Sulfasalazine

Salazopyrin En-tabs is a preparation intended for systemic treatment of inflammatory bowel diseases. Today it is very popular. 

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Indications Sulfasalazine

Indications for use Salazopyrin En-tabs - treatment of diseases associated with the intestine. This powerful tool, which as a monotherapy and combination therapy can in a short time to save a person from serious problems.

The specificity of the drug consists in the elimination of ulcerative colitis and Crohn's disease. In addition, the medication treats rheumatoid arthritis in adults, juvenile polyarticular or oligoarticular rheumatoid arthritis.

This tool is mainly used by adults. Special practice in the treatment of children was not performed. The drug has good properties and is able to ease a person's condition in a short time. To date, in medical practice, the drug is widely used as a combination therapy and as a separate tool. The pain in the intestines recedes after the first intake of the drug. Salazopyrin En-Tabs is a unique and effective tool designed to solve serious problems. 

Release form

The form of release of a medicine - a tablet. They are taken inside and at the same time washed down with a sufficient amount of water. Auxiliary components of the agent are: pregelatinized starch, wax white, carnauba wax, talc, macrogol 20000, magnesium stearate, silicium dioxide colloidal anhydrous, propylene glycol and cellulose acetophosphate.

One tablet contains 500 mg of the basic substance and additional components. Thanks to cohesive work, it is possible to achieve a positive result in a short time.

In addition to the tablets, there is also a solution. Depending on the individual characteristics of a person and the doctor's recommendations, one or another form of release is chosen. There is no special difference in this case. Not all patients are able to freely swallow a pill, which causes a lot of inconvenience. In this case, greatly simplifies the process of making the release form in the form of a solution. How to use salazopyrin En-Tabs is decided by the patient or his attending physician. 

Pharmacodynamics

Pharmacodynamics Salazopyrin En-tabs-sulfasalazine in the large intestine is cleaved by bacteria. Thus, it forms two main metabolites, sulfapyridine and mesalazine (5-aminosalicylic acid). It is extremely difficult to separate the clinical significance of all these components.

Sulfasalazine completely affects immunocompetent cells in vitro and has immunological activity in vivo. It inhibits the production of T cells and killer cells. In addition, he can oppress the production of both immunoglobulins and rheumatoid factor. These effects are explained by the inhibitory effect of sulfasalazine on the production of IL-1 and IL-2 cytokines. It was noted that the component actively affects the binding of tumor necrosis factor (TNF-α) to the corresponding receptors.

In addition to all the above, the main substance actively affects the metabolism of arachidonic acid and prostaglandins. They in turn play an important role in educational and immunological reactions. In itself, sulfasalazine is an inhibitor of 15-hydroxydehydrogenase (15-PGDH). It is the main catabolic enzyme of prostaglandins.

The results of many in vitro studies suggest that sulfasalazine, along with its major metabolites, inhibits bacterial growth. Bacteriostatic effect on some bacterial species is also observed in the clinical application of Salazopyrin En-Tabs.

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Pharmacokinetics

Pharmacokinetics Salazopyrin En-tabs - the bioavailability of the drug when used in a tablet format is 5-10%. Its maximum concentration in blood plasma is reached within 3-6 hours after acceptance. The degree of binding to proteins is at a high level and is 99%.

As for the trend towards cumulation, it is moderate. The concentration of the active component in the blood serum after 24 hours after the administration is negligible. A similar situation develops with urine.

Sulfapyridine is rapidly absorbed and partially metabolized by acetylation / hydroxylation in the liver. Metabolites are completely excreted along with urine. Non-acetyl sulfapyridine only partially binds to blood plasma proteins. At the same time, its maximum concentration is achieved within 12 hours after administration. The equilibrium state occurs after 5 days. After withdrawal of the drug within 3 days, its concentration in the blood plasma is significantly reduced.

Patients with slow acetylation are at risk of developing side effects due to high levels of the main component in blood plasma. The drug is absorbed approximately 20%. It is derived as a pharmacologically inactive acetyl-5-aminosalicylic acid together with urine. Most Salazopyrin En-Tabs remains in the large intestine. 

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Dosing and administration

The method of administration and dose are set individually. For this purpose, the tolerability of the drug and the effectiveness of therapy are taken into account. Patients who have not previously taken this medication should increase the dose gradually, within the first 9 days. Tablets are swallowed not breaking and not chewing. The drug is recommended to use after eating. The dose is 1 gram, which is equal to two tablets.

When systemic treatment of inflammatory bowel diseases, adults use 1-2 grams per day. But these data do not concern the elderly. To break a dose it is necessary for 3 receptions. If necessary, the daily allowance is increased to 8 grams.

For maintenance treatment, 2-3 grams per day for 3 doses. Children older than 6 years with an acute condition of 40-150 mg per kilogram of weight per day. The dose is also divided into 3 doses. For maintenance treatment, 20-75 mg / kg / day for 3 doses is sufficient.

When systemic treatment of rheumatoid arthritis in adults and juvenile rheumatoid arthritis (with polyarthritis or oligoarthritis) 

Adults take 500 mg per day. Each week, the dose is increased by 500 mg, until it reaches 2 grams per day. Divide this rate by 2-4 admission. The duration of treatment is usually 12 weeks. According to this scheme, Salazopyrin En-Tabs is taken. 

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Use Sulfasalazine during pregnancy

Use of Salazopyrin En-Tabs during pregnancy is unacceptable. There were no special studies on this subject. It is difficult to say what effect the drug can have on the developing organism. When choosing a medicine, many features should be considered.

Use the remedy is possible only if the expected positive effect for the mother is significantly higher than the negative impact on the baby's body. In the first trimester, taking any drug is prohibited. There is a risk of causing serious pathologies in the child. For the first time months there is a risk of miscarriage. All this must be understood.

Any medication, including Salazopyrin En-Tabs, should be taken under the supervision of the attending physician. Use it is possible only in cases when without such therapy you can not do. But at the same time, you have to take into account all possible risks. Salazopyrin En-tabs can cause serious damage not only to the mother's body, but also to the developing fetus in her womb.

Contraindications

 Contraindications to the use of Salazopyrin En-Tabs are available, and the main one is the intolerance of the active ingredients of the drug. A person who has hypersensitivity should immediately stop taking medication. The organism can inadequately react to this, which will lead to the development of a serious allergic reaction.

In addition to intolerance, the use of medication can not be taken in people who have a persistent dislike of the body sulfanilamide and salicylate. Porphyria also falls under this category. Naturally, a child's age does not imply the use of this medication.

The product does not pose a particular danger to a person if it is taken correctly and according to instructions. But to start independent treatment, in no case is not worth it. Rather, it is an individual procedure and thereafter unforeseen situations may arise. Therefore, to avoid serious complications, take Salazopyrin En-Tabs with the permission of your doctor. 

Side effects Sulfasalazine

Side effects of Salazopyrin En-Tabs concern many organs and systems. In general, there may be swelling of the face, fever, loss of appetite, serum sickness and even staining of body fluids in yellow.

From the side of the cardiovascular system, the occurrence of pericarditis may occur. The central nervous system is also capable of responding in a peculiar way. It is not excluded aseptic meningitis, encephalopathy, dizziness, headache and peripheral neuropathy.

Notice the serious problems and the skin. Often there is an alopecia, epidermal necrolysis, red flat lichen, Stevens-Johnson syndrome, urticaria, exfoliative dermatitis and erythema. From the gastrointestinal tract are abdominal pain, nausea, upset stomach, pseudomembranous colitis and exacerbation of ulcerative colitis.

On the hematopoiesis side it is macrocytosis, thrombocytopenia, agranulocytosis, leukopenia, hemolytic anemia and megaloblastic anemia. Musculoskeletal: arthralgia. There may be mental disorders, ringing in the ears, hematuria, nephrotic syndrome, and a violation of taste sensations / smell. All this can cause misuse of Salazopyrin En-Tabs. 

Overdose

An overdose of medication is possible when using too much a dose. The risk of getting a serious condition occurs in people with impaired renal function. Symptoms of overdose standards. The person begins to feel nausea, then there is vomiting and pain in the abdomen.

It is advisable to wash the stomach when the first signs appear. The body should be freed from the harmful effects of the drug. After this, symptomatic and supportive therapy is performed. In this case, much depends on the state of man. It is not excluded alkalinization of urine.

After washing the stomach, you need to carefully monitor the patient's condition. The fact is that in some cases, there may be methemoglobinemia or sulfagemoglobinemia. All this requires appropriate treatment.

In order to avoid an overdose, it is not necessary to take the remedy with individual intolerance to certain components and independently increase the dose. Otherwise, Salazopyrin En-Tabs will cause serious harm. 

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Interactions with other drugs

Interactions Salazopyrin En-tabs with other drugs are not excluded. This drug with simultaneous reception of digoxin can reduce absorption of the latter. Sulfasalazine is able to inhibit the enzyme thiopurin methyltransferase when used simultaneously with thiopurin-6-mercaptopurine or azathioprine. This can lead to suppression of bone marrow function and leukopenia.

The use of sulfasalazine and methotrexate in patients with rheumatoid arthritis does not change the pharmacokinetic characteristics of the drugs. But, despite this, there were cases when the frequency of side effects from the gastrointestinal tract increased.

This medication is able to enhance the effect of anticoagulants and oral hypoglycemic agents. Therefore, use Salazopyrin En-Tabs with extreme caution and under the guidance of a specialist. This will avoid side effects and not reduce / increase the functionality of other medicines. 

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Storage conditions

Storage conditions Salazopyrin En-Tabs plays a significant role. It is important to comply with the temperature regime, it should not exceed 15-25 degrees. This is an optimal condition for long-term storage of the drug. During the whole time the product should be in individual packaging.

It is desirable that the storage location is warm, dry and without direct sunlight. Many medicines, including Salazopyrin En-Tabs, do not tolerate excessive moisture. Therefore, put the product in the refrigerator or give it freezing is not worth it. You can not give the drug to children. Therefore, you need to store it in an inaccessible place. This will avoid serious side effects and negative effects on the developing organism.

Observance of all storage conditions will allow using the medication for the entire available time. You need to pay attention to external data means. If the color, odor or taste has become otherwise, Salazopyrin En-Tabs is not advisable. 

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Shelf life

Shelf life of the drug is 5 years. For all this period you need to take care of quality storage conditions. It is important that the product is not exposed to direct sunlight. Under prohibition is moisture and heat.

The best storage is the first aid kit. Naturally, it should be removed away from children. They are able not only to damage the drug itself, but also its own organism.

Observe the temperature regime, it is enough 15-25 degrees of heat. In this case, the place should be dry and dark. In such conditions, the medication can be kept for a preset time. You need to pay attention to external data. Tablets should not change color, smell and taste. Otherwise, this indicates a violation of storage conditions. Such a drug can not last for 5 years. After expiration date, use Salazopyrin En-Tabs in no case be.

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