Ocular side effects of anti-rheumatic medications: what a rheumatologist should know. Immunoglobulin suppression was slowly reversible and rarely accompanied by clinical findings. J Rheumatol 22 (1995): 191-2, 26. We comply with the HONcode standard for trustworthy health information -, increased sensitivity of the skin to sunlight, bluish color of the fingernails, lips, skin, palms, or nail beds, blistering, peeling, or loosening of the skin, pains in the stomach, side, or abdomen, possibly radiating to the back, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, red skin lesions, often with a purple center, redness, blistering, peeling, or loosening of the skin, sores, ulcers, or white spots in the mouth or on the lips, Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs. Ocular mucous membrane pemphigoid (MMP), as a potentially blinding disease, is an indication for systemic immunosuppressive treatment. (Mucha-Haberman syndrome), rhabdomyolysis, photosensitization, arthralgia, Hepatitis generally resolved over several weeks after therapy discontinuation, although some patients progressed to fulminant hepatic failure. Haines JD, Jr "Hepatotoxicity after treatment with sulfasalazine." Call your doctor for medical advice about side effects. Azulfidine (sulfasalazine)." The use of enteric-coated preparations may decrease gastrointestinal side effects. J Rheumatol 21 (1994): 748-9, 22. or rare adverse reactions include: Blood dyscrasias: aplastic anemia, 1. Reply (0) Report. In Summary. discontinuation of the drug. A few also presented with a rash. in swallowing, blistering, peeling, or loosening of the skin, aching joints and Along with its needed effects, sulfasalazine may cause some unwanted effects. Serious side effects include dry eye/keratoconjunctivitis sicca (KCS) which will appear as squinting, mucoid eye discharge, and eye discomfort. Immunologic side effects are usually immunoglobulin suppression and systemic lupus erythematosus (SLE). Experience suggests that Alloway JA, Mitchell SR "Sulfasalazine neurotoxicity: a report of aseptic meningitis and a review of the literature." Other serious side effects include lack of energy, persistent vomiting, diarrhea, lack of appetite, paleness, fever, and skin rashes. frequency of one in every thirty patients or less. Very rarely Sulfasalazine has caused permanent staining of extended wear soft contact lenses (see section 6 for further information). Some of these cases were Erturk E, Casemento JB, Guertin KR, Kende AS "Bilateral acetylsulfapyridine nephrolithiasis associated with chronic sulfasalazine therapy." Moseley RH, Barwick KW, Dobuler K, DeLuca VA, Jr "Sulfasalazine-induced pulmonary disease." Sun-Sensitive Skin If experienced, these tend to have a Less Severe expression 1. J Rheumatol 20 (1993): 909-10, 55. J Rheumatol 21 (1994): 750-1. What Do I Need to Know Before Taking Sulfasalazine? In most cases of sulfasalazine-induced SLE, patients received the drug for greater than 1 year. Always take your sulfasalazine exactly as your doctor has told you. What drugs interact with Azulfidine (sulfasalazine)? Highlights of sulfasalazine. Siam AR, Hammoudeh M "Sulfasalazine induced systemic lupus erythematosus in a patient with rheumatoid arthritis." The improvement rate of pruritus was 14.3% in the placebo group and 91.3% in the sulfasalazine group. Side Effects of Sulfasalazine. reactions which have not been reported with this specific drug, the Recovery of granulocytes was generally seen within 1 to 2 weeks after drug discontinuation, and leukocyte counts and differential returned to normal in 1 to 3 weeks. Scand J Gastroenterol 17 (1982): 389-93, 8. reactions be considered when Azulfidine Tablets are administered. crystalluria, proteinuria, and hemolytic-uremic syndrome. At the initiation of sulfasalazine therapy, ocular inflammation was controlled in all patients but one. Hamadeh MA, Atkinson J, Smith LJ "Sulfasalazine-induced pulmonary disease." Peppercorn MA "Sulfasalazine. Sulfasalazine can cause reduced sperm count in some men which is reversible in 2-3 months after stopping treatment. Kuipers EJ, Vellenga E, de Wolf JT, Hazenberg BP "Sulfasalazine induced agranulocytosis treated with GM-CSF." Metabolism and nutrition system disorders: folate J Rheumatol 16 (1989): 1166-7, 51. Eur J Clin Pharmacol 43 (1992): 215-8, 52. Ann Pharmacother 43 (2009): 393-4, 71. These occur in about one-third of the Several potentially dangerous side effects have been reported rarely with sulfasalazine. Schwartz AG, Targan SR, Saxon A, Weinstein WM "Sulfasalazine-induced exacerbation of ulcerative colitis." Can Med Assoc J 131 (1984): 43-5, 13. Gastrointestinal issues and hypersensitivity are the most common reason for cancelation of sulfasalazine, and more the 13% of the patients can’t tolerate this medication. Mean follow-up was 12 months (range, 2–35 months). (Lyell's syndrome) with corneal damage, drug rash with eosinophilia and Clin Pharm 12 (1993): 179, 46. The tablets come in the form of immediate release and prolonged release. It also changes the color of the urine and tears making it slightly yellow-orange. Youssef PP, Bertouch JV "Sulphasalazine induced aplastic anaemia." Additionally, canthaxanthin, which can be taken orally as a tanning agent and is used in some foods as a coloring, can deposit in the retina in little crystals that can change some electroretinogram readings. Cross-sensitivity may exist with In one review of 62 cases of sulfasalazine-induced agranulocytosis, 6.5% of patients died. periorbital edema, conjunctival and scleral injection, and alopecia. 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