Sulphasalazine

Class

• Mesalazine derivative anti-inflammatory agent

Indications

• inflammatory bowel disease

• rheumatoid arthritis

• enthesitis related arthritis like juvenile spondyloarthropathie

Administration/Absorption

• • Poorly absorbed from the gut

    • Most effects are within the gut?

  • Affinity for connective tissue and accumulates in joint spaces

Dosage

Distribution

Mechanism

• Metabolised to:

  • • sulfapyridine which gives rise to side-effects

    • 5-aminosalicylic acid (5-ASA) which gives therapeutic effects

• Reduces the synthesis of eicosanoids and inflammatory cytokines

• No immunosuppressant action

• Systemic decrease in IL-1, TNF-alpha (and IL-6)

Excretion

Side effects

• agranulocytosis

• hypospermia

• Immune thrombocytopenia

Interactions

Contraindications