Sulphonamides include- Sulfisoxazole, Sulfasalazine.

Refer Sulpdadiazine

Interacting drugs- summary -

 Sulphasalazine +

 Digoxin

  digoxins bioavailability decreased , resulting in a reduced therapeutic effect

 Folic acid

  signs of folate deficiency occured (eg low folate. megaloblastic anemia,macrocytosis, teticulocytosis) but specific symptoms related to the defiency have not been reported

Mild to moderate infections.

 Sulphonamides include-

Sulfisoxazole, Sulfasalazine.

Refer Sulpdadiazine

Severe hypersensitivity reactions, blood dyscrasias, renal or hepatic toxicity, fibrosis alveolitis.

Anorexia, nausea, vomiting, peripheral neuropathy, convulsions, depression, headache,

drowsiness. Irreversible yellow staining of contact lens, skin, urine and other body fliuds. Male

infertility, alopecia, renal hepatic toxicity.

Hypersens to sulphasalazine,sulphonamides or salicylates.

Infants under 2 years. Intestinal & urinary obstruction.

Porphyria. SLE, blood dyscrasias.

Special precautions:

Regular blood checks. Impaired renal or hepatic function.

Reversible oligospermia may occur in male patients, diabetes, pregnancy, inflammatory bowel diseases, rheumatoid arthritis.

Indications:

Mild to moderate infections.

Dosage:

Adults - 3 to 4 gm/day in evenly divided doses of 1 to 2gm/day, may lessen adverse effects.

Children more than 2 years old- 40 to 60 mg/24 hours in 4 to 6 divided doses.

Maintenance- Adults- 500 mg 4 times a day. Children- 20 to 30 mg/kg/day in 4 divided doses.

SULPHASALIZINE-

1. Allergies- tell your doctor if ever had any allergic reactions to sulphasalazine or any of sulfa drugs, or furosemide or thiazaide diuretics , oral antidiabetics , glaucoma medicine , acetozolamide, or salicylates or any of the food products, preservatives or flavours

2. Pregnancy-not studied in pregnant woman. Reports on woman who had taken sulphasalzine during pregnancy have not shown that it causes brth defects or oter problems.

3. Breast feeding- sulfa medicines pass into breast milk in small amounts anfd have shown to cause unwanted side effects in nursing babies with glucose 6 phosphate hydrogenase G6PD defeciency. It may be necessary to take another medicine or stop breast feeding

4. Children- should not be used in children upto 2 years of age because it may cause brain problems. Sulfasalzine has not shown to cause different side effects or problems in children over the age of 2 years than it does in adults.

5. Older adults-not tested and has not shown different side effects or problems than in younger patients

6. Other medicines- Tell your doctor if you are taking any of the following- Acetoaminophen or Analbolic steroids or Androgens or Antithyroid agents- or Carbamazepineor Carmustine or Chloroquie or Dantrolene or Daunorubicin or Disulfiram or Divalproex Estrogens or

7. Other medical problems- make sure that you tell your doctor if you have any other medical problems especially- Blood problems or Glucose -6 PD -patients with these problems may have an increased chance of side effects affectig the blood Kidney disease

 8. Dosing- Do not give sulfasalazine to infants and children upto 2 years of age Each dose of sulfasalzine should be taken with a full glass of water.

9. Missed dose- if you do missa dose takeit as soo as possible. However,if it is almost time for your next dose skip the missed dose and go back to your regular dosing schedule Do not double doses

10. Storage- Keep out of reach of children Store away from heat and direct light Do not store the capsule or tablet form of this medicine inte bathroom, near tekitchen sink  in oterdamp places. Heat or moistire may cause te medicineto break down keep teoral liquid andenema forms of this medicine from freezing

Do not keep outdated medicine no longer in use. Be sure that that any discarded medicine is kept out of reach of children.