Sulfasalazine - Arthritis drug?
Discussion
As I said, it was very effective for me, but eventually it stopped working (all treatments will lose effectiveness eventually). I was then taking methotrexate as well. Then sulfasalazine was replaced by leflumonide. Eventually (we're talking a few years here) they just didn't work at all, and now I'm on biologics (humira) which has been a miracle drug. I still take methotrexate, which supposedly prolongs the effectiveness of humira.
BTW, sulfasalazine, methotrexate and leflumonide are not anti-infammatories, they are DMARDs. For the anti-inflammatory part I was taking naproxen, which started when I started on methotrexate. It was naproxen which required me to also take omeprazole to counter the stomach acid issues naproxen causes.
On the whole, none have caused any side-effects of note. However, the doseage of methotrexate was increased as time went on. As this happened I started to get more and more mouth ulcers, which was annoying. The consultant increased my folic acid intake, which sorted that out.
As you might gather, I was taking a LOT of tablets every day/week at one point (leflumonide, naproxen, omeprazole daily, methotrexate and folic acid weekly). Now it's the minimum dose of methotrexate each week, followed by 2x days of folic acid. Then a fortnightly injection.
BTW, sulfasalazine, methotrexate and leflumonide are not anti-infammatories, they are DMARDs. For the anti-inflammatory part I was taking naproxen, which started when I started on methotrexate. It was naproxen which required me to also take omeprazole to counter the stomach acid issues naproxen causes.
On the whole, none have caused any side-effects of note. However, the doseage of methotrexate was increased as time went on. As this happened I started to get more and more mouth ulcers, which was annoying. The consultant increased my folic acid intake, which sorted that out.
As you might gather, I was taking a LOT of tablets every day/week at one point (leflumonide, naproxen, omeprazole daily, methotrexate and folic acid weekly). Now it's the minimum dose of methotrexate each week, followed by 2x days of folic acid. Then a fortnightly injection.
mgsontour said:
I wanted to know if it's successful and what side effects came with it and if better options were available? Thanks again
Generally a safe and well tolerate drug which after time will not give the desired effect in terms reducing anti-inflammatory effect. In terms of adverse events have a look at the BNF entry which lists common, less common etc https://www.medicinescomplete.com/#/content/bnf/_8...In addition have a look at the NICE treatment pathway for rheumatoid arthritis which will give an idea of what treatments are available
https://pathways.nice.org.uk/pathways/rheumatoid-a...
I started on this drug for RA about 25 years ago...I am now on a biological anti TNF
Sulphasalazine can take a long time to work / get into your system, or not work at all (it was useless for me.)
The only side effect I can recall was it turns your urine a much more orange colour than normal.
Edited for additional comment:
I think for arthritis they usually start you on the cheaper medications first in case they work...IMHO There are much better drugs available. (I think my current anti TNF medicine is about £12k per year however)
Sulphasalazine can take a long time to work / get into your system, or not work at all (it was useless for me.)
The only side effect I can recall was it turns your urine a much more orange colour than normal.
Edited for additional comment:
I think for arthritis they usually start you on the cheaper medications first in case they work...IMHO There are much better drugs available. (I think my current anti TNF medicine is about £12k per year however)
Edited by beerexpressman on Tuesday 3rd September 15:38
I've been on it for around 10 years now for Psoriatic arthritis, they start you off on lower doses and work you up the ideal dose with regular blood tests to check that nothing untoward is happening.
i'm on 4 tablets a day with no side affects other than orange wee, at the start I was yo-yo'd around on doseage due to blood test results, but that all settled down.
It did loose its effectivness, so at the start of this year I was put on Methotrexate, which is working...and then some! alongside the Sulfasalazine.
i'm on 4 tablets a day with no side affects other than orange wee, at the start I was yo-yo'd around on doseage due to blood test results, but that all settled down.
It did loose its effectivness, so at the start of this year I was put on Methotrexate, which is working...and then some! alongside the Sulfasalazine.
After sulfasalzine i tried weekly injections of gold compound, this went on for 8 months with no effects so that was when we tried methotrexate which did work however due to the length of time i've had RA (mostly undiagnosed) the damage is already done to my joints by osteo arthritis.
Damn, is this one I've not tried then? 
I'm on the top dose of methotrexate by injection and an anti-TNF (adalimumab). Done all the naproxen, arcoxia, amitriptylene, omeprazole, folic acid etc (although I don't take any pills any more).
It's the 3rd anti-TNF I've tried (after certolizumab and sekukinumab), and have to say it's the only thing that's made any difference. Literally overnight turnaround in condition.
I'm on the top dose of methotrexate by injection and an anti-TNF (adalimumab). Done all the naproxen, arcoxia, amitriptylene, omeprazole, folic acid etc (although I don't take any pills any more).
It's the 3rd anti-TNF I've tried (after certolizumab and sekukinumab), and have to say it's the only thing that's made any difference. Literally overnight turnaround in condition.
I’ve been on this drug for 18 months, along with methotrexate and more recently cosentyx. Have been slowly coming off it for a couple of months.
Sulphasalazine didn’t do much for me, methotrexate made the biggest difference early on. I didn’t ever notice any side effects, other than my wee turning orange that is.
Sulphasalazine didn’t do much for me, methotrexate made the biggest difference early on. I didn’t ever notice any side effects, other than my wee turning orange that is.
I have a form of arthritis that just seems to cause swelling. For example, one of my little fingers is about twice as fat as it should be, so I can't bend in fully. Wrists are puffed up, and there's a pocket of inflammation on one knee. My bones are all perfect thankfully.
Sulphasalazine was mentioned but they've put me on Methotrexate instead, as they say it is by far the best. 10mg a week. I did actually start on it in May but stopped after 4 weeks. Now I'm due to start on it again next week. During that 4 weeks I didn't experience any change to my symptoms, but I'm led to believe maybe 3 months will be required.
Sulphasalazine was mentioned but they've put me on Methotrexate instead, as they say it is by far the best. 10mg a week. I did actually start on it in May but stopped after 4 weeks. Now I'm due to start on it again next week. During that 4 weeks I didn't experience any change to my symptoms, but I'm led to believe maybe 3 months will be required.
I'm an RA sufferer from 35 years of age, turning 50 in January next year.
From my experience, I would say SSZ is useless and is the go-to drug to start a patient from the outset. Drug regimes are cost driven and the hospital/consultant will try the cheapest drug to see if the patient responds before upping the treatment. I was on it from 2006, it was useless, then they introduced Methotrexate (MTX) which is an anti-inflammatory drug for RA. This kept the swelling down but the disease was still active.
On these drugs my joints were still being damaged, I have had the knuckles removed on two toes on my right foot, the toes being fused so I have two toes shorter than the others.
I then was introduced to the new boilogical drugs and I (after blagging HAS score tests to get on the regime) was prescibed Etanercept (brand name Enbrel), a once-weekly injection. Nurse reckoned it cost £10-12k per year and would take about 3 months to work.
It took 3 weeks! What a revelation! From someone who would look at stairs and dread the climb, I now play badminton and hold down a FT job, albeit an admin role.
I thought I was finished at 35-37 years old, I was wiped out by RA.
I have now gone on the the generic version of Etanercept (Erelzi) after the patent ran out and I think it costs half the price of Enbrel. I seem to be the same on it so I'm glad to be helping the NHS out with the costs of my treatment! It's so good the consultant has taken me off MTX but this was more because I refused to take folic acid as I've had no adverse reactions to anything in 14-15 years. I refused to just keep paying out for 'scripts! She said she can't keep me on MTX if I don't take the folic acid - I said fine!
Whatever you do - lie, blag, bribe - get onto the biological drugs - don't waste time on SSZ.
From my experience, I would say SSZ is useless and is the go-to drug to start a patient from the outset. Drug regimes are cost driven and the hospital/consultant will try the cheapest drug to see if the patient responds before upping the treatment. I was on it from 2006, it was useless, then they introduced Methotrexate (MTX) which is an anti-inflammatory drug for RA. This kept the swelling down but the disease was still active.
On these drugs my joints were still being damaged, I have had the knuckles removed on two toes on my right foot, the toes being fused so I have two toes shorter than the others.
I then was introduced to the new boilogical drugs and I (after blagging HAS score tests to get on the regime) was prescibed Etanercept (brand name Enbrel), a once-weekly injection. Nurse reckoned it cost £10-12k per year and would take about 3 months to work.
It took 3 weeks! What a revelation! From someone who would look at stairs and dread the climb, I now play badminton and hold down a FT job, albeit an admin role.
I thought I was finished at 35-37 years old, I was wiped out by RA.
I have now gone on the the generic version of Etanercept (Erelzi) after the patent ran out and I think it costs half the price of Enbrel. I seem to be the same on it so I'm glad to be helping the NHS out with the costs of my treatment! It's so good the consultant has taken me off MTX but this was more because I refused to take folic acid as I've had no adverse reactions to anything in 14-15 years. I refused to just keep paying out for 'scripts! She said she can't keep me on MTX if I don't take the folic acid - I said fine!
Whatever you do - lie, blag, bribe - get onto the biological drugs - don't waste time on SSZ.
Fastchas said:
Whatever you do - lie, blag, bribe - get onto the biological drugs - don't waste time on SSZ.
Agreed. My rheumatologist fast tracked me because I was "one of her worst" patients and methotrexate wasn't having any effect, even going from 10 to 25mg pills, then the injection.The only drawback (and I don't know if it's the meth or the antiTNF) is I've picked up a nasty wee infection because my immune system is fubared.
I'm in Scotland so don't pay for prescriptions (at point of use anyway!). It's great just walking out with the bag and you've not handed over any money. Although the flip side is I have to suffer Sturgeon as head honcho. All things considered I'd rather pay.
mgsontour said:
Wow. . . .I didn't realise this RA was as big a problem. . I thought I was one of the few in pain! Blessings to you all
Cheers.I guess I'm lucky that I don't really suffer too much pain. When I do it's because I'm trying to, for example, bend one of my swollen fingers more than it wants to. At rest I don't really feel anything.
I've been like this for about 2 years. One thing I have noticed is that if I eat little or no food for a day then the next day the stiffness/swelling doesn't feel so bad. Never been able to narrow it down to a particular food group, it just seems the less I eat the better I feel. Even if I eat nothing and just have beer all day. Obviously not a long term solution
All the best to you too
technodup said:
greed. My rheumatologist fast tracked me because I was "one of her worst" patients and methotrexate wasn't having any effect, even going from 10 to 25mg pills, then the injection.
The only drawback (and I don't know if it's the meth or the antiTNF) is I've picked up a nasty wee infection because my immune system is fubared.
I'm in Scotland so don't pay for prescriptions (at point of use anyway!). It's great just walking out with the bag and you've not handed over any money. Although the flip side is I have to suffer Sturgeon as head honcho. All things considered I'd rather pay.
This probably caused the onset of RA, which is an immuno-deficient disease although they don't know what triggers it ie trauma, infection etc.The only drawback (and I don't know if it's the meth or the antiTNF) is I've picked up a nasty wee infection because my immune system is fubared.
I'm in Scotland so don't pay for prescriptions (at point of use anyway!). It's great just walking out with the bag and you've not handed over any money. Although the flip side is I have to suffer Sturgeon as head honcho. All things considered I'd rather pay.
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