Sulfasalazine

Day three on sulfasalazine, taking one a day and increasing to 4 gradually. I was going to increase to two today, taking a second one tonight but I am feeling a lot of nausea today :-(

Could it be that I did my MTX injection last night and the combination of the sulfasalazine today?

To be honest I'm not sleeping well either, however I am more tossing and turning due to aches and pain. Lamb...I'm drinking a lot! Every time I think of hydration I think of you and reminding people to drink water :-)

Has anyone had side effects from the Sulfasalazine? Any idea how fast it works? My Rhuemy was going to put me on enbrel but said sulfasalazine works faster....

The nausea your feeling is prolly the Sulfasalazine. It's famous for that. In fact, it's hardly ever rx'ed anymore in the states due to the large percentage of patients who are unable to tolerate it. And unfortunately, it has a very low success rate. Perhaps in combo therapy you may have more success, but on it's own Sulfasalazine is pretty much useless for the majority of people. I tried it once for about 2 months. It just made me sick at my stomach is all. No relief. But don't be discouraged. For the lucky few people it works for, it works well. And it's prolly the safest DMARD on the market by far. Long term side effects are not really a concern with this drug as far as I know.

Hi,

I did have side effects at first, a bit of upset stomach but it went away fairly quickly. I've been on 2 pill twice a day for 6 or 7 months if not longer. Definitely need lots of water too due to the sulfur part of that medication. Also, it does take a little while to work, I think it was about 2 or 3 months but I can't quite remember.

I read some info online that there should not be more than 6 hrs between doses. I only read it in one source so far so I'm not sure how true it is. Also, I don't know about you but my doc didn't give me Folic Acid supplements as he did with Mtx. Sulfasalizine apparently inhibits the body's ability to absorb folic acid as well so I have increased my dose of that through different foods. Folic acid deficiency can make you tired too. I hope that info helps a bit.

I am also continuing with the folic acid, the pharmacist said it's important I remain on it. I am also on MTX 25 mg injections weekly, drinking a ton of water! The 6 hours in between makes sense as it states morning and evening so I will do the same. I had a lot of fatigue and nausea when I started the MTX, so having both now is probably the cause. Hopefully my body adjusts and the side effects go away quickly because to be honest I'm at the point where I feel like switching to something else. Thanks for your feedback, it's greatly appreciated :-)

Dini said:

Hi,

I did have side effects at first, a bit of upset stomach but it went away fairly quickly. I've been on 2 pill twice a day for 6 or 7 months if not longer. Definitely need lots of water too due to the sulfur part of that medication. Also, it does take a little while to work, I think it was about 2 or 3 months but I can't quite remember.

I read some info online that there should not be more than 6 hrs between doses. I only read it in one source so far so I'm not sure how true it is. Also, I don't know about you but my doc didn't give me Folic Acid supplements as he did with Mtx. Sulfasalizine apparently inhibits the body's ability to absorb folic acid as well so I have increased my dose of that through different foods. Folic acid deficiency can make you tired too. I hope that info helps a bit.

Hi Chris, Thanks for the feedback....now I would of rather tried enbrel, however I've started the Sulfasalazine now so will continue and cross my fingers this works. Good to hear that it's one of the safest Dmards :-)

Chris said:

The nausea your feeling is prolly the Sulfasalazine. It's famous for that. In fact, it's hardly ever rx'ed anymore in the states due to the large percentage of patients who are unable to tolerate it. And unfortunately, it has a very low success rate. Perhaps in combo therapy you may have more success, but on it's own Sulfasalazine is pretty much useless for the majority of people. I tried it once for about 2 months. It just made me sick at my stomach is all. No relief. But don't be discouraged. For the lucky few people it works for, it works well. And it's prolly the safest DMARD on the market by far. Long term side effects are not really a concern with this drug as far as I know.

I have been on Sulfasalazine for 9 months. Initially, I had nausea, which for me is strange because I rarely if ever get nausea. It did pass after about 2 weeks and my body adjusted to it. When I started it I had pretty severe right foot pain. I have bad Achilles tendonitis and my toes are stiff and swollen. I also had wrist pain with obvious swelling. Within 3 weeks of taking the Sulfasalazine my pain was gone. I still had the swelling but no pain.

The Sulfasalazine worked really well for me for 6 months. I started with 1 pill 3 x day and then when my symptoms began coming back she increased to 2 pills in the morning, 1 pill in the afternoon, and 2 pills at night. It did help but my flare is just getting worse and the Sulfasalazine is just not enough.

The only other side effect I really have trouble with from the Sulfasalazine is insomnia. Although, I have suffered from insomnia my entire life (even as a kid) off and on so maybe I am just more susceptible to that particular side effect.

I did have a very short period of heart palpatations when my doc increased the dosage. I started taking B12 supplements because it can affect B12 absorption as well as folic acid absorption. As a side note, I am vegetarian so that could be a reason why I had that particular side effect.

I am to start MTX injections this weekend. I am also supposed to stay on the Sulfasalazine because my Rheumy feels it is helping but just isn't quite enough.

Thanks Crabbygirl! I am still only taking one pill a day and will be increasing to two tomorrow. I am also injecting 25my of methotrexate every Tuesday night. I started the MTX in April taking pills and then changed to injections. I find the injections are way better then the pills as far as side effects, although I dread injection day.

I have been having a bit of nausea so far and probably will continue with each increase as that was what happened with the MTX. I'm also finding my appetite is pretty much gone, again probably due to the nausea. The last few days have been good energy wise so that is a plus. I'm wondering if I should continue to increase to 4 daily or maybe just remain at 2 and increase if I flare again. I've been taking folic acid daily along with other vitamins. I hope that once you add the MTX you will find more relief! I'm feeling positive about this now as my energy level has changed and that is huge, however this seemed to be the pattern with the MTX too. I had some really good days and thought I was doing well and then a flare would hit. I am finding I am having less pain in my hands lately....crossing my fingers this works.

Crabbygirl said:

I have been on Sulfasalazine for 9 months. Initially, I had nausea, which for me is strange because I rarely if ever get nausea. It did pass after about 2 weeks and my body adjusted to it. When I started it I had pretty severe right foot pain. I have bad Achilles tendonitis and my toes are stiff and swollen. I also had wrist pain with obvious swelling. Within 3 weeks of taking the Sulfasalazine my pain was gone. I still had the swelling but no pain.

The Sulfasalazine worked really well for me for 6 months. I started with 1 pill 3 x day and then when my symptoms began coming back she increased to 2 pills in the morning, 1 pill in the afternoon, and 2 pills at night. It did help but my flare is just getting worse and the Sulfasalazine is just not enough.

The only other side effect I really have trouble with from the Sulfasalazine is insomnia. Although, I have suffered from insomnia my entire life (even as a kid) off and on so maybe I am just more susceptible to that particular side effect.

I did have a very short period of heart palpatations when my doc increased the dosage. I started taking B12 supplements because it can affect B12 absorption as well as folic acid absorption. As a side note, I am vegetarian so that could be a reason why I had that particular side effect.

I am to start MTX injections this weekend. I am also supposed to stay on the Sulfasalazine because my Rheumy feels it is helping but just isn't quite enough.

I'm also having a tough time sleeping, however I believe it's more due to aches and pains through the night.

TaraLynn said:

Thanks Crabbygirl! I am still only taking one pill a day and will be increasing to two tomorrow. I am also injecting 25my of methotrexate every Tuesday night. I started the MTX in April taking pills and then changed to injections. I find the injections are way better then the pills as far as side effects, although I dread injection day.

I have been having a bit of nausea so far and probably will continue with each increase as that was what happened with the MTX. I'm also finding my appetite is pretty much gone, again probably due to the nausea. The last few days have been good energy wise so that is a plus. I'm wondering if I should continue to increase to 4 daily or maybe just remain at 2 and increase if I flare again. I've been taking folic acid daily along with other vitamins. I hope that once you add the MTX you will find more relief! I'm feeling positive about this now as my energy level has changed and that is huge, however this seemed to be the pattern with the MTX too. I had some really good days and thought I was doing well and then a flare would hit. I am finding I am having less pain in my hands lately....crossing my fingers this works.

Crabbygirl said:

I have been on Sulfasalazine for 9 months. Initially, I had nausea, which for me is strange because I rarely if ever get nausea. It did pass after about 2 weeks and my body adjusted to it. When I started it I had pretty severe right foot pain. I have bad Achilles tendonitis and my toes are stiff and swollen. I also had wrist pain with obvious swelling. Within 3 weeks of taking the Sulfasalazine my pain was gone. I still had the swelling but no pain.

The Sulfasalazine worked really well for me for 6 months. I started with 1 pill 3 x day and then when my symptoms began coming back she increased to 2 pills in the morning, 1 pill in the afternoon, and 2 pills at night. It did help but my flare is just getting worse and the Sulfasalazine is just not enough.

The only other side effect I really have trouble with from the Sulfasalazine is insomnia. Although, I have suffered from insomnia my entire life (even as a kid) off and on so maybe I am just more susceptible to that particular side effect.

I did have a very short period of heart palpatations when my doc increased the dosage. I started taking B12 supplements because it can affect B12 absorption as well as folic acid absorption. As a side note, I am vegetarian so that could be a reason why I had that particular side effect.

I am to start MTX injections this weekend. I am also supposed to stay on the Sulfasalazine because my Rheumy feels it is helping but just isn't quite enough.