Sulfasalazine is a drug with a long history. In addition to being used to treat ulcerative colitis, it has also been used to treat rheumatoid arthritis and ankylosing spondylitis. Clinical confirmation: Sulfasalazine has a significant therapeutic effect on low back pain, peripheral arthritis, morning stiffness, changes in erythrocyte sedimentation rate and C-reactive protein, and X-ray lesions of the sacroiliac joints in patients with ankylosing spondylitis.
Sulfasalazine is the most widely used second-line drug in the treatment of ankylosing spondylitis. It is mainly suitable for patients with ankylosing spondylitis accompanied by peripheral arthritis. It can improve peripheral joint symptoms; secondly, it can prevent and treat ankylosing spondylitis. inflammation complicated by iritis; it is also effective against combined intestinal infection (more than 60% of patients with ankylosing spondylitis have intestinal inflammation). It can inhibit microorganisms in the intestine and improve the condition.
Of course, sulfasalazine is not suitable for all patients,
Precautions for Sulfasalazine The following are the precautions for taking this drug
Seven major precautions for sulfasalazine
①Need to know allergy history
Before taking the medicine, you need to know whether you have a history of allergies to sulfonamide drugs. People with allergies should not use it.
②In order to prevent adverse drug reactions, it is recommended to gradually increase the dose from a small amount
The initial low-dose medication is 0.5g each time, 2 times/d, and then gradually increase to 1g each time, 2 times/d according to the condition and drug response. It is generally not recommended to increase to 3g/d.
Nitropyridine ③ Drink more water and take it with sodium bicarbonate
The metabolite of sulfasalazine, acesulfonamide, has low solubility in acidic urine and is easy to precipitate and crystallize, causing mechanical irritation to the kidneys, causing low back pain, hematuria, and even anuria. However, in an alkaline environment, Increased solubility.
Therefore, when taking sulfasalazine for a long time or in large doses, you should drink more water and increase urine output (urine output should not be less than 1.5 L/d) to reduce the concentration of the drug in the urine.
④ Do not take it with acidic medicine
Some acidic drugs, such as vitamin C and pepsin mixture, should not be combined with sulfasalazine to prevent acidification of urine, which will reduce the solubility of the metabolite acesulfonamide in the urine and precipitate crystals, resulting in crystalluria and damage to the kidneys.
⑤ If you are allergic to sulfasalazine, you can switch to mesalazine
If gastrointestinal reactions are severe, anal suppositories can be used instead.
⑥ Sulfasalazine can be used in pregnant women during pregnancy, but the dose should not be >2g/d
Folic acid should be supplemented at the same time (to reduce the risk of cleft lip). It can also be used by those who deliver full-term newborns (without glucose-6-phosphate dehydrogenase deficiency) and mothers who are breastfeeding.
Men should stop taking the drug for 3 months before conceiving again (sulfasalazine can cause male spermopenia, but it is generally reversible and can be recovered after stopping the drug for several months).
⑦ Generally, liver and kidney function should be reviewed 3 to 4 months after taking the medicine.
In addition, the combination of sulfasalazine and thalidomide in the treatment of ankylosing spondylitis not only has good efficacy, but also has few side effects. The price of sodium carbonate is not expensive and is worth recommending.
In order to avoid possible adverse reactions of thalidomide (such as drowsiness), it should be taken before going to bed, starting with a small dose and gradually increasing the dose, such as starting from 25 to 50 mg every night. The tolerated dose of Chinese people is often 100 mg every night. Within. In order to prevent possible numbness of the limbs, vitamin B6 can be used in combination. Once numbness of the limbs occurs, it should be stopped in time. Those who experience constipation due to taking thalidomide can be combined with total glycosides of paeony. It is absolutely prohibited to use during pregnancy.
