Sulfasalazine : Has anyone had low folic acid while... - NRAS


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Indersisive71 profile image
16 Replies

Has anyone had low folic acid while taking sulfasalazine I am not sure whether I should be taking it

16 Replies
KittyJ profile image

I didn’t whilst I was on it, I assume the person who ordered the test will tell you what to do, have they not contacted you?

Indersisive71 profile image
Indersisive71 in reply to KittyJ

It was a read a article and it said sulfasalazine can decrease your folic acid ,I will phone the rheumi nurse and ask her thanks for replying

helixhelix profile image
helixhelix in reply to Indersisive71

An article in what? Lots of rubbish around. And do you know your levels are low?

If you have a good diet most people have ok folic levels. So you would need to get tested to see if it is an issue.

KittyJ profile image
KittyJ in reply to Indersisive71

so you haven’t been tested? I think it’s a very uncommon side effect which I assume you would know if you had it and would be given supplements. I wouldn’t do too much reading and going looking for problems, it can cause unnecessary worry 😊

Luludean profile image
Luludean in reply to Indersisive71

I was prescribed Sulphasalazine by the rheum consultant , but , the gp practice nurse phoned me . It would have clashed with Digoxin. I would never have known that. Life is complicated.

AgedCrone profile image

I’m sure those of us who have taken SSZ would have mentioned that if it was so……I don’t remember ever reading a post saying that….speak to your rheumy nurse…she will confirm whether it is true or not.

bpeal1 profile image

I’ve been taking Sulphasalazine for more than 15 years. I’ve never been told I need to take folic acid. I’m currently on 2g (4 tablets) twice a day - double the usual dose for RA although lower than is often used for other conditions.

sylvi profile image

I am on sulpha with no side effects. xxx

Maureengibson profile image

most of the research seems to be quite old, like 1980s discussing Sulphasalazine and folic acid. The MRAS do mention it in the booklet, but seem to suggest you only need supplements only if taking MTX along side it. Best speak to your rheumatologist nurse, and get your levels checked, if you’re concerned. Especially if you have any of the symptoms such as worsening fatigue, sore tongue or ulcers, pale skin of loss of appetite. I wouldn’t worry too much about it though

Indersisive71 profile image
Indersisive71 in reply to Maureengibson

Thank you for replying, I will do that

Airdale profile image

Sulfasalazine raised my liver enzymes to levels that if I continued on it i would have developed medically induced hepatitis. I was put on Plaquenil, and have no further liver issues.

mads1 profile image

Hello Indersisive71, I just got a call today from the nurse - regular bloods show i am low in folic acid, not on sulfasalazine, apparently low energy and tiredness are the symptoms .This has happened a few time over the years on different drugs, it might be more to do with RA. DO you get regular blood tests done?

Indersisive71 profile image
Indersisive71 in reply to mads1

Hi thanks for replying, yes I do have regular blood tests every three months they found last time my iron levels were down but that's getting sorted now

Wannabeabago profile image

I take folate every day and have since I got RA except for when I was on MTX and then didn’t take it that day.

CripLady profile image

Sulfasalazine works for me. I also take Mtx. Folic 6 days a week (not mtx day).

Jackie1947 profile image

Been on Sulphasazine for 16 years with no problems. Don't believe all you read. I tend not to

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