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Drug Change

Seen my Rheumatologist been taken off the mtx and given Sulfasalazine. Still got to get blood tested every 2weeks.He wants me to build up to 6 500mg tabs every day. Anyone out there on this with advice for me. Can I split this dose 3 in the morning and 3 at night or do I have to take the 6 all at once. Feels like I'm going from the frying pan to the fire

7 Replies

Hi Jim1063

I am not sure about splitting the dose, best to ask your Specialist or GP or call your RA helpline if there is one within your Rheumatology Dept where you are.

I experienced the opposite: started off on Sulphasalazine but it was nearly 2 years ago; had to come off fast due to reaction and infection of respiratory tract.

Hope you find the right advice from health professionals. :-)


I have been on Sulpha for 7 years now. I built up to 3g, i.e. 6 tablets that I took 3 with breakfast and three before dinner. But I built up quite slowly, adding in 1 tablet every couple of weeks. Overall it took about 3 months to get used to them as gave me an excitable stomach to start with.

I'm now on 2g as the extra 2 tablets didn't seem to make any difference!


I'm on the same. 2 in the am and 2 in the pm. You split the dose.


Hi. I've recently had Sulfa added to my drugs cocktail and this was how I was advised to take it. Pretty standard as I understand it.

Week one. 1 in morning

Week two. 1 in morn 1 at night

Week three. 2 in morn 1 at night.

Week four. 2 in morn 2 at night.

So assumedly you'll be taking 3 in morn 3 at night by week 6.

As I reduced to 3 a day due to headaches and stomach issues I've just checked my recent prescription and its 1 three times a day.

When it's a new drug to you its increased slowly whilst they monitor your bloods just as they'd have done with Mtx.

Hope this helps



I take two in the morning and two in the evening so i would say yes you can split the dose,BUT just check with your rheumy before you do it.xxxx


I had sulfasalazine 1 year, stopped because works fine for Ra but side effects not so nice... i got depression and insomnia. Just stopped 3 weeks ago, feeling better but RA built back... so doctor said have to go MTX shots . Not easy been guinea pigs

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Hi - I'm on 2 twice a day. From what I understand one should leave at 8 hrs inbetween doses if poss. Also- I'm on omeprazole twice a day (among other things) and one should leave about 2 hrs grace between omeprazole (on anything similar) between that and sulfasalazine. I was asked to increase to 6 a day but it didn't suit me so I stayed on 2 twice a day - all fine.


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