among them, & also Jjic, as I recall. If you do go on it, try the enteric-coated tablets, drink plenty of water daily, and also ask your gastro to Rx a folic acid supplement-- because steady sulfa can interfere with the body's absorption of folic acid. I tried sulfasalazine early in my UC career, but got off it within a yr due to photosensitivity issues. Best wishes and please keep us posted as your time permits. / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 6/22/2010 4:22 AM (GMT 0)
Asacol and Colazal just made things worse for me Sulfa seems to help I think.
Posted 6/22/2010 4:31 AM (GMT 0)
Zippy...you do realise that sulfasalazine does have mesalasine in it (same as asacol)? it's not the sulfa, per se, that helps the UC....Maybe it's a better delivery system for you, however...whereas the ASacol and Colazal aren't delivered as effectively?

q
Posted 6/22/2010 8:37 AM (GMT 0)

I have been on the sulfa for the past two months and it seems to be working for me. I have bene on Asacol since my initial diagnosis, but due to arthiritis my doc wanted me to try the sulfa based to help with the pain.

I'm on 6mp as well and seem to do quite well at the moment.

Posted 6/22/2010 2:00 PM (GMT 0)
It's definitely an option and I recently read that the sulfasalazine is good for liver problems as well (forget what exactly, however). There are plusses to it for sure, unless the side effects get you...sigh.

q
Posted 6/22/2010 5:25 PM (GMT 0)
Well, I started the Sulfa today. We'll see! Keeping my fingers crossed.
Posted 6/22/2010 5:38 PM (GMT 0)
Good luck!
Posted 6/23/2010 12:44 AM (GMT 0)
I have sulfa allergies so I can't take it. Wish I could though, it's much cheaper than lialda or asacol.
Posted 6/23/2010 1:59 AM (GMT 0)
expecting226

I was diagnosed with UC about 1974 at age 30. Prednisone and Sulfasalazine put it into remission. Took two Sulfa tabs twice a day for 30 years with no side effects. UC in total remission until about 2004 when I stopped drinking coffee. I had no idea that caffeine and nicotine help keep UC in remission. I have never smoked. Tried all the UC medications to no avail. In 2007 I had a total colectomy and ileostomy. Hope you have good results with Sulfasalazine.

Dan
Posted 6/24/2010 1:46 PM (GMT 0)
Expecting......... I am one of the lucky ones that has had nothing but success with Azulfidine/Sulfasalazine.  I have had colitis since 1982.  This is really the only drug that works for me, and of course it doesn't hurt that it is so affordable.  Good luck, I hope it works for you.

Posted 6/24/2010 4:22 PM (GMT 0)
Interesting GUT article comparing Sulfasalzine and mesalamine drugs.

www.ncbi.nlm.nih.gov/pmc/articles/PMC1773399/
Posted 6/24/2010 4:32 PM (GMT 0)
Yes, it is a good article, and although written in 2002, some doctors still aren't on the 5ASA band wagon.

Interesting about the 1g optimum dosage for rectal, but I dont see that it says to combine oral/rectal.

One most interesting point is the osalazine induced diarrhea for low limited UC...treats and helps stool consistency for easier exit.

q
Posted 6/24/2010 4:34 PM (GMT 0)
Wow, what a great article! I am going to put it above in our article thread so we have ready access to it, OK?
I loved the statement, ostensibly backed by research, that the continual taking of 5-ASA meds decreases long-term cancer risk by 75%!!!!!!!!!
That's more than enough to keep me packin'my pills!
Posted 6/24/2010 4:49 PM (GMT 0)
[img]/community/emoticons/turn.gif[/img] Now there's a hopeful and optimistic statistic!!!!!
q
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