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Sulfasalazine, sold under the brand name Azulfidine among others, is a medication used to treat rheumatoid arthritis, ulcerative colitis, and Crohn's disease. [5] It is considered by some to be a first-line treatment in rheumatoid arthritis. [ 6 ]
Mesalazine is the active moiety of sulfasalazine, which is metabolized to sulfapyridine and mesalazine. [20] It is also the active component of the prodrug balsalazide along with the inert carrier molecule 4-aminobenzoyl-beta-alanine. [21] It is in the category of disease-modifying antirheumatic drugs (DMARDs) family of medications. [22]
Once remission is induced, maintenance levels can be used: sulfasalazine 2 g/day, mesalamine 1.2-2.4 g/day, or olsalazine 1 g/day. Patients on high dose sulfasalazine require folic supplementation (1 mg/day) because it inhibits folate absorption. If oral Mesalazine is still not working, prednisone is often given, starting at 40–60 mg/day.
Sulfasalazine has been a major agent in the therapy of mild to moderate ulcerative colitis for over 50 years. In 1977, it was shown that 5-aminosalicylic acid (5-ASA, mesalazine/mesalamine) was the therapeutically active component in sulfasalazine. [110]
Sulfasalazine; Mesalazine (5-Aminosalicylic acid) Side effects may include abdominal pain, diarrhea, headaches, and nausea. [1] References This page was last edited ...
5-ASA compounds, such as mesalazine and sulfasalazine, have shown to be of very little efficacy in the treatment of Crohn's disease, either for induction or for maintenance of remission. [2] Current guidelines do not advise the use of 5-ASA compounds in Crohn's disease.
4-Aminosalicylic acid has also been used in the treatment of inflammatory bowel disease (ulcerative colitis and Crohn's disease), [13] but has been superseded by other drugs such as sulfasalazine and mesalazine.
The drug was derived from salicylic acids like mesalazine (5-aminosalicylate), aspirin (acetylsalicylate), and sulfasalazine. [2] By inhibiting mPGES-1 (also known as prostaglandin E synthase (PTGES)), it blocks prostaglandin E2 production. [2] [5] Crisdesalazine is described as having a dual action, additionally acting as a direct free radical ...