Sulfasalazine

• Salazosulfapyridine
• IUPAC: 2- hydroxy-5- [4 - (2- pyridylsulfamoyl ) - phenyldiazenyl ] -benzoic acid
• 5 - [4 - (2- Pyridylsulfamoyl ) - phenylazo ] salicylic acid

A07EC01

Intestinal anti-inflammatory drug

220 ° C ( decomposition)

Risk

Template: Infobox chemical / molecular formula search available

Sulfasalazine (INN), also known as salazosulfapyridine, is an anti-inflammatory drug which is used in particular for the treatment of inflammatory bowel diseases such as Crohn's disease or ulcerative colitis, as well as in rheumatoid arthritis. Chemically a compound of the sulfonamide sulfapyridine with 5- aminosalicylic acid (5- ASA, mesalazine also called ). As salazosulfapyridine is only cleaved by colonic bacteria into its components of sulfapyridine and 5 -ASA, but the latter is the actual active substance, it can only be effective in the colon. On the other hand, can be prevented by his gift that the drug is already recorded in the small intestine ( absorbed ) is in the colon and thus arrives no more effective amount.

Operation

Sulfasalazine the prodrug is absorbed in the upper small intestine ( jejunum ) is partially, but a larger part of cleaved only in the colon by the bacterial enzyme azoreductase to sulfapyridine and 5-aminosalicylic acid. The sulfonamide sulfapyridine itself is also anti-inflammatory and is used for the treatment of rheumatoid arthritis, but is also responsible for a large part of the side effects of sulfasalazine. The 5- aminosalicylic acid reduces inflammation via inhibition of arachidonic acid metabolism, free-radical scavenging and inhibition of the immune system. The individual mechanisms are described in detail in the article about 5 -ASA.

Areas of application

Salazosulfapyridine is used mainly in the acute treatment and prevention of relapse of ulcerative colitis application. But even with Crohn's disease, here it is used mainly in colon involvement. Another field of application is in joint disease ( arthropathy ), which typically occur as concomitants of chronic inflammatory bowel disease. Finally, it is also regarded as a basic therapeutic in chronic polyarthritis.

Side effects

Depending on the dose of the medication can cause nausea, vomiting, loss of appetite, decreased intake of the vitamin folic acid and headache. Regardless dose often occur with changes in blood count to decrease in white blood cells ( leukocytes), a shorter service life and increased breakdown of red blood cells ( hemolytic anemia) or reduction of platelets ( thrombocytopenia). In rare cases, these side effects result in a complete disappearance of the threatening called granulocytes (agranulocytosis ), or a complete failure of the bone marrow. Common side effects include skin rashes continue that can rarely go to a Stevens -Johnson syndrome, abdominal pain, nausea and vomiting, and elevations in liver enzymes, which can rarely be an expression of hepatitis again.

Fertility

In women, fertility is not affected by the medication of sulfasalazine. In men, the drug may affect sperm motility. The number of spermatozoa seem to be decreased during therapy. It is therefore possible that men are not capable of procreation during sulfasalazine therapy. This normalizes but 2-3 months after discontinuation of the drug.

Pregnancy, lactation and fertility

Women should take before or in an already pregnancy occurs during medication of sulfasalazine necessarily folic acid. Sulfasalazine reduces apparently the folic acid absorption. Breast-feeding is not recommended.

Trade names

Azulfidine (D), Colo- Pleon (D), Pleon RA ( D), Salazopyrin (A, CH ), various generics (D, A)