Saaz

📦 Every order is covered by our Reshipment Assurance Policy — if your parcel does not arrive within 20 business days, we reship it.

Why order from MedsBase

Our generic medications are sourced from WHO-GMP certified manufacturers and shipped worldwide in discreet, plain packaging — no medication name on the parcel exterior. Card payments are routed through a regulated processor (statement descriptors include a regulated card-payment processor — never “MedsBase” or any medication name). Crypto and SEPA bank transfer are also accepted. Every order is backed by our Reshipment Assurance Policy.

Why order from MedsBase

Saaz is supplied from a WHO-GMP certified manufacturer. Every order ships discreetly worldwide and is covered by our Reshipment Assurance Policy — if it does not arrive within 20 business days, we reship at no cost. Sulfasalazine is on the WHO Essential Medicines List for both inflammatory bowel disease and rheumatoid arthritis — it is the most extensively studied conventional DMARD with multi-decade follow-up.

Mechanism

Sulfasalazine is a prodrug: 5-ASA linked to sulfapyridine through an azo (-N=N-) bond. Less than 30 percent is absorbed in the small intestine; the remainder reaches the colon where bacterial azoreductases cleave the bond. 5-ASA acts locally on colonic mucosa via PPAR-γ agonism, COX/LOX inhibition, NF-κB suppression, and reactive-oxygen scavenging — this is the IBD-relevant action. Sulfapyridine is absorbed systemically and accounts for most side effects (rash, photosensitivity, oligospermia, haematological); in rheumatoid arthritis the systemic sulfapyridine is thought to be the active moiety, modulating cytokine production and folate metabolism.

Indications

• Mild-to-moderate ulcerative colitis (induction and maintenance)
• Crohn’s colitis (less effective in small-bowel Crohn’s)
• Rheumatoid arthritis (csDMARD)
• Juvenile idiopathic arthritis, especially polyarticular and enthesitis-related types
• Psoriatic arthritis (peripheral disease)
• Ankylosing spondylitis with peripheral arthritis

Dose

UC induction: 1–2 g four times daily (max 4 g/day), reduce to 2 g/day for maintenance. RA / JIA: start 500 mg/day, increase by 500 mg weekly to 1 g twice daily (max 3 g/day). Folic acid 5 mg weekly recommended on RA dose. Take with food to reduce GI upset. Hepatic or renal impairment: caution, halve the dose.

Side effects

• Common (10–30 percent): nausea, anorexia, headache, abdominal pain, oligospermia (reversible male infertility, fully reverses 2–3 months after stopping), orange-yellow body fluids (urine, sweat, tears, contact lenses)
• Skin: rash, photosensitivity, urticaria; rare Stevens-Johnson syndrome and TEN
• Haematological: leukopenia, thrombocytopenia, megaloblastic anaemia (folate antagonism), haemolysis in G6PD deficiency — baseline and 3-monthly FBC for first year
• Hepatic: transaminase rise (rare hepatitis); baseline and 3-monthly LFTs
• Pulmonary: rare interstitial pneumonitis
• Lupus-like syndrome (rare, with anti-histone antibodies)

Drug interactions

• Azathioprine, mercaptopurine: 5-ASA inhibits TPMT, raising 6-MP levels — monitor FBC.
• Methotrexate: additive folate antagonism — supplement folic acid.
• Digoxin: sulfasalazine reduces digoxin absorption.
• Folate-deficient or low-folate diet: deficiency may worsen.

Frequently Asked Questions

Will my urine really turn orange?

Yes — sulfasalazine and its metabolite sulfapyridine are coloured. Urine, sweat, tears, and contact lenses can take an orange-yellow tint. It is harmless and reverses on stopping the drug.

How long until I feel better?

For UC: stool blood and tenesmus often improve within 2–4 weeks; full effect by 8–12 weeks. For RA: it takes 8–12 weeks to feel benefit; do not stop early.

Why do I need folic acid with it?

Sulfasalazine inhibits folate absorption and metabolism. Folate deficiency causes megaloblastic anaemia and worsens cytopenia. 5 mg weekly is standard with the RA dose.

Is it safe in pregnancy?

Yes — among the safest DMARDs in pregnancy. Continue through pregnancy if needed for IBD or RA. Folic acid supplementation 5 mg/day is essential. Sulfasalazine causes reversible oligospermia in men and should be stopped 3 months before conception attempts in male partners.

What blood tests do I need?

Baseline FBC, LFTs, U&E, and G6PD if of African, Asian, or Mediterranean ancestry. Then FBC and LFTs at 2 weeks, 4 weeks, then 3-monthly for the first year, then 6-monthly thereafter.

Can I drink alcohol on it?

Light to moderate alcohol is acceptable; heavy alcohol increases hepatotoxicity. Discuss with the prescriber.

How is it different from mesalamine (Asacol/Mesacol)?

Mesalamine is just the 5-ASA portion without the sulfa carrier. Mesalamine has fewer side effects (no sulfa allergy risk, no oligospermia) but is more expensive. Sulfasalazine is preferred when DMARD effect is needed for joint disease in addition to gut disease.

I have a sulfa allergy. Can I take it?

No. Switch to mesalamine (Asacol, Mesacol, or Pentasa) for IBD; switch to a different DMARD (methotrexate, leflunomide) for arthritis.

Storage

Below 30°C in a dry place. Keep tablets in the original blister.

What if I miss a dose?

Take it as soon as you remember unless it is close to the next dose. Do not double up.

Other Gastro Health Medications

• Asacol — Mesalamine 400 mg DR
• Mesacol — Mesalamine 400 mg
• Sazo — Sulfasalazine 500 mg
• Salazar — Sulfasalazine 500 mg
• Pentasa Suppositories — Mesalazine 1 g
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