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Re: sulfasalazine

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I take the higher dose of folic acid to compensate for the effects of

sulfasalazine, which I take for UC.

Hi, I was searching for posts on sulfasalazine and found this remark.

What effects does sulfasalazine have? What experiences did the quoted

poster have and others who take or have taken this med? --And, how

doeds the med work for you? Does anyone take it to also help with

joint pain -and does it help with this? My son is switching from

Pentasa to Sulfasalazine this week (to have the added benefit of pain-

killer for his joints). He took Pentasa for 19 months. Also, is there

an adjustment period with GI symptom-like side effects? How long,

typically? My son had this when starting on his Pentasa, was sick with

symptoms identical to his IBD for a long time before he adjusted. I am

also nervous about the sulfasalazine not working out and that if/when

our son goes back on Pentasa, he will have the same difficult

adjustment on Pentasa that he did before. Any experience with this,

too, or thoughts??

Thank you,

Meghan, mom to 14yo Wyatt -psc, ibd, genetic fap, gerd, autoimmune

hives, disabled

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> I was on sulfasalazine for the better part of 14 years with my UC

and it was by far the best maintenance drug that I had ever tried.

Since your son also has joint pains, this would be a good switch for

him as the added ingredient of sulphur should provide some relief for

that since it is similar to aspirin. I noticed that it was helpful

controlling the abdominal pain I occasionally had with my ulcerative

colitis.

This sounds wonderful, thank you for posting, Rick. And, abdominal

pian is one of the few symptoms that still bother my son from time to

time (he is almost fully in remission with his ibd -a crohn's

colitis 'hybrid'), so honing in on that specific symptom sounds

really good.

> The side effects that I can recall from sulfasalazine is that I had

more gas than normal and more foul smelling gas as well.

My son gets the abdominal bloat, trapped upper intestinal gas and

burping, but maybe he'll just trade that one for the other. We have

a dog, so we might not even notice the difference if Wyatt gets the

lower intestinal gas and flatulence. :o)

>You asked specifically about GI side effects

Wyatt's GI said it was GI side effects that would be the likely

problem and since that what's he had with Pentasa at first, I figured

that's what it would be with sulfasalazine. He is starting 'slowly',

starting with a lower dose and working up to the full amount -his doc

said that might help, that and coated tablets.

Thank you again -very much.

-Meghan, mom to 14yo Wyatt -psc, ibd, genetic fap, gerd, autoimmune

hives, disabled

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> I've taken sulfasalazine for UC for most of the last 30 years.

I've been asymptomatic (with UC) for all but a couple of months of

that time. There are a lot more 5-ASA medications now (Pentasa,

Dipentum, etc.); sulfasalazine was probably the first. It's an oldie

but a goodie, and has been very effective for me. I have asked about

changing to one of the newer formulations, and was told not to if

it's working for me.

This also sounds wonderful, thank you Arne. I'm glad it has worked

so well for you, too. Did you have an adjustment period when you

began on it or no real problems from the get-go?

> In a simplistic sense, it turns into aspirin when it gets to the

bowel.

Is this safe for psc, too, then --must be if you and Rick have both

been on so long w/o problems??

> It impairs folic acid absorption, which is why folic acid

supplementation is often prescribed. I took sulfasalazine for 28

years before taking folic acid. The folic acid deficiency results in

an elevated MCV (mean corpuscular volume of red blood cells).

Ah, it was your post I saw while searching. Thank you so much for

expanding on this for me. I will call my son's GI tomorrow and ask

if Wyatt should take folic acid or have a blood test to check for it

after starting on the sulfasalazine (assuming there is blood test).

This is very helpful information.

> In men, it causes temporary infertility, which is reversible by

stopping the medication.

The medication alone causes this or the folic acid deficiency while

taking the medication? Is it definitively reversible, no question

about it? My son is already saving his old toys in our garage for

his future child(ren) and I'm inclined toward becoming a grandparent

someday, I must admit. What a curious side effect. Any idea why?

Thank you again,

Meghan, mom to 14yo Wyatt -psc, ibd, genetic fap, gerd, autoimmune

hives, disabled

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> I've taken sulfasalazine for UC for most of the last 30 years.

I've been asymptomatic (with UC) for all but a couple of months of

that time. There are a lot more 5-ASA medications now (Pentasa,

Dipentum, etc.); sulfasalazine was probably the first. It's an oldie

but a goodie, and has been very effective for me. I have asked about

changing to one of the newer formulations, and was told not to if

it's working for me.

This also sounds wonderful, thank you Arne. I'm glad it has worked

so well for you, too. Did you have an adjustment period when you

began on it or no real problems from the get-go?

> In a simplistic sense, it turns into aspirin when it gets to the

bowel.

Is this safe for psc, too, then --must be if you and Rick have both

been on so long w/o problems??

> It impairs folic acid absorption, which is why folic acid

supplementation is often prescribed. I took sulfasalazine for 28

years before taking folic acid. The folic acid deficiency results in

an elevated MCV (mean corpuscular volume of red blood cells).

Ah, it was your post I saw while searching. Thank you so much for

expanding on this for me. I will call my son's GI tomorrow and ask

if Wyatt should take folic acid or have a blood test to check for it

after starting on the sulfasalazine (assuming there is blood test).

This is very helpful information.

> In men, it causes temporary infertility, which is reversible by

stopping the medication.

The medication alone causes this or the folic acid deficiency while

taking the medication? Is it definitively reversible, no question

about it? My son is already saving his old toys in our garage for

his future child(ren) and I'm inclined toward becoming a grandparent

someday, I must admit. What a curious side effect. Any idea why?

Thank you again,

Meghan, mom to 14yo Wyatt -psc, ibd, genetic fap, gerd, autoimmune

hives, disabled

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> I took sulfasalizine and folic acid for 17 years pre-transplant.

It did a fine job for me with only one side effect. It makes the

effects of the sun much more intense, so you must use sun block.

Did it cause a rash or did you burn more easily/quickly? Thanks for

this additional possible side effect. This is wonderful, getting so

much information for my son. I hope you are doing well post-

transplant, no complications or problems.

>I have not had joint pain, so I cannot say how it works for that,

but would think that since it reduces inflammation that it would work

well for that too.

We're hoping so, otherwise we'd stick with Pentasa.

> For a brief period of time I was on another drug that was more

expensive, but did not work better so I ask to return to

sulfasalizine. I do not remember any adjustment period.

No adjustment period would be wonderful for my son. I hope he has

the same experience as you. Thank you again, Joe.

-Meghan, mom to 14yo Wyatt -psc, ibd, genetic fap, gerd, autoimmune

hives, disabled

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> It is orange as long as you are on the med.

Well, maybe he'll just consider it festive then -he likes fall

colors. :o) We always try to spin a quirk a positive way at our house.

Thank you, Joe.

-Meghan, mom to 14yo Wyatt

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No rash, and with Norwegian ancestry (going back to at least the 1700s

both sides), I'm not sure I could tell if I burned more easily

anyway! :)

Arne

> Did it cause a rash or did you burn more easily/quickly?

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I also have taken sulfasalazine for over 30 years, and can't remember being told that folic should be added. I'll go back on it. I find that it's easy to get off the track on meds as the years go by. And sometimes Drs disagree about the usefulness of some meds. I've been asked by one Dr why I was "taking that stuff" re several meds.

I always put in a good word for sulfasalazine. It halted my UC literally over night. No side effects in all that time.

Don

Please be a blood/organ donor

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I also have taken sulfasalazine for over 30 years, and can't remember being told that folic should be added. I'll go back on it. I find that it's easy to get off the track on meds as the years go by. And sometimes Drs disagree about the usefulness of some meds. I've been asked by one Dr why I was "taking that stuff" re several meds.

I always put in a good word for sulfasalazine. It halted my UC literally over night. No side effects in all that time.

Don

Please be a blood/organ donor

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> I burned more easily - no rashes.

Thanks for the info.

> I am doing well post-transplant. No restrictions and taking less

meds than I did pre-transplant. I was told the first year can be a

roller coaster while your body adjusts to the new organ. I have been

very lucky. A small bump initially, then smooth sailing since then.

It sounds like a new lease on life -I'm so glad it's going so well and

hope it continues to or gets even better for you.

-Meghan, mom to 14yo Wyatt

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> No rash, and with Norwegian ancestry (going back to at least the

1700s both sides), I'm not sure I could tell if I burned more easily

anyway! :)

:o) My husband and son are part Norwegian. My Mother-in-law's maiden

name is Amundsen. We are normally good with sunscreen, but I'll tell

Wyatt he has to be even more mindful of it on sulfasalazine.

-Meghan, mom to 14yo Wyatt

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> I also have taken sulfasalazine for over 30 years, and can't

remember  being told that folic should be added. I'll go back on it. I

find that it's easy to get off the track on meds as the years go by.

And sometimes Drs disagree about the usefulness of some meds. I've been

asked by one Dr why I was " taking that stuff " re several meds. I

always put in a good word for sulfasalazine. It halted my UC literally

over night. No side effects in all that time.

Thanks, Don. I haven't heard a negative word on it so far -that's

impressive.

-Meghan, mom to 14yo Wyatt

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>

>

>

>

> Did you have an adjustment period when you began on it or no real

problems from the get-go?

> No, other than learning I HAD to take it. I had no side effects

other than orange urine.

>

> Is this safe for psc, too, then --must be if you and Rick have both

been on so long w/o problems??

> It’s a well established drug, with well-known efficacy and side

effects, that has many more years under its belt than others. My

hepatologist recommended it over other alternatives based on my (good)

results with it.

>

> I would have typed the same thing as Arne. I've been on it since 2

months before my official diagnosis (1984). At one point my doc

switched me to Asacol but I did not have nearly the same result, so we

went back. I do take Folic Acid because Sulfasalize is known to

deplete it. My bone density tests have always been within normal

range so all is well.

>

> (MO)

>

I saw you live in MO. I live near KC. Where do you go for treatment?

Who is your doctor?

Ellen

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