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Points to remember about Sulfasalazine are:

– This is seventy year old medication.
– It was developed as a combination of an anti-inflammatory and a sulfa antibiotic to treat Rheumatoid Arthritis.
– It is the first disease modifying drug (DMARD) that was actually developed to treat Rheumatoid Arthritis.
– Enteric coated form of Sulfasalazine would minimize stomach side-effects.
– It can be used by itself or along with other DMARDs such as Methotrexate, Plaquinel.
– Periodic blood testing is needed to look for possible toxicity specifically affecting liver and Neutrophils.
– Although never approved by FDA, it is used to treat variety of inflammatory conditions including:
– Rheumatoid Arthritis
– Psoriatic Arthritis
– Spondyloarthropathy
– Ankylosing Spondylitis
– Juvenile Rheumatoid Arthritis
– Ulcerative Colitis
– It can help both bowel and joint symptoms in patients with inflammatory bowel disease who also have associated arthritis.
– It may take up to three months to see an effect.
– At times the improvement is so slow that Sulfasalazine has to be stopped to see if the patient actually becomes worse off of it. Becoming worse off of this treatment would be indication of a response and treatment with Sulfasalazine can thus be resumed.