Sulfasalazine Allergies

Sulfasalazine is an anti-inflammatory drug that is used for a number of autoimmune conditions. Since it was first discovered, it has been found as a useful drug for ulcerative colitis. However, the medication is a sulfa drug and hence may cause allergies in susceptible people. To avoid these allergies, doctors today use a variety of similar drugs that provide similar effects but allow them to avoid the use of this agent. Other drugs which are useful in treating ulcerative colitis include corticosteroids and immunosuppressants, such as azathioprine and 6-mercaptopurine.

Use of Sulfasalazine

Sulfasalazine is made up two chemicals -- sulfapyridine and 5-aminosalicylic acid. The pharmacological activity of sulfasalazine lies with 5-aminosalicylic acid, or 5-ASA. It is unknown how 5-ASA works; according to "Rang and Dale's Pharmacology;" it may act by neutralizing free radicals, or by decreasing the activity of inflammatory cells.
Sulfasalazine is used primarily for mild ulcerative colitis and rheumatoid arthritis. It is also commonly used off-label for Crohn's disease, ankylosing spondylitis, psoriasis and psoriatic arthritis. Use of sulfasalazine for ulcerative colitis and Crohn's disease can help to maintain remission and decrease flare-ups of these conditions.

Allergic Reactions

Sulfasalazine is a sulfa-type of drug. Individuals with sulfa allergies may manifest allergic symptoms because of the sulfapyridine agent. One type of allergic reaction is that of hives, which takes the form of itchy, red welts on the skin that may change shape or size. This typically occurs within one to three days after taking the medication. Individuals with these reactions may have an accompanying fever. More severe allergic reactions include anaphylaxis, a severe allergic response in which there is a fall in blood pressure, constriction of the airways and a weak pulse. Stevens Johnson Syndrome can be triggered by sulfa drugs; it is a severe skin allergic reaction in which there are a variety of rashes. The condition is life-threatening and can be fatal without rapid treatment.

Other Side Effects

Besides its allergic symptoms, sulfasalazine can cause a variety of other side effects. Sulfasalazine can cause nausea and diarrhea. It may cause a folate deficiency; individuals taking this are advised to take vitamin supplements. Changes in blood cell counts can occur; and a few fatalities have emerged as a result of this. A few causes of fibrosing alveolitis, have also been reported. Other rare side effects include liver disease and male infertility.

Alternatives

Approximately 3 percent of individuals are estimated to have sulfa allergies. As a result, doctors rarely prescribe sulfasalazine. Since the allergy is due to the inactive sulfapyridine agent, a variety of synthetic drugs have been made in which this agent is not included. These include drugs such as mesalazine, olsalazine and balsalazide. These all have the same effectiveness as sulfasalazine but without the risk of triggering sulfa allergies.
Individuals with sulfa allergy may have similar reactions when taking sulfa antibiotics, such as trimethroprim-sulfamethoxazole. In addition, most diuretics are sulfa agents, as are sulfonylureas, a medication used for type 2 diabetes mellitus. Celecoxib, an analgesic, and sumatriptan, a medication for migraine, are other examples of sulfa agents.