Sulfasalazine question

[Shyandretiring]

Hi everyoneI hope you can help me.

I am now on my 3rd week of sulfasalazine ( 1 morning 2 evening ) I keep reading that you must take the doses within 8 hours of each other and not to exceed 8 hours has anyone else read this and does anyone know what happens if you exceed 8 hours between doses doesnt it work as well or at all ???

Kind regards

Shy

[zen4]

Hello I have taken Sulfasalazine for over 30 years and never been told that by any consultants! Of course it could be new information and maybe it works more efficiently that way ? I take mine about 13 hours apart! You could vheck on the nurse advice line? I'm sure many others will answer Best wishes Jasmine

[Shyandretiring in reply to zen4]

Thank you JasmineIf you have been taking it for over 30 years with 13 hours in between and it works for you then I think I have my answer !

Are you on 1000 mg in the morning and a 1000mg in the evening ?

Warm regards

Shy

[zen4 in reply to Shyandretiring]

Hello again Yes I did used to take 1000 x2 daily for many many years initially then it was not so effective so it was put up to 1500 x 2 but then another couple of years later I added Hydroxichloroquine but it effected my eyes so then tried leflunamide but that didn't suit me either so went back onto the sulfazalazine again at the high level as I didn't qualify for biologics! A few years later I was finally allowed Baracitinib, a very recent and new type of medication but I have still been taking the sulfazalaxine at a low dose. I have never had any problems with it. It does take a good few weeks to kick in fully as do all these DMARD drugsSee what everyone else says It could be most effective by having the 8hr gap Hope you are feeling a lot better soon

[Shyandretiring in reply to zen4]

Thank you for the comprehensive reply , can I ask why didnt qualify for any biologics Warm regards

Shy

[zen4 in reply to Shyandretiring]

Its all to do with the DAS score. I more often have 1 or 2 joints that flare up and only rarely a large number I am not sure what you know about DAS but they count the flared hot and swollen joints, look at your blood results and listen to what you say and what they see and that gives a score If you don't reach a high enough number you don't qualify. Strangely they don't count ankles and toes in the score and at the time they were my biggest problem along with a couple of other joints You can read about this on the NRAS Booklet you can order for free Its excellent

[Shyandretiring in reply to zen4]

Thank you zen4I did not know about the DAS score so that is very helpful if the sulfersalazine deos not work, as I have 5 or 6 inflammed joints with this flare up.

Thank you so much for your advice again.

[zen4 in reply to Shyandretiring]

I think if sulfazalaxine didn't work then you would most likely have to try other conventional drugs like methotrexate leflunamide or Hydroxychloroquine before you would be able to have the newer more selective Biologic drugs whatever you're score . They have come of patents now but are are still a lot more expensive! Anyway hopefully it will work

[Shyandretiring in reply to zen4]

Thank you so much for your kind messages.Warm regards

Shy

[Soreknees2016]

I’ve been on Sulfasalazine for about 4 years and never heard of that - I take mine (500mgx2] after breakfast and before bed, so prob min 12/13 hours apart and it’s worked very well for me.

[Shyandretiring in reply to Soreknees2016]

Thank you for your reply SorekneesThe 8 hour thing has totally thrown me but you have reassured me that 12-13 hours is ok.

Thank you so much

[Soreknees2016 in reply to Shyandretiring]

I was actually wondering if maybe it’s that doses between days must be at least 8 hours apart ? For example, if for some reason, I didn’t take my 2 tabs in the morning, but took my morning and evening dose of 4 tabs together at midnight, I should then wait until at least 8 am the next day before taking the next dose. That would seem to make sense so there would be no risk of taking too much. Hope that helps!

[Shyandretiring in reply to Soreknees2016]

Yes you could be onto something there Thank you

Shy

[Beadie]

Hi I've been taking salfasalazine for 5 yrs now , after I had covid my 2 x 500mg aday wasn't working the same so it was put upto 3 x 500mg twice aday and 1 x 10mg Leflunomide aday, I take it 8am and 8pm everyday, it works great for me and I've had no issues at all, everything is good. Wish you luck with yours.xx

[Shyandretiring in reply to Beadie]

Thank you BeadieThat is very reassuring as I am in week 3 of taking sulfasalazine ( 1x500 mg am and 1000mg. Pm and 2 tabs of steroids am but am still in a lot of pain.

Warm regards

Shy

[Pops77]

Hi there, along with others I’ve been on 500mg BD and take it with breakfast then dinner . I don’t count the hours and have never been told that … take care and best wishes x

[Shyandretiring in reply to Pops77]

Thank you pops77Very reassuring

Warm regards

Shy

[Boxerlady]

I'm on 3 tablets twice a day and have always taken them with breakfast and tea and have never thought about the time. 😉

[Shyandretiring in reply to Boxerlady]

Thank you so much for your reply BoxerladyYou have put my mind at rest after reading that confusing article about taking it within 8 hours of each other.

Warm regards

Shy