Sulfasalazine

Understanding sulfasalazine

Sulfasalazine is a commonly used disease-modifying anti-rheumatic drug (DMARD) used to treat inflammatory arthritis, such as rheumatoid arthritis or psoriatic arthritis.

Before starting medication

Please read the information on sulfasalazine before starting this medication. It is important you understand how this medications works and why it is being prescribed, as well as how to take the medication correctly.

Sulfasalazine medication tablets

Answering some of your questions about sulfasalazine

When to attend for blood monitoring

We monitor to can pick up changes at an early stage. It is important to attend for blood tests to ensure it is safe to continue the drug.

When you start sulfasalazine attend for your first bloods test 2 weeks after then

  • Every 2 weeks x 4  (in total)
  • Monthly x 3
  • Then every 3 months

We will monitor and prescribe sulfasalazine for the first 3 months. Once stable this is then handed over to your GP to prescribe.

We will only contact you if the results are abnormal.

It is important to attend for blood tests to ensure it is safe to continue the drug. No bloods, no medication. Safe prescribing is a priority.

You will have to book your own blood test. To book a blood test at St Luke’s Hospital, please ring 01274 365056 or 01274 365170 to make an appointment. Alternatively, you can book your own blood test appointment. Phone lines are open Monday to Friday between 8.30am and 4pm.

How to take sulfasalazine

Daily medication 500mg tablets:

  • Week 1: 1 tablet (500mg) after breakfast
  • Week 2: 1 tablet after breakfast and 1 tablet after evening meal
  • Week 3: 2 tablets after breakfast and 1 tablet after evening meal
  • Week 4: 2 tablets after breakfast and 2 tablets after evening meal

Then remain on 2 tablets morning and evening every day. To be swallowed whole with water, do not crush.

Pregnancy and fertility

Sulfasalazine is safe to take during pregnancy and while breastfeeding but you need to take folic acid 5mg every day throughout your pregnancy.

It may cause a reduction in sperm count but does not make you infertile. If you have any concerns then contact our advice line.

General advice

Do not take sulfasalazine if you are allergic or sensitive to aspirin or sulfonamides.

Limit alcohol and avoid binge drinking. Do you know your safe limits? Learn more on NHS.UK – Alcohol units.

Avoid live vaccines. This includes, but is not limited to, rabies, MMR, yellow fever and some forms of shingles vaccine. You should advise any travel clinic that you are taking immunosuppression.

Flu, Covid and Pneumonia vaccines are inactive vaccines – this means they are not live vaccines. Your GP will call you for these vaccines and we strongly advise that you have these.

Read more about vaccinations (Versus Arthritis).

Avoid contact with chickenpox. (As adults we tend to develop shingles rather than chicken pox, you may require anti-viral treatment from your GP).

Prevent sunburn. (Check for changes in the skin and monitor freckles and moles for such as changes in size, shape, colour and weeping). Have any changes checked with your GP.

Sunburn can lead to skin damage which increases the risk of developing skin cancers. We recommend “slip, slap, slop” – slip on a shirt to cover up, slap on a hat, slop on the sunscreen. Find out more on NHS.UK – Sunscreen and sun safety.

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