Description
Sulfasalazine Pharmacodynamics
Sulfasalazine selectively accumulates in the intestinal connective tissue with the release of 5-aminosalicylic acid (5-ASA), which has anti-inflammatory activity, and sulfapyridine, which has antimicrobial bacteriostatic activity.
Indications
– Ulcerative colitis (treatment of exacerbations and maintenance therapy in the remission phase);
– Crohn’s disease (mild and moderate forms in the acute phase);
– rheumatoid arthritis; juvenile rheumatoid arthritis with ineffectiveness of non-steroidal anti-inflammatory drugs (NSAIDs).
Contraindications
– Hypersensitivity to sulfasalazine or other components of the drug, as well as to sulfonamides or salicylates;
– porphyria;
– granulocytopenia;
– aplastic anemia;
– congenital deficiency of glucose-6-phosphate dehydrogenase (risk of jaundice);
– hepatic and/or renal insufficiency;
– children younger than 10 years of age and/or weighing 35 kg or less, with chronic inflammatory bowel disease (for this dosage form and dosage);
– Intestinal or urinary tract obstruction;
– Children younger than 6 years of age with juvenile rheumatoid arthritis (efficacy and safety not established);
– Breast-feeding period.
Caution:
Bronchial asthma, atopic dermatitis, history of allergic reactions (cross-allergic reactions to furosemide, thiazide diuretics, sulfonylurea derivatives, carbohydrate inhibitors are possible), systemic forms of juvenile rheumatoid arthritis (risk of serum disease); pregnancy.
Dosage and administration
- Inside, after a meal.
- Ulcerative colitis, Crohn’s disease.
- Adults and children over 16 years old: in 1st day – 500 mg 4 times per day; in 2nd day – 1 g 4 times per day; in 3rd and subsequent days – 1.5-2 g 4 times per day.
- After acute clinical symptoms of ulcerative colitis subside, a maintenance dose – 500 mg 3-4 times daily for several months is administered to adults and adolescents and / or body weight over 65 kg.
- For children from 10 to 16 years old and / or body weight from 35 to 50 kg – 500 mg 4 times a day.
- Maintenance therapy for children and adolescents under 16 years of age and/or with body weight less than 65 kg is not recommended.
- Maximal daily dose for adults is 8 g, for children under 16 years old – 2 g.
- Rheumatoid arthritis and juvenile rheumatoid arthritis
- Adults and children over 16 years of age: during the first week – 500 mg once a day, during the second week – 500 mg twice a day, during the third and further – 500 mg 3 times a day.
- The therapeutic dose may be 1.5 to 3 g/day. Clinical effect appears after 6 to 10 weeks of therapy. The course of treatment is 6 months or more.
- Children 6 to 8 years of age and / or body weight 20-29 kg: 1 tablet 2 times a day;
- Children from 8 to 12 years of age and/or body weight 30-39 kg: 1 tablet 2 to 3 times a day;
- Children at 12 to 16 years of age and/or with body weight of 40-50 kg: 1 tablet 3 times a day or 2 tablets 2 times a day;
- Children over 16 years of age and/or over 50 kg of body weight: 2 tablets 2 times a day.
- Maximum daily dose for children is 2 g or 40-50 mg/kg body weight.
