Sulfasalazine

Details About Generic Salt ::  Sulfasalazine 

Main Medicine Class:: #N/A   Sub Medicine Class ::  #N/A

7H. DRUGS FOR INFLAMMATORY BOWEL DISEASE in 7. GASTROINTESTINAL SYSTEM
SULFASALAZINE
SULFONAMIDE | ANTI-INFECTIVE, GI ANTI-INFLAMMATORY, ANTI-RHEUMATIC
also comes under 12D. Anti-Rheumatic Drugs (DMARDs) in 12. Musculoskeletal Disorders & Pain
PK: A: Small intestine M: Colonic intestinal flora E: Urine

Indications & Dose: INFLAMMATORY BOWEL DISEASE PO Adult 1g TID/QID, gradually reduced to 2g/day on remission Child >2 yr: 40-60mg/kg /day in divided doses reduced to 20-30mg/kg/day for maintenance of remission | RECTAL Adult Suppository: 1g HS & morning, gradually reduce dose based on response after 3 wk. Enema 3g HS Child Suppository: 5-8 yr: 1g, 8-12 yr: 1.5g, 12-18 yr: 2g. Enema: 2-7 yr: 1-1.5g, 7-12 yr: 1.5-2.25g, 12-18 yr: 3g, retain for 1h at least | JUVENILE IDIOPATHIC ARTHRITIS PO Child 2–18 yr: Initially 5mg/kg BID 1st wk, then 10mg/kg BID 2nd wk, then 20mg/kg BID 3rd wk, MD 20-25mg/kg BID max 2g/day (2-12 yr) & 3g/day (12-18 yr) | POLYARTICULAR JUVENILE RHEUMATOID ARTHRITIS PO Child >6 yr: 30-50mg/kg/day in 2 divided doses max 2g/dayPatients who inadequately respond to analgesics & NSAIDs | RHEUMATOID ARTHRITIS PO Adult EC tablet: 500mg/day 1wk, then increase by 500mg/day q1wk max 3g/day in 2-4 divided doses

Contra: Hypersensitivity, porphyria, GI/GU obstruction, children

Precautions: G6PD deficiency, renal/hepatic imapirment, blood dyscrasias, allergy/asthma, ß-hemolytic streptococcal infect

ADR: Serious: hepatic & pulmonary dysfunction, cyanosis, cirrhosis, Others: dizziness, urticaria, oligospermia, yellow-orange discoloration of skin, urine & other body fluids, nausea, vomiting, abdominal discomfort, headache, fever, rash, blood disorders

DDI: Serious Mercaptopurine/Azathioprine leads to hematological toxicity, Ethambutol/Ampicillin/Rifampicin reduces drug efficacy, Digoxin reduces drug levels, Etanercept reduces neutrophil count

Diet: After food with adequate water

Monitor: CBC, LFTs, urine analysis, signs of infection

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