Sulfasalazine

Question 1

Monitoring

Answer 1

Renal function should be monitored before starting an oral aminosalicylate, at 3 months of treatment, and then annually during treatment.

Blood disorders

Close monitoring of full blood counts (including differential white cell count and platelet count) is necessary initially, and at monthly intervals during the first 3 months.

Liver function

Liver function tests should be performed at monthly intervals for first 3 months.

3

Question 2

Warning signs

Answer 2

• Malaise, fever, sore throat and other signs of infection
• Unexplained bruising
• Jaundice

Question 3

ACTION REQUIRED

Answer 3

-Advise patients that there maybe yellow-orange discoloration of the urine, other body fluids and the skin
• Advise patients that some soft contact lenses may be stained

• Patients should ensure they maintain an adequate fluid intake

• Oral sulfasalazine inhibits the absorption and metabolism of folic acid leading to folic acid deficiency. This can be corrected using folic acid supplements
• Use with caution in patients with G-6-PD deficiency since it may cause haemolytic anaemia