Sulfasalazine
- OralSulfasalazineSalazopyrinNot absorbed well – therefore most effective within the gut
Mechanism of Action
- Inhibits 5-aminoimidazole-4-carboxamidoribonucleotide (AICAR) transformylase, which results in increased adenosine release at the inflamed site. Adenosine binds to A2 receptors on inflammatory cells resulting in reduced inflammation.
Clinical Use
- Indications
- Acute episodes and maintenance of inflammatory bowel disease
- Rheumatoid arthritis
- Seronegative arthritis – reactive arthritis, psoriatic arthritis, anklyosing spondylitis
- Adverse Effects
- CNS - headache
- Gastrointestinal - abdominal pain / nausea / vomiting / diarrhoea
- Worsening of ulcerative colitis
- Hepatotoxicity - elevated LFTs