Sulfazine tablets

Sulfazine

  • Active Ingredient: Sulfasalazine
  • 500 mg
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What is Sulfazine?

The active ingredient of Sulfazine brand is sulfasalazine. Sulfasalazine affects a substance in the body that causes inflammation, tissue damage, and diarrhea. Molecular Formula: C18H14N4O5S In comparison, peak plasma levels of both SP and 5-ASA occur approximately 10 hours after dosing. This longer time to peak is indicative of gastrointestinal transit to the lower intestine where bacteria mediated metabolism occurs. SP apparently is well absorbed from the colon with an estimated bioavailability of 60%. In this same study, 5-ASA is much less well absorbed from the gastrointestinal tract with an estimated bioavailability of from 10 to 30%. Serious infections, including fatal sepsis and pneumonia, have been reported. Some infections were associated with agranulocytosis, neutropenia, or myelosuppression. Discontinue Sulfasalazine if a patient develops a serious infection. Closely monitor patients for the development of signs and symptoms of infection during and after treatment with Sulfasalazine. For a patient who develops a new infection during treatment with Sulfasalazine, perform a prompt and complete diagnostic workup for infection and myelosuppression. Caution should be exercised when considering the use of Sulfasalazine in patients with a history of recurring or chronic infections or with underlying conditions or concomitant drugs which may predispose patients to infections. Severe hypersensitivity reactions may include internal organ involvement, such as hepatitis, nephritis, myocarditis, mononucleosis-like syndrome (i.e., pseudomononucleosis), hematological abnormalities (including hematophagic histiocytosis), and/or pneumonitis including eosinophilic infiltration. Serious skin reactions, some of them fatal, including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, have been reported in association with the use of Sulfasalazine. Patients are at highest risk for these events early in therapy, with most events occurring within the first month of treatment. Sulfasalazine should be discontinued at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity. Severe, life-threatening, systemic hypersensitivity reactions such as drug rash with eosinophilia and systemic symptoms have been reported in patients taking Sulfasalazine. Early manifestations of hypersensitivity, such as fever or lymphadenopathy, may be present even though rash is not evident. If such signs or symptoms are present, the patient should be evaluated immediately. Sulfasalazine should be discontinued if an alternative etiology for the signs or symptoms cannot be established.

Used for

Sulfazine is used to treat diseases such as: Alopecia, Crohn's Disease, Crohn's Disease, Acute, Crohn's Disease, Maintenance, Inflammatory Bowel Disease, Juvenile Rheumatoid Arthritis, Lymphocytic Colitis, Psoriatic Arthritis, Rheumatoid Arthritis, Ulcerative Colitis, Ulcerative Colitis, Active, Ulcerative Colitis, Maintenance, Uveitis.

Side Effect

Possible side effects of Sulfazine include: loss of appetite; dark urine; nausea; black, tarry stools; muscle aches; cough; light-colored stools.

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Contraindications

Sulfazine tablets are contraindicated in:

Patients with intestinal or urinary obstruction, Patients with porphyria as sulfonamides have been reported to precipitate an acute attack, Patients hypersensitive to Sulfazine, its metabolites, sulfonamides, or salicylates.

Rated Sulfazine for Crohn's Disease -- Acute Report

I am a 55 year old female. I have had GERD since I was 23 years old. I have had my gall bladder removed developing insisional hernia 2x with a resolution of putting in mesh. After those surgeries I had 5 episodes of diverticulitis in one year. I have IBS and have tested positive 6 years for Barrets Esophagus and no less than three polyps during colonoscopy during the same time period. I asked my Gastrointestinal Dr. to prescribe this medication Sulfazine to help with my symptoms. 500mg 2x a day. He was doubtful that it would help but prescribed it anyway.I have taken it for 1 year now. At my last colonospy and egd I had no polyps and my test was negative for B.E. Thus lowering the odds of developing cancer. But the side effects from taking this medication include: joint pain, easy brusing, peteicie, anemia and lesions containing a purple appearance. I have an appointment with my Dr.in the near future and will need to disontinue the medication. It also game me some relief from the pain that never went away from my gall bladder surgery.

Rated Sulfazine for Ulcerative Colitis Report

My young daughter was put on this drug for ulcerative colitis. It was miraculously effective at first and put her in complete remission for a year. But after a year, she started bleeding again. After going on and off pediapred (prednisone) for a year and always going back onto this drug as she came off the prednisone, we figured out that it wasn't helping and was possibly making it worse. She then went on Pentasa when coming off prednisone, but had same problem. Finally we went to Imuran but our doctor wanted her on Pentasa and Imuran at the same time until the Imuran was full strength. But within two days of restarting the Pentasa, she started bleeding. We stopped the Pentasa and immediately she stopped bleeding. She has been in remission for a couple of months now, on just Imuran. We are fairly certain that Pentasa and probably Sulfazine (they are both 5-ASA drugs) were actually causing her to bleed.

General

Sulfazine tablets should be given with caution to patients with severe allergy or bronchial asthma. Adequate fluid intake must be maintained in order to prevent crystalluria and stone formation. Patients with glucose-6 phosphate dehydrogenase deficiency should be observed closely for signs of hemolytic anemia. This reaction is frequently dose related. If toxic or hypersensitivity reactions occur, the drug should be discontinued immediately.

Maintenance Therapy

Adults: 2 g daily.

Children, six years of age and older: 30 mg/kg body weight in each 24-hour period, divided into 4 doses.

The response of acute ulcerative colitis to Sulfazine tablets can be evaluated by clinical criteria, including the presence of fever, weight changes, and degree and frequency of diarrhea and bleeding, as well as by sigmoidoscopy and the evaluation of biopsy samples. It is often necessary to continue medication even when clinical symptoms, including diarrhea, have been controlled. When endoscopic examination confirms satisfactory improvement, the dosage of Sulfazine should be reduced to a maintenance level. If diarrhea recurs, the dosage should be increased to previously effective levels. If symptoms of gastric intolerance (anorexia, nausea, vomiting, etc.) occur after the first few doses of Sulfazine, they are probably due to increased serum levels of total sulfapyridine and may be alleviated by halving the daily dose of Sulfazine and subsequently increasing it gradually over several days. If gastric intolerance continues, the drug should be stopped for 5 to 7 days, then reintroduced at a lower daily dose.

Some patients may be sensitive to treatment with Sulfazine. Various desensitization-like regimens have been reported to be effective in 34 of 53 patients, 4 7 of 8 patients, 5 and 19 of 20 patients. 6 These regimens suggest starting with a total daily dose of 50 to 250 mg Sulfazine initially, and doubling it every 4 to 7 days until the desired therapeutic level is achieved. If the symptoms of sensitivity recur, Sulfazine should be discontinued. Desensitization should not be attempted in patients who have a history of agranulocytosis, or who have experienced an anaphylactoid reaction while previously receiving Sulfazine.

Forms and strengths

Generic: Sulfazine

  • Form: oral tablet (immediate-release)
  • Strength: 500 mg
  • Form: oral tablet (extended-release)
  • Strength: 500 mg

Brand: Azulfidine

  • Form: oral tablet (immediate-release)
  • Strength: 500 mg

Brand: Azulfidine EN-Tabs

  • Form: oral tablet (extended-release)
  • Strength: 500 mg

Sulfazine (SSZ), sold under the trade name Azulfidine among others, is a medication used to treat rheumatoid arthritis, ulcerative colitis, and Crohn’s disease.

Rated Sulfazine for Rheumato >Report

I have been taking sulfsalazine (500 mg, 3 - 5 tablets a day) for five months now and the pain from the RA has diminished by 90% which is great but I still have some other problems like numbness in my hands and the weakness of my arms and legs. Having some other blood tests to determine what may be causing these problems.

Practical tips for using Sulfazine in dermatology

As the dermatological indications are all off-label, treatment should only be started after receiving patient consent. Contraindications to its use are:

  • hypersensitivity ( allergy ) to sulphonam >glucose -6-phosphate-dehydrogenase) deficiency
  • acute intermittent porphyria and variegate porphyria

A pretreatment work-up should include:

  • a complete blood and platelet count
  • screening for G6PD deficiency
  • liver and renal function tests with urinary protein measurement
  • antinuclear and anti- DNA antibody tests if necessary
  • N-acetyltransferase (NAT2) genotyping if necessary.

Information for Patients

Patients should be informed of the possibility of adverse reactions and of the need for careful medical supervision. The occurrence of sore throat, fever, pallor, purpura, or jaundice may indicate a serious blood disorder. Should any of these occur, the patient should seek medical advice. They should also be made aware that ulcerative colitis rarely remits completely, and that the risk of relapse can be reduced by continued administration of Sulfazine at a maintenance dosage. Patients should be instructed to take Sulfazine tablets in evenly divided doses preferably after meals. Additionally, patients should be advised that Sulfazine may produce an orange-yellow discoloration of the urine or skin.

Nursing Mothers

Sulfonamides, including Sulfazine, are present in human milk (see Pregnancy, Clinical Considerations). Insignificant amounts of Sulfazine have been found in milk, whereas levels of the active metabolite sulfapyridine in milk are about 30 to 60 percent of those in the maternal serum. Caution should be exercised when Sulfazine is administered to a nursing mother.

There are reports with limited data of bloody stools or diarrhea in human milk fed infants of mothers taking Sulfazine. In cases where the outcome was reported, bloody stools or diarrhea resolved in the infant after discontinuation of Sulfazine in the mother or discontinuation of breastfeeding. Due to limited data, a causal relationship between Sulfazine exposure and bloody stools or diarrhea cannot be confirmed or denied. Monitor human milk fed infants of mothers taking Sulfazine for signs and symptoms of diarrhea and/or bloody stools.


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