Sulfasalazine

Question 1

Monitor

Answer 1

Full blood count, renal function, urea and electrolytes, liver function

Question 2

Warning signs

Answer 2

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

Question 3

Actions 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

Question 4

Interactions

Answer 4

• Reduced absorption of digoxin resulting in sub-therapeutic plasma levels.
• Bone marrow suppression and leucopenia with 6-mercaptopurine or azathioprine.