Introduction
Zulfidin 500 is a medicine used to treat various inflammatory conditions of the joints (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis), skin (psoriasis), and bowel (ulcerative colitis, Crohn’s disease).
Zulfidin 500 is to be taken with food. This will help you prevent an upset stomach. You should take it regularly and at the same time each day to get the maximum benefit from it. Keep taking it as recommended by your doctor and complete the dose even if you feel better. Taking it with plenty of water can help you avoid kidney problems such as kidney stones.
Using this medicine may cause some common side effects such as nausea, headache, loss of appetite, vomiting, diarrhea, weight loss, and gastrointestinal discomfort. You should consult with your doctor if any of these side effects do resolve with time or get worse. Your doctor may help with ways to reduce or prevent these symptoms.
To make sure the medicine is safe for you, before taking this medicine, let your doctor know if you have any problem with your heart, kidneys, or liver. Also, tell your doctor about all the other medicines you are taking. Your doctor may recommend regular blood tests to check your kidney and liver functions, and blood components. Pregnant and breastfeeding mothers should consult with their doctors before taking the medicine.
Uses of Zulfidin 500
- Rheumatoid arthritis
- Ulcerative colitis
- Crohn’s disease
- Ankylosing spondylitis
Side effects of Zulfidin 500
Common
- Diarrhea
- Gastrointestinal discomfort
- Headache
- Loss of appetite
- Nausea
- Oligospermia (low sperm count)
- Vomiting
- Weight loss
How to use Zulfidin 500
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Zulfidin 500 is to be taken with food.
How Zulfidin 500 works
Zulfidin 500 is a Disease Modifying Anti-Rheumatoid Drug (DMARD). It works by suppressing the overactivity of the immune system in autoimmune diseases and blocks the chemical messengers that cause inflammation (swelling).
What if you forget to take Zulfidin 500?
If you miss a dose of Zulfidin 500, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Inflammatory bowel disease, Rheumatoid arthritis
Administration
Should be taken with food. Take after meals. Ensure adequate fluid intake.
Adult Dose
Oral
Inflammatory bowel disease
Adult: Initially, 1-2 g 4 times daily until remission occurs. Maintenance: 2 g/day in divided doses.
Rheumatoid arthritis
Adult: As enteric-coated tablet: Initially, 500 mg daily for the 1st wk increased by 500 mg every wk. Max: 3 g daily in 2-4 divided doses.
Rectal
Inflammatory bowel disease
Adult: As suppository: 0.5-1 g in the morning and night, either alone or as an adjunct to oral treatment.
Hepatic impairment: Avoid use.
Child Dose
Oral
Inflammatory bowel disease
Child: >2 yr: 40-60 mg/kg/day in divided doses. Maintenance: 20-30 mg/kg/day in divided doses.
Rheumatoid arthritis
Child: For polyarticular juvenile rheumatoid arthritis: >6 yr: As enteric-coated tablet: 30-50 mg/kg/day in 2 divided doses. Begin treatment with 1/4 to 2/3 of expected maintenance dose and increase wkly to reach maintenance dose in 1 mth. Max: 2 g daily.
Rectal
Inflammatory bowel disease
Child: As suppository (may be given as divided doses): 5-8 yr: 500 mg bid; 8-12 yr: 500 mg in the morning and 1 g at night; 12-18 yr: 1 g bid.
Renal Dose
Renal impairment:
CrCl (ml/min) Dosage Recommendation
10-30ml/min Admin twice daily.
<10ml/min Admin once daily.
Contraindication
Hypersensitivity to sulphonamides or salicylates, porphyria, <2 yr of age, intestinal or urinary obstruction, blood dycrasias, history of leucopenia with gold therapy.
Mode of Action
Actual mechanism not determined. Sulphasalazine may have direct anti-inflammatory action in the colon. It also systemically interferes with secretion by prostaglandin synthesis inhibition.
Precaution
Hepatic/renal impairment, G6PD deficiency, allergic bronchial asthma, lactation.
Lactation: Excreted into human breast milk; caution with breastfeeding, some reports of bloody stools or diarrhea in human milk fed infants of mothers taking sulfasalazine
Side Effect
>10%
Anorexia (~33%),Headache (~33%),Nausea (~33%),Vomiting (~33%),Gastric distress (~33%),Apparently reversible oligospermia (~33%)
<1%
Skin rash,Pruritus,Urticaria,Fever,Heinz body anemia,Hemolytic anemia,Cyanosis
Potentially Fatal: Severe hypersensitivity reactions, blood dyscrasias, renal and hepatic toxicity, fibrosing alveolitis.
Pregnancy Category Note
Pregnancy category: B; D if used for prolonged periods or near term; increased potential for kernicterus in the newborn
Interaction
Plasma levels reduced by rifampicin and ethambutol. Interferes with absorption of folic acid. Additive leucopaenia with gold therapy for rheumatoid arthritis. Increased haematological toxicity with azathioprine. Reduced serum levels of digoxin.