Sulfasalazine

Hi all, if anybody could help it would ba appreciated, been on sulfa for 3 weeks, started feeling a bit achey all over like the flu, could this be a side effect of the sulfa and has anybody else found this with sulfasalazine, and if it passes over time being on this! Any help would be helpful. Thanks. lady B x 😊

[dtech]

I've been on it for five years and not had that effect. Are you sure it's not the RA causing the aches and fatigue?

[Hidden in reply to dtech]

Hi dtech thanks for your reply, glad to here you don't have this effect, and you could be right, maybe it is my RA causing the aches and pains. It could be just a coincidence. Have to ring my rheumy if it persists for to long, thanks. lady B x😊

[dtech in reply to Hidden]

No problem. The weather at the moment doesn't help! It's pouring down here. Even though a lot of people say wet weather doesn't affect RA, it does mine! Lol.

[Hidden in reply to dtech]

Thanks dtech, and your right, the weather is raining to here and it's gone a lot colder, I'm quite newly diagnosed as well, so still learning about RA, thanks a lot for your reply, it's helped a lot, Lady B 😊xx

[earthwitch]

Yes, I had exactly that as a hypersensitivity reaction to SSZ. I got to the point where I felt really really awful, and even though my GP said it was just flu and keep taking the SSZ, I decided to stop. With daily antihistamines the flu symptoms completely went away. I believe that even if you do react like this, sometimes slowing down the increases, (including going back to the last dose you were OK with for a while longer) can allow you to be tolerant of it, but that really didn't work for me. Even though I waited a couple of weeks, then started at a much lower dose I still almost immediately got that horrible flu-like illness straight off.

Just be aware that many doctors don't really recognise this as a hypersensitivity reaction, and will try to tell you its just flu. It used to be listed as a side effect in the monitoring guidelines for GPs and was a reason for stopping SSZ, but it seems to have been taken out of the list of reasons to stop it. I ended up going against doctors advise in stopping it, though they did recognise later that I had reacted, once I'd tried it a second time and had the same symptoms. I now have sulpha drugs recorded as an allergy because of that.

It is a bit hard to decide when to consider that it is a reaction and not flu, but for me it was about a week of symptoms getting increasingly worse, and I just had a gut feeling it was the meds. Interestingly it can be a side effect that can come on at any time, not just soon after you start it, though I think its more commonly triggered as you increase the dose.

[Hidden in reply to earthwitch]

Hi earthwitch, thank you for your reply, sorry the selfs didn't work for you, I'm on my second med now as I couldn't tolerate max either, I will leave for a little bit longer with the sulfa, if still the same in a week or 2 I will mention it to my rheumy thanks again, lady B 😊x

[Anko12 in reply to earthwitch]

I had a very similar reaction and developed obstructive bronchitis after 3 weeks on medication, where onset was rapid( less than 48 hours). The rheumatologist denied any connection with the med, however he advised that I stop the meds and restart with max 2 a day. In the meantime I have found several journal articles asserting relationship between these symptoms and the SSZ

[Hidden]

Hi LadyB

I never had any of those side effects. I was told that you need to gradually increase your dose of sulfa every week to help prevent side effects. Are your pills coated so they don't upset your tummy?

The sulfa is starting to kick in for me,so I hope it does for you too. But please contact your doctor to make sure everything is OK

Take care

Sue

[Hidden in reply to Hidden]

Hi sue, I to am gradually upping my dose week by week, and I don't really know if my tablets are coated or not! I know they are an orange colour, with a powdery consistency,on the outside, does this mean they are coated? Thanks. Lady B 😊x

[Hidden in reply to Hidden]

My presciption reads sulfasalazine EC . I was told the "EC"

means it has a coating on it. My sulfa has no taste or it is not powdery.

[Hidden in reply to Hidden]

Thanks sue, my prescription has not got the EC mark on it so may not be coated, I suppose different pharmacists may use different ones, maybe next time I get my prescription I could ask for them to be coated, they don't seem to upset my stomach though, and there doesn't seem to be a taste to them, maybe they are just a different manufacturer, see how I get along, take care and thanks sue. Lady B x😊

[Hidden in reply to Hidden]

According to my rheumy, the "EC" helps to prevent unwanted side effects. This form of the drug breaks down in your bowels, not your stomach. Yes, I think you should ask your rheumy to prescribe the "EC" tablets.

Best wishes

Sue

P.S. I live in Canada, so maybe the "EC" tablets are called something else in another country

[Hidden in reply to Hidden]

Thanks again sue and I will, ask my pharmacist next time, you could be right to sue, maybe they are different as I am in England, but I will ask next time I get my prescription from the doctor, thankyou. Lady B x😊

[nomoreheels in reply to Hidden]

Lady B, if they're upsetting your tum what you need to ask your Rheumy or GP for (whoever signs off your prescription) is gastro resistant or enteric coated (EC) tablets. I suspect you've been prescribed uncoated as it's considerably cheaper (£5.79 per 112) as opposed to gastro resistant (£12.78 per 112).

Hope this helps.

[Hidden in reply to nomoreheels]

Hi nomoreheels, thanks for your reply and I will do, I think I have been prescribed I coated, I will make an appointment to see my go asap, see if I can have them changed, thanks for your advice, this has helped me a lot, thankyou, lady b x😊

[nomoreheels in reply to Hidden]

Just had a thought, if you have a patient information leaflet it will give the particulars of SSZ including if they're coated.

[Hidden]

Hi nomoreheels just looked at the leaflet and it just says sulfasalazine 500mg tablets, so I think they are the type that's not coated, I will see my gp, they may be able to prescribe the coated for me, thankyou lady B x😊