Do you have Ankylosing Spondylitis ? If so, you probably have pain in your back, hips, and other joints, and morning stiffness. When treating this condition, doctors first try to give you painkillers like Ibuprofen and Naproxen, which are called NSAIDS (nonsteroidal anti-inflammatory drugs) . But sometimes these medications don't work for you. Or you may not be able to use these NSAIDs due to other health problems. That's when your doctor might consider another medication like Sulfasalazine. Especially if you have ankylosing spondylitis and inflammatory bowel disease (IBD) , Sulfasalazine can often be a good solution.
How does this drug called Sulfasalazine actually work inside the body?
Simply put, Sulfasalazine is a drug that controls inflammation in the body. There are chemicals called prostaglandins that help cause pain and inflammation in our bodies. Sulfasalazine works by stopping the production of those chemicals. This drug was originally approved to treat a condition called ulcerative colitis , which affects the intestines.
But it doesn't just reduce pain. Doctors call this medication a DMARD (disease-modifying antirheumatic drug) . What does that mean? This means that in addition to controlling the pain and swelling caused by arthritis, this medication can also change the nature of the disease itself. This means that it can not only suppress the symptoms, but also prevent long-term damage to your joints. Therefore, this medication can also help prevent your daily activities from becoming incapacitated due to ankylosing spondylitis.
How effective is this medicine for ankylosing spondylitis?
Ankylosing spondylitis mainly affects the spine. Sulfasalazine is most helpful if you have problems with your peripheral joints, in addition to your spine. This means it can help reduce pain and swelling in your joints. It can also help reduce stiffness in your back and make you feel a little more relaxed.
But let's be honest. Studies have not yet clearly proven that using this medicine will significantly improve spinal movement or significantly improve your physical function. It also does not have much effect on inflammatory conditions that occur in the tendons that connect to the joints.
In one study, sulfasalazine was compared with another drug called etanercept . Etanercept is in a class of drugs called TNF-alpha inhibitors that work in a different way. In that study, etanercept was found to be significantly more effective than sulfasalazine. So, if NSAIDs don't work for you, there may be other medications that may work better for you than sulfasalazine. The best thing to do is talk to your doctor about what's right for you and whether sulfasalazine is worth trying.
How should I use Sulfasalazine?
This comes in the form of a pill. The most important thing is to take this medicine with food. To avoid stomach upset, drink it with a full glass of water. Your doctor will usually start you on one or two pills a day. Then, you can gradually increase the dose as needed.
Remember, it is essential to drink plenty of water or other fluids throughout the day while taking this medication. Do not take this medication on an empty stomach. Also, do not take this medication after taking antacids for gastritis.
Another important point is that this medication may have a small effect on the body's absorption of the nutrient folate. Therefore, your doctor will often tell you to take a folic acid pill along with this medication. This is especially important if you are pregnant or planning to become pregnant.
What to do if you miss a dose of medication?
If you forget to take a pill , take it as soon as you remember. But never take two doses at once. If it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time.
What are the side effects of this medicine?
Like any medicine, Sulfasalazine can have side effects. However, not everyone gets them. Let's take a look at the common and rare side effects.
| Side Effects of Sulfasalazine | |
|---|---|
| Commonly seen side effects | |
| Headache | This can happen when the dosage of the medication increases. |
| Nausea and vomiting | It is most common in the early stages of starting medication. |
| Fever | It can occur as a reaction in the body. |
| Skin rash | It may be a symptom of an allergy. |
| Male infertility | Sperm count may decrease, but this returns to normal after stopping the medication. |
| Sensitivity to sunlight | The skin can burn easily. |
| Yellowing of the skin and urine | This is nothing to worry about and is caused by the medication. However, it is important to inform the doctor. |
| Rare but potentially serious side effects | |
| Hepatitis, pneumonitis, Stevens-Johnson syndrome, hemolysis, kidney inflammation, and low white blood cell count. | |
You should not be alarmed by these rare but serious side effects. Your doctor will monitor you closely while you are taking this medicine. After the first 6 weeks, and then every 6 months, your blood will be tested to check your blood cell counts and kidney function. If you develop any new symptoms that you think may be a side effect of the medicine, tell your doctor right away.
Who should not use Sulfasalazine?
If you are allergic to sulfa drugs, you should not take this medicine. However, sometimes, even if you experience minor allergic symptoms when you start taking the medicine, the medicine works well for your ankylosing spondylitis condition. In such cases, talk to your doctor about whether it is appropriate to continue taking the medicine. It is possible that your body will gradually get used to the medicine and the reaction will disappear. In such cases, your doctor will start with a very low dose and gradually increase the dose.
Take-Home Message
- Sulfasalazine is not just a painkiller. It is a disease-modifying antirheumatic drug (DMARD ) that prevents joint damage.
- Always take this medicine with a meal and plenty of water. Avoid taking it on an empty stomach.
- While taking the medication , be sure to have the blood tests prescribed by your doctor on time . This is very important for your safety.
- Tell your doctor immediately if you experience any unusual symptoms, especially fever, skin rashes, or extreme fatigue.
- Although sperm count in men may be affected, it is temporary and returns to normal after stopping the medication.
- Do not stop taking the medication or change the dosage for any reason without medical advice.
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