Sulfasalazine: My rheumatologist has increased my daily... - NRAS


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Pat64 profile image
19 Replies

My rheumatologist has increased my daily dose of sulfasalazine from 4/500mg tablets to 5/500mg as the RA in my wrist joints is not well enough controlled. I was wondering if anyone has had a similar increase in the drug and if it was tolerated or produced side effects. I have been taking sulfasalazine for a year after initial RA diagnosis and with few problems.

19 Replies
helixhelix profile image

I take 5 tabs a day with no problems. Took me a while to get used to them, but they're fine now. (plus Hydroxy and MTX and about 5 others of course....). I am 5ft 9, and 10.7 stone so there's a fair bit of me - I don't know if body weight makes a difference.

sylvi profile image

I take four a day and it has helped. I have only been on the four since

Sunflower62 profile image

I take 6 a day three in the morning three at night just make sure you are taking the coated tablets!

aristojune profile image

Hi Pat - since Oct I take 6/500mg daily due 2 same problem with wrists - no side affects but no improvement in wrists - due back and rheumy in Feb so they prob going 2 add another drug into the mix - lesser of 2 evils? Dont know

stbernhard profile image


I have been on 3000mg (six tablets) for four years now. Side effects are a very subjective issue for me. If I feel they are no worse than the benefit I get then I tend to accept them. I hope you don't get any. All the best.

Clare-NRAS profile image

Hello Pat

What you may find helpful is to actually talk to someone who has been taking an increased dose of Sulfasalazine. NRAS has trained telephone support volunteers who we are able to match with a call request. They would then call you at a mutually convenient time and be able to share their experience of in this instance tolerating SSZ and chat about other aspects of living with RA etc. Many people find this really helps a great deal. If you would like to arrange a volunteer call just contact our helpline on 0800 298 7650 to give us your details.

Best of luck


NeonkittyUK profile image
NeonkittyUK in reply to Clare-NRAS

I did not know if this ... what an excellent idea. I once did this many years ago with my then rheumy nurse to help a couple of newly diagnosed patients with RA but it wasn't an ongoing thing. Just a couple of people she knew would feel at ease with me ans vice versa.

mattcass profile image

Hi Pat64 Nice to talk to you for some reason I thought the maximum was 3,000mgs a day nobody at anytime has said otherwise, My RA is has targeted both wrist constantly well almost i get flareup 2/3 daily at the moment I will talk to my RA consultant next week to see if increasing my Safasalazine doseage will or could help, My god we have tried everything else, Because of my Lung issues i am on only allowed the two mildest RA treatments, Will let you know how I get on. mattcass

Scottishlad profile image

I was on 6 tablets a day for a couple of years until I needed other treatment added.

Sulphasalazine can cause increased sun sensitivity. I used at least factor 15 in the UK and factor 30 or even 50 when abroad and still got a tan!

Shy535 profile image

Hi Pat, I was on 6 tabs a day for a while, now I'm down to 4 tabs with the introduction of a new med. when I first increased to 6 tabs I would get dizzy from time to time. Dizziness went away. I do have to be careful with the sun sensitivity. I hope you don't have any side effects. :-)

johnjohn profile image

A liitle advise never stop taking it unless you change to another med ..I wasn't given entric coated been the normal ones for 17 years until recently ,i stopped due to stomach issues the doctors had to wait and see kind of attitude no 1 mentioned there was entric coated tablets available so now i'm in the middle of a massive flare up now I'm absolutely crippled what i'm trying to say is even if you feel so much better never stop taking the tablets

Dianemikey4948 profile image

Hi, I have been taking 4 Sulphasine for 5+ years and like you I had increasing problems with my wrists, my dose was increased to 6 in October, I have to say initially the increase made me feel unwell with nausea and headaches and I lost a lot of weight quickly, things have improved now and I am positive for the future, good luck with the increase and for the future. Di. Xx

tigershay1 profile image

Om on 4 sulfasalazine per day with 4 naproxin i still have lot stiffness and pain in hands wrists but my lung probs dictate drugs so occupational rheumy therapist for me for stronger splints . Its starting in my ankles and shoulder now . Best wishes x

Marz21 profile image

Hi, I increased to 6 sulf a day last year, had tried to increase too quickly previously and had to wind back due to nausea and rely more on steroids. Nausea, headaches time to time second time round with the increase, but settled down. I tend to need to urinate more often, and would recommend taking tablets with food which seems to help with nausea. Hope it helps dampen your symptoms. X

NeonkittyUK profile image

I was 6 and a half stone (and 5ft 5ins!) when I first took them in 1995 as RA had ravished my muscles and fat, and I tolerated six a day really well. Never had any major problems or side effects or bad blood results. Just wish they would have made them a bit smaller as I am not a good tablet swallower .. not even if it is a tiny one. I just made sure I had a long drink ready to take them with. I did think they gave me more sun sensitivity in a hot summer but this can be dealt with and they do colour your urine orange a little but it is no big deal. For me they worked great for ten years before they lost some efficacy. Then changed to something else. Good luck. NK ;-)

Chappy1 profile image

I now take 6 a day. Have for about 2 years now. I remember having a problem with a little nausea at first but nothing like MTX.

They have worked wonders for me.

Moses5 profile image

I've been taking 6 a day for the past year, the only side affect I've had is I need to go to the loo more often, the swelling in my hands have gone down & I don't have hardly any flare ups now, I'm also taking 10mg of Leflunomide a day. I've found if I do a lot of cleaning the next day my hands are a bit stiff other than that I'm fine,

Moomin8 profile image

Hi- I know this post was some time ago...but I have been asked to increase from 4 to 6 a day and have had to take it back to 4 as I felt awful! As I have to work, I couldn't manage so I've taken it back down to 4. Can I try 2 in the morning, 2 at lunchtime and 2 in the evening?

nomoreheels profile image
nomoreheels in reply to Moomin8

I wasn't on SSZ long Moomin but I didn't take it all in one go. Like I did with MTX tablets I split the dose, though just morning & evening, as advised by the Registrar who prescribed them initially.

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