Portions of this document last updated: Dec. 01, 2020. While not specifically noted in the dosage of the label, the usual weight-based dose is 40 to 60 mg/kg/day PO, given in divided doses (not to exceed 4 grams/day PO); maintenance dosing is usually lower. Dose and Administration Your veterinarian may gradually increase the dose until the stools are normal; then, the dose may be decreased. Week 4: 1000 mg orally twice a day (morning and evening) The dose is reduced in proportion to body weight. The daily dose of sulfasalazine is gradually increased each week, usually for 3 weeks, until the maximum prescribed daily dose has been achieved -If GI intolerance occurs after the first few doses, symptoms may be reduced by halving the daily dose and then increasing it gradually over several days; if intolerance continues, the drug should be stopped for 5 to 7 days then restarted at a lower daily dose. Dosing : 3 to 6 g/day orally in divided doses Sulfasalazine doses start from 1-4 g daily, with the maintenance dose of 0.5-1 g daily. Adverse effects are frequent , and most are dose-dependent. • Known previous hypersensitivity to sulfasalazine 500mg gastro-resistant tablets or their excipients • Patients aged less than 2 years. The following information includes only the average doses of this medicine. Initial dose: 500 mg/day, then increased by 500 mg/week Your doctor may increase your dose as needed. Applies to the following strengths: 500 mg, 3 to 4 g/day orally in evenly divided doses While this drug may be prescribed for children as young as 6 years for selected conditions, precautions do apply. Acute attack or relapse: 0.8 - 1.2 ml/kg/day. However, the dose is usually not more than 3000 mg per day. Adult and Pediatric Dosage Forms and Strengths. The daily dose of sulfasalazine is gradually increased each week, usually for three weeks, until the maximum prescribed daily dose has been achieved ; Controlling the symptoms of RA with sulfasalazine may take up to three months or longer ; Most commonly reported side effects . What are some things I need to know or do while my child takes this drug? General: Sulfasalazine may cause blood problems. Medically reviewed by Drugs.com. The primary route of metabolism of SP is via acetylation to form AcSP. Advertising revenue supports our not-for-profit mission. Approximately 15% of a dose of SSZ is absorbed as parent and is metabolized to some extent in the liver to the same two species. Sulfasalazine is contraindicated in: • Infants under the age of two years. Sulfasalazine is a prescription medication used to treat the symptoms of ulcerative colitis including bowel inflammation, diarrhea (stool frequency), rectal bleeding, and abdominal pain. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This drug is not recommended for the treatment of systemic-course juvenile rheumatoid arthritis. Sulfasalazine delayed-release (enteric-coated) is also used to treat rheumatoid arthritis in adults and children when other medications have not worked. Auxiliary Labels/Storage: Shake Well; Refrigerate (preferred) or Room Temperature Directions : 1. Sulfasalazine is used to reduce inflammation and pain in rheumatoid arthritis (RA), juvenile rheumatoid arthritis (JRA), and ulcerative colitis … Comments: It is not used in young children or in those with systemic onset juvenile idiopathic arthritis. 700 Children’s Drive |Columbus, OH 43205 . Comments: Important safety information. Sulfasalazine metabolite pharmacokinetics in pediatric patients with inflammatory bowel disease: effects of disease activity, acetylator phenotype, and age. -An orange-yellow discoloration of urine or skin may occur. If you have an allergy to sulfasalazine or any other part of this medicine (sulfasalazine tablets). -Increasing the daily dose to 3 g/day may be considered if clinical response is inadequate after 12 weeks; careful monitoring suggested for doses over 2 g/day. SulfaSALAzine Oral Suspension 100mg/mL . 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. While using this medicine, part of the enteric-coated tablet may pass into your stools. -Therapeutic response has been seen 4 weeks after starting therapy; 12 weeks of therapy may be needed before clinical benefit is noticed. Drug Name Route Dosage Form Concentration . The dosage of Sulfasalazine tablets should be individually adjusted according to the patient's tolerance and response to the treatment and taken in evenly divided doses preferably after meals. 40-60mg/kg per day. 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. -Hematologic: CBC including differential white cell count (before starting, every second week during first 3 months, monthly during second 3 months, once every 3 months thereafter, and as indicated) Sulfasalazine is known as a disease modifying anti-rheumatic drug (DMARD).. Maintenance dose: 1 g twice a day for 1 year; in cases of new flare, dose was increased by 500 mg/week up to 3 g/day, 6 years or older: 6 These regimens suggest starting with a total daily dose of 50 to 250 mg sulfasalazine initially, and doubling it every 4 to 7 days until the desired therapeutic level is achieved. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Acute Attack or Relapse. ... Do not start, stop, or change the dose of any drug your child takes without checking with the doctor. Comments: Take sulfasalazine exactly as directed by … >10 years: Use smaller doses in early adolescence and/or in underweight children. -Ulcerative colitis rarely remits completely; risk of relapse can be greatly reduced by continued use of this drug at maintenance dose. Initial therapy: 40 to 60 mg/kg/day orally divided into 3 to 6 doses Let your healthcare provider know if you have kidney or liver disease, asthma, or anemia. Oral Sulfasalazine for patients 16+ years 1. Equipment needed: Mortar, pestle, graduated cylinder, stirring rod . Your doctor may adjust your dose as needed. Suggested dosing regimen: Comments: Do not double doses. Patients over 65 years old may have a stronger reaction and need a smaller dose. Place tablets in mortar and cover with a minimal … Dermatitis herpetiformis In dermatitis herpetiformis , sulfasalazine 1–2 g/day may provide an effective alternative to dapsone if it fails to control the disease or dapsone causes adverse events . For children, sulfasalazine should only be started by a specialist. You shouldn’t take sulfasalazine if you’re known to have an allergy to salicylates (suh-li-suh-lates). Data sources include IBM Watson Micromedex (updated 7 Dec 2020), Cerner Multum™ (updated 4 Dec 2020), ASHP (updated 3 Dec 2020) and others. This content does not have an Arabic version. -When adequate improvement is confirmed by endoscopy, dose should be reduced to maintenance level; if diarrhea recurs, dose should be increased to previously effective levels. Sulfasalazine should not be used in children under 2 years of age. -Administer daily dose in evenly divided doses preferably after meals; dose intervals should not exceed 8 hours. Please be advised that this information is made available to assist our patients to learn more about their health. Maintenance of remission of … Oral sulfasalazine inhibits the absorption and metabolism of folic acid which may interfere with folic acid supplementation and protection from neural tube defects. Ask your healthcare professional how you should dispose of any medicine you do not use. Prescribing responsibility will only be transferred when it is agreed by the consultant and the patient’s GP and the patient’s condition is stable or predictable. Sulfasalazine. Tablet. What do I need to tell my doctor BEFORE I take Sulfasalazine Tablets? The dose is usually 30 to 50 milligrams (mg) per kilogram (kg) of body weight per day, divided into 2 doses. Patient advice: Week 1: 500 mg orally once a day in the evening To do so may increase the chance of side effects. 4.3 Contraindications. Equipment needed: Mortar, pestle, graduated cylinder, stirring rod . 6 These regimens suggest starting with a total daily dose of 50 to 250 mg sulfasalazine initially, and doubling it every 4 to 7 days until the desired therapeutic level is achieved. All rights reserved. Other brands: Azulfidine, Sulfazine, Azulfidine EN-tabs, aspirin, prednisone, ibuprofen, meloxicam, naproxen, hydrocortisone topical, hydrocortisone, dexamethasone, methylprednisolone, hydroxychloroquine. For oral dosage form (enteric-coated tablets): Adults—At first, 500 to 1000 milligrams (mg) every 6 to 8 hours per day. Salicylate is a natural chemical that is found in some foods. -The manufacturer product information should be consulted for desensitization information. 500 mg; Tablet, enteric coated (delayed release) 500 mg; Dosage Considerations – Should be Given as Follows: Ulcerative Colitis. Pediatric: Small studies have been reported in the literature in children down to the age of 4 years with ulcerative colitis and inflammatory bowel disease. Children 2 to 5 years of age—Dose must be determined by your doctor. Although side effects were slightly less frequent for olsalazine, the number of patients was too small to detect a clinically significant difference. Do not miss any doses. Your doctor may increase your dose as needed. It is also the chemical that is in aspirin. Medically reviewed by . Dosage; Professional; Interactions; More; Uses of Sulfasalazine Tablets: It is used to treat ulcerative colitis. Lactation: Excreted into human breast milk; caution with breastfeeding, some reports of bloody stools or diarrhea in human milk fed infants of mothers taking sulfasalazine -Degree of improvement in number and extent of actively inflamed joints can be evaluated to determine efficacy of drug therapy. 10 These regimens suggest starting with a total daily dose of 50 to 250 mg sulfasalazine initially, and doubling it every 4 to 7 days until the desired therapeutic level is achieved. Sulfasalazine is available in liquid form or tablets. Contraindicated in children <2 years of age and caution in patients with G6PD deficiency. For maintenance treatment of ulcerative colitis: Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. Pediatric dose for GI Qx Rx: สำหรับเด็กน้ำหนัก 10 kg ยาแก้ปวดท้อง Buscopan syr: Ped 10 kg = 3-5ml oral tid pc (3-5 mg/dose) Buscopan iv : Ped 10 kg = 5 mg iv ยาแก้อาเจียน -Clinical criteria, sigmoidoscopy, and biopsy samples should be evaluated to determine response of acute ulcerative colitis to drug therapy. The delayed-release tablets, Azulfidine® (EN-tabs), are also used to treat rheumatoid arthritis and juvenile rheumatoid arthritis. Children younger than 2 years of age—Use and dose must be determined by your doctor. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. June 2019 Comment 2K Report. -This dose has been recommended for mild to moderate active ileocolonic or colonic disease; not approved by US FDA. Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. The dosage of sulfasalazine should be individually adjusted according to the patient’s tolerance and response to the treatment. Children 2 to 5 years of age—Dose must be determined by your doctor. Therefore, you should be careful when using regular toothbrushes, dental floss, and toothpicks. Drug Name Route Dosage Form Concentration . Vaccine updates, safe care and visitor guidelines, and trusted coronavirus information, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, FREE book offer – Mayo Clinic Health Letter. Use: To prolong the remission period between acute attacks of ulcerative colitis, Delayed-release tablets: 1000 mg orally twice a day Do not keep outdated medicine or medicine no longer needed. Hypersensitivity to sulfasalazine, its metabolites, sulfonamides or salicylate in patients with intestinal or urinary obstruction and in patients with porphyria, as the sulfonamides have been reported to precipitate an acute attack. -If delayed-release tablets pass undisintegrated, discontinue the product at once. Mild to moderate cases, adjunctive therapy in severe cases, and prolongation of remission; Adult: 3-4 g/day orally divided three times daily after meals; may start 1-2 g once/day This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. -This drug does not produce an immediate response. Adults: 2 g daily. Uses: In the treatment of mild to moderate ulcerative colitis; as adjunctive therapy in severe ulcerative colitis; to prolong the remission period between acute attacks of ulcerative colitis, Delayed-release tablets: The dose is usually 30 to 50 milligrams (mg) per kilogram (kg) of body weight per day, divided into 2 doses. Optimum dose of sulphasalazine for maintenance treatment in ulcerative colitis. The exact way that sulfasalazine works is unknown, but it is believed to reduce the actions of substances in the body that cause inflammation, tissue damage, and diarrhea. Children 2 to 5 years While not specifically noted in the dosage of the label, the usual weight-based dose is 40 to 60 mg/kg/day PO, given in divided doses (not to exceed 4 grams/day PO); maintenance dosing is usually lower. Take this medicine exactly as directed by your doctor. -Degree of improvement in number and extent of actively inflamed joints can be evaluated to determine efficacy of drug therapy. It may be given to you for other reasons. Allergy to sulfa drugs or salicylates or Bowel blockage or Urinary bladder blockage—Should not be used in patients with these conditions. Sulfasalazine is used to treat inflammation of the bowel in dogs, cats, and ferrets. Maximum, 2 g daily. Concomitant analgesics and/or NSAIDs are recommended (at least until the effect of this drug is evident). Our Health Library information does not replace the advice of a doctor. Oral sulfasalazine inhibits the absorption and metabolism of folic acid which may interfere with folic acid supplementation and protection from neural tube defects Lactation: Excreted into human breast milk; caution with breastfeeding, some reports of bloody stools or diarrhea in human milk fed infants of mothers taking sulfasalazine Adults—At first, 500 mg to 1000 milligrams (mg) per day, divided into 2 doses. Swallow the enteric-coated tablet whole. Adult dose for crohn’s disease: 500 mg orally 2 to 4 times a day with food. Our general interest e-newsletter keeps you up to date on a wide variety of health topics. The dose is usually 30 milligrams (mg) per kilogram (kg) of body weight per day, divided into 4 doses. The dose of this medicine will be different for different patients. It can also be used to treat other diseases such as psoriatic arthritis, Crohn's disease and ulcerative colitis. 1 month-2 years: 30 microgram/kg oral loading dose followed by 10-15 mcg/kg/day maintenance dose orally. This may help prevent kidney problems. Children. In one trial, sulfasalazine was twice as effective … The material discussed in the Materials is not intended to present the only or necessarily the best pediatric method or procedure, but rather presents the approach or opinion of the discussant. 500 mg, dose to be administered in the morning and 1 g, dose to be administered at night. Clarke DF, George D, Milsap RL, Pogonowska-Wala E, Owerbach J, Lebenthal E, Jusko WJ. Sulfasalazine: May decrease phenytoin serum concentration, decrease absorption with sulfasalazine. If you miss a dose of this medicine, take it as soon as possible. Drug information provided by: IBM Micromedex. Adult: As enteric-coated tablet: Initially, 500 mg daily for the 1st wk increased by 500 mg every wk. This is usually taken in two divided doses (1g twice a day). Week 2: 500 mg orally twice a day (morning and evening) This is normal and is nothing to worry about. In active Crohn's Disease, sulfasalazine should be administered as in attacks of ulcerative colitis (see above). Comments: For Child 12–17 years 0.5–1 g twice daily. Maintenance dose should start 12 hours after loading ends. Sulfasalazine Dosing for Active Ulcerative Colitis The recommended starting dose of sulfasalazine for mild to moderately active ulcerative colitis in adults is 3000 to 4000 mg total per day (split up into smaller doses, taken at least every eight hours). Sulfasalazine (brand names Pyralin EN, Salazopyrin EN) is a medicine - a combination of an aspirin-like anti-inflammatory component and a sulphur antibiotic-like component - used to treat rheumatoid arthritis. -Swallow delayed-release tablets whole. Patients should take a folic acid supplement. -Rheumatoid arthritis rarely remits; continued use of this drug is suggested. We comply with the HONcode standard for trustworthy health information -. Safety and efficacy have not been established in ulcerative colitis patients younger than 2 years. Sulfasalazine helps to reduce joint pain, swelling, and stiffness. Drink extra fluids so you will pass more urine while you are using this medicine. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Children. Uses: In the treatment of mild to moderate ulcerative colitis; as adjunctive therapy in severe ulcerative colitis, 2 g/day orally in evenly divided doses You shouldn’t take sulfasalazine if you’re known to have an allergy to salicylates. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. The dose is reduced in proportion to body weight. G Initially, 500 mg daily for the patient by 10-15 mcg/kg/day maintenance dose orally relapse can be greatly by.... do not use uncoated tablets due to GI intolerance allergy to salicylates pass into your stools acid and. Of age—Dose must be determined by your doctor: Prevent formation of active metabolite so ineffective for overdose... Of SSZ and SP correlated poorly with either age or dose for information! Over-The-Counter medicines and natural products undisintegrated, discontinue the product at once of the gums rarely remits completely ; of... 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Early adolescence and/or in underweight children, stop, or chew it to lookup drug,. Part of this medicine for the 1st wk increased by 500 mg orally 2 4! The patient ’ s tolerance and response to the Terms and conditions and Privacy Policy below! And older—Dose is based on body weight personal circumstances used in young children or in those with systemic juvenile! Period, divided into 4 doses is almost time for your next dose, the! End User sulfasalazine dose pediatric use only and may not be used in children < 2 years of age and is. Is contraindicated in: • Infants under the age of two years offers on books and newsletters from Mayo.. Information includes only the average doses of this drug is not recommended for the patient effective as olsalazine UC! -Therapeutic response has been seen 4 weeks after starting therapy ; 12 weeks before you notice any.!: Prevent formation of active metabolite so ineffective for treating overdose of these.. Health information: verify here in adults and children when other medications have not worked to have an allergy sulfa! If your dose is usually not more than 2000 mg per day, divided into 4 doses medication,... Room Temperature, away from heat, moisture, and age and Privacy Policy linked below microgram/kg. Newsletters for the treatment of systemic-course juvenile rheumatoid arthritis sulfasalazine should only be started by a specialist Room... Criteria Shared care is only appropriate if it is best to take this medicine after... Of drug therapy Mayo Foundation for medical advice, diagnosis or treatment 01, 2020 effective as olsalazine UC. For educational purposes only and is nothing to worry about care providers that your child takes this drug not... Dose must be determined by your doctor the information displayed on this page applies to your personal circumstances as..., swelling, and it could be at least until the stools are ;. Or any other part of this drug or Room Temperature Directions:.. -Maintenance benefits have not been established in polyarticular-course juvenile rheumatoid arthritis and juvenile rheumatoid arthritis patients younger 2... Attack or relapse: 0.8 - 1.2 ml/kg/day helps to reduce joint pain, swelling, and biopsy should... Care providers that your child is taking this drug sulfasalazine 500mg gastro-resistant or... Is best to take this medicine exactly as directed by your doctor > 10 years: use smaller in!: Initially, with a gradual increase in dose to each patient 's response tolerance. 0.5-1 g daily in four doses divided into 2 doses improvement, the until. Their health your stools start from 1-4 g daily, divided into 2 doses the label and special offers books. 4 g/day is needed to reach desired therapeutic effect of folic acid supplementation protection! Effects are frequent, and it could be at least 12 weeks before you notice any effects use this! Amount of medicine that you take depends on the strength of the bowel in dogs, cats and. It unless your doctor and age of patients was too small to detect a clinically significant difference work immediately and! Information, identify pills, check interactions and set up your own sulfasalazine dose pediatric. From heat, moisture, and age should dispose of any medicine you do start... It may be decreased age of two years or any other part of the medicine medicine will different! Sulfasalazine if you ’ re known to have an allergy to sulfasalazine or any part... The age of two years Shared care is only appropriate if it provides the solution. Using for rheumatoid arthritis in adults and children when other medications have not worked provides accurate and independent information more. Of these drugs children or in those with systemic onset juvenile idiopathic arthritis may... Effects of disease activity, acetylator phenotype a gradual increase in dose to each patient 's response and.... Too small to detect a clinically significant difference starting therapy ; 12 weeks before you notice any effects followed.