Sulfasalazine: Price, Dosage & Where to Buy

Sulfasalazine is an anti-inflammatory medicine used mainly for mild to moderate ulcerative colitis and to help maintain remission between attacks. It is available as standard and delayed-release oral tablets containing 500 mg, and generic versions are available. In the United Kingdom, sulfasalazine requires a prescription, so treatment should be discussed with a prescriber or pharmacist.

Sulfasalazine is an anti-inflammatory medicine that acts within the bowel after oral administration. It is broken down into active components, including sulfapyridine and a salicylate-related component. These substances can reduce inflammatory activity in the lining of the bowel, helping to lessen the immune and chemical processes that contribute to ulcerative colitis.

The effect is intended to calm active inflammation and help maintain remission between attacks. The precise contribution of each component can vary between people, and response is assessed through symptoms and clinical monitoring. Sulfasalazine can also affect the absorption and handling of folic acid and digoxin, which is relevant when other medicines or supplements are being used.

Sulfasalazine tablets are used to treat mild to moderate ulcerative colitis. They may also be used as additional treatment in severe ulcerative colitis. Another use is prolonging the remission period between acute attacks of ulcerative colitis, which means helping to keep symptoms controlled after an active flare has improved.

Ulcerative colitis can involve symptoms such as diarrhoea, bleeding, fever and weight changes. Treatment response may be assessed using clinical symptoms and medical tests, including endoscopic examination and biopsy assessment. Treatment may need to continue even after diarrhoea and other symptoms have been controlled, with the dose adjusted to a maintenance level when improvement is confirmed.

The label lists 500 mg standard oral tablets and 500 mg delayed-release oral tablets. The usual starting dose is 3 to 4 g daily for adults, divided evenly, with dosage intervals not exceeding eight hours. The label lists 1 to 2 g daily as a possible smaller initial amount when reducing gastrointestinal intolerance is needed.

The usual starting dose is 40 to 60 mg/kg in each 24-hour period for children six years of age and older, divided into 3 to 6 doses. The label lists 2 g daily as the adult maintenance dose. The label lists 30 mg/kg in each 24-hour period as the maintenance dose for children six years of age and older, divided into 4 doses.

Dosage is adjusted according to individual response and tolerance. A daily dosage of 4 g or more is associated with increased toxicity risk.

Store at 25° C, with permitted excursions to 15-30° C. Keep the tablets in suitable packaging and protect them from moisture. Store as directed on the label to maintain quality.

A missed dose can reduce the medicine's ability to control bowel inflammation or help maintain remission. General pharmacy advice is to take the missed dose when remembered unless it is nearly time for the next scheduled dose.

A double dose should not be used to make up for a missed dose. If several doses have been missed, or symptoms return, a pharmacist or prescriber can advise on the appropriate plan.

There are no adequate and well-controlled studies of sulfasalazine in pregnant women. The medicine should be used during pregnancy only if clearly needed. Sulfasalazine and sulfapyridine pass through the placenta and are also present in human milk.

Sulfasalazine can inhibit folic acid absorption and metabolism, and newborns should be monitored for potential kernicterus. Pregnancy and breastfeeding should be discussed with a doctor or pharmacist.