Sulfasalazine

[Nigel N]

Have just entered my third week of Sulfasalazine treatment and whilst I realise it may take a lot longer for the benefits to kick in, I just feel really 'pants'.

Completely knackered all the time, feel like I am on the edge of flu and, not really nauseous, but I just feel ill.

Anybody out there with experience of this drug, and perhaps a little light for the end of the tunnel ? 

[david_8]

hi, Nigel

we are all diff peps, and react to our meds differently
but as your patient information leaflet states report any side effects to your gp
and get checked out

? how/what where your last blood results

rule of thumb give them a good 12wks to kick in
was on high dose for quite a time, and noticed no diff to my p or pa
and only had minor side effects IE yellow urine/eye whites


http://www.arc.org.uk/arthinfo/patpubs/6252/6252.asp

[Talis]

Sorry you are feeling naff, side efects may get less as you get more tolerant to the drug.

I only lasted a few weeks on supfa myself as it made me constantly sick.

Hang in there

[MrT]

Hi Nigel,

Sorry your feeling S###. Yes, I also felt very tired on the sulfa. Am now on methotrexate 15mg and would definitely say the tiredness is less. Having said this a number of people have found quite the opposite. I think the rule here is that everyone is different, and there is no way, as yet, of predicting who will respond best to/recieve less side effects from a particular agent.

The tiredness did get better with time on the sulfa. I do remember week 3 to be about the worst actually (1500mg?), so keep going with it. At this stage I stuck at 3 tabs (1500mg) for a bit longer, rather than stepping up to 4 tabs (2g) as was planned the next week. Having said that, as David mentioned this should be done under supervision by your GP. Blood tests would certainly be something for them to think about, however, it may just be your body needs a bit longer adjusting to the medication.

Good luck,

[Sue S]

Hi Nigel, definitely everyone is different.   I was not on sulfa very long as I found I could hardly leave the bathroom - terrible pains and the runs so could not carry on like that.   On MTX felt was always on the edge of flu and did nothing for the PA, so am in limbo with prednisalone for a few weeks now whilst deciding next options.

If it was only tiredness, I think I would have gone on a bit longer to see if it worked.

All the best.

Sue S.

[AlanTyson]

...Anybody out there with experience of this drug, and perhaps a little light for the end of the tunnel ? 

I have been on 2g/day of sulfasalazine for a year or two, with monthly blood-monitoring tests, and also took 3g/day (with no testing) for about a year c.1981, as an anti-inflammatory for ulcerative colitis. I noticed no effects apart from intermittent bright yellow urine (and the late discovery from a newspaper article that it was a promising male contraceptive).

(Enormous quantities of steroids and then drastic surgery fixed the colitis!)

My understanding of its use in PA has been that no noticeable positive effects are to be expected. The hope, based on promising results in rheumatoid arthritis (with similar symptoms to PA) is that it will delay the progress of PA, and is therefore a welcome and fairly innocuous addition to the rather small range of more drastic possible drug treatments. If my information is correct, it is a prophylactic measure; one will never know whether it worked for an individual or not, because you can't tell how bad the PA would have been without it. It's a bit like taking anti-malarials.

It's also a lot more sensible than taking vitamin pills, which millions of people do, just in case they're good. If you're deficient they'll do you good; if not they're useless and potentially poisonous.

If any lurking rheumatologist knows better than this from further studies since I started on it, please tell us, preferably with literature references! I'm seeing my friendly local rheumatologist next week for my 6-monthly visit, and I'll ask her if there's anything new in the literature.

[AlanTyson]

..... I'm seeing my friendly local rheumatologist next week for my 6-monthly visit, and I'll ask her if there's anything new in the literature

I saw her today and asked about efficacy of sulphasalazine. She said there is now quite good evidence that it is indeed efficacious in Psoriatic Arthritis. It could well take 12 weeks for any noticeable benefit, if it works. She commented that PA developments & studies usually came later than RA. It's one of the better DMARDs, she said.

[Missy]

Interesting thread (&info)

My Doc is wanting my rheumy to try me on this before MTX.

Looking to start it around Xmas time