Crohn's disease is an intestinal pathology that tends to progress. The inflammatory process spreads transmurally and is characterized by various local and systemic complications. The disease affects the entire thickness of the intestinal wall, narrows its lumen, and forms infiltrates, abscesses and ulcers. To stop the disease process, the patient is prescribed anti-inflammatory drugs.
Such effective medications for eliminating the symptoms of Crohn's disease and ulcerative colitis (UC) include the medications "Sulfasalazine-EN" and "Sulfasalazine". Medicines are also prescribed for rheumatoid arthritis to relieve pain and inflammation. Like many drugs, they have their contraindications and side effects. What does the drug “Sulfasalazine-EN” consist of? What is its difference from “Sulfasalazine”? All information can be found in the article.
Chemical properties
Sulfadiazine sodium belongs to the group of antimicrobial agents - sulfonamides .
The substance is synthesized in the form of a white or light yellow crystalline powder that has no specific odor. When exposed to light for a long time, the compound turns yellow and disintegrates in the presence of an acidic environment. The product is insoluble in water and org. solvents, but dissolves well in alkalis .
Molecular weight of the compound = 250.3 grams per mole.
A substance similar in sound, sulfozine , was previously used in psychiatry for pyrotherapy in schizophrenia and for pacifying violent patients.
Sulfazine is not used in psychiatry. Sulfasin injections are also not given. The medicine is available in the form of tablets or ointments for topical use.
The drug "Sulfasalazine"
The drug belongs to the group of anti-inflammatory drugs, prescribed for the treatment of Crohn's disease and ulcerative colitis. Produced in yellow-brown tablet form. The medicine contains sulfasalazine (500 mg).
The drug has anti-inflammatory and antimicrobial effects. It also has immunosuppressive and antirheumatic effects. The main substance of the tablets, sulfasalazine, has a positive effect on the intestines thanks to two active components. These are sulfapyridinone and aminosalicylic acid. The drug “Sulfasalazine-EN” has a bacteriostatic effect against diplococci, staphylococci and Escherichia coli. Difference from "Sulfasalazine", description of the active ingredient - all information is presented in the instructions.
Pharmacodynamics and pharmacokinetics
The substance blocks the processes of folate and inhibits the activity of SH-containing enzymes in microbial cells, disrupts the synthesis of tetrahydrofolic acid , pyrimidines and purines . The product is active against gram-positive and gram-negative bacteria, including Pseudomonas aeruginosa, streptococci, gonococci, E. coli, meningococci, protozoal infections, Candida fungi, dermatophytes .
Bioavailability when taken orally is about 80%. The drug is metabolized primarily by the kidneys. The half-life of the substance ranges from 10 hours to 1 day.
The ointment, which contains Sulfazin, has moderate osmotic activity , acts locally, less than 10% of the active substance enters the systemic bloodstream.
Action
The drug is used to eliminate the symptoms of Crohn's disease and UC. Sulfasalazine is released to aminosalicylic acid, which has an anti-inflammatory effect at the site of erosion. Sulfapyridine is also formed, which has antimicrobial activity and inhibits the functions of gonococci, streptococci and Escherichia coli.
When taken orally, the tablets are almost not absorbed in the intestines. Here they are broken down under the influence of intestinal microflora and form sulfapyridine by 75% and aminosalicylic acid by 25%. Over the course of three days, the substances are mainly excreted by the kidneys and only in a tiny percentage by feces. This effect on the patient’s body is exerted by the drug “Sulfasalazine-EN”. The difference from Sulfasalazine, reviews about the drug - all this information should be studied before starting treatment.
Indications for use
Sulfadiazine sodium is prescribed:
- for the treatment of infectious and inflammatory diseases of the urinary tract;
- for trachoma and toxoplasmosis ;
- patients with pneumonia , cerebral meningitis , sepsis , if other antibacterial agents are not effective enough.
The substance used in the ointment is:
- for the treatment of superficial wounds and burns with mild exudation;
- for trophic ulcers , bedsores , ulcers that do not heal for a long time;
- in patients with keratomycosis ;
- after skin grafting.
When is the medication used?
The medicine is prescribed for the following pathologies:
- UC;
- Crohn's disease;
- rheumatoid arthritis.
It is prohibited to take the medicine in the following cases:
- kidney and liver disease;
- anemia;
- porphyria;
- pregnancy;
- lactation;
- hypersensitivity to substances included in the drug.
Before starting the treatment process, it is necessary to carefully study all contraindications to taking the drug “Sulfasalazine-EN”. Difference from “Sulfasalazine, special instructions - all information is important. The drug can be used after consultation with a specialist.
Contraindications
Sulfazine is contraindicated:
- if you are allergic to this substance;
- persons with renal failure or leukopenia ;
- pregnant women;
- with neutropenia ;
- up to 3 months of age;
- during lactation;
- with deficiency of glucose-6-phosphate dehydrogenase .
Also, the ointment should not be prescribed for the treatment of deep purulent wounds and burns with severe exudation .
Indications and contraindications
The medicine is prescribed for the following pathologies:
- UC;
- Crohn's disease;
- various forms of rheumatoid arthritis.
Contraindications:
- severe pathology of the kidneys and liver;
- blood diseases;
- age up to 5 years;
- increased hypersensitivity to the components.
The drug “Sulfasalazine - EN” has an insignificant difference from “Sulfasalazine”. Instructions for use describe similar indications and contraindications. A specialist will tell you which medication to use in a particular case.
Sulfazin, instructions for use (Method and dosage)
Depending on the disease and dosage form, there are different treatment regimens.
Tablets are usually prescribed in a saturating dose of 2 to 4 grams per day. Then take 1 gram every 4 hours for 1-2 days. Then they switch to taking one gram of the product every 7 hours.
For children, the initial dosage is calculated from the ratio of 0.1 grams per 1 kg of weight, then 25 mg per kg every 4-6 hours.
The ointment is used exclusively topically. After cleaning and proper treatment of the wound surface, the drug is applied in a layer of 3 mm; a maximum of 300 mg of ointment can be applied. It is also recommended to apply a bandage with ointment, which should be changed at least 1-2 times a day. The duration of treatment is approximately 21 days.
Sulfasalazin
A complete clinical blood count, including white blood cell count, red blood cell and platelet counts, and biochemical liver function tests should be performed before starting sulfasalazine and every other week for the first three months of therapy. Over the next three months, the same laboratory tests should be performed monthly, then once every three months and in accordance with clinical indications.
Assessment of renal function (including urinalysis) should be performed in all patients before starting therapy and at least monthly during the first three months of treatment. Thereafter, monitoring should be performed as clinically indicated.
The presence of clinical signs such as sore throat, fever, pale skin, purpura or jaundice during sulfasalazine therapy may indicate myelosuppression, hemolysis or hepatotoxicity.
Treatment with sulfasalazine should be discontinued until the results of blood tests are obtained (see section "Special Instructions", subsection "Influence on laboratory results").
Life-threatening skin reactions: SSD and TEN have been reported with the use of the drug Sulfasalazine. Patients should be alerted to clinical signs and symptoms and should be closely monitored for the development of skin reactions. The highest risk of developing SJS and TEN is during the first weeks of treatment. If clinical manifestations or symptoms of SJS and TEN occur (eg, progressive skin rash, often with blistering or mucosal involvement), treatment with Sulfasalazine should be discontinued.
The best results in the treatment of SJS and TEN are achieved with early diagnosis and immediate discontinuation of any suspicious drug. Early discontinuation of the drug is associated with a better prognosis.
If a patient develops SJS or TEN while taking Sulfasalazine, sulfasalazine therapy should not be restarted in that patient.
Impact on laboratory results
In patients exposed to sulfasalasia or its metabolite (mesalamine/mesalazine), there have been several reports of possible false-positive urinary normeganephrine liquid chromatography results.
Sulfasalazine or its metabolites may interfere with ultraviolet absorption, especially at 340 nm, as well as with some laboratory tests using dihydronicotinamide adenine dinucleotide (NADH) or dihydronicotinamide adenine dinucleotide phosphate (NADPH) to measure ultraviolet absorption at this wavelength. Examples of such tests may include: determination of concentrations of urea, ammonia, lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase and glucose.
When using sulfasalazine in high doses, changes in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase-muscle/brain (CK-MB), glutamate dehydrogenase, or serum thyroxine concentrations may occur.
Consult with your diagnostic laboratory regarding the laboratory testing technique to be used. Caution should be used when interpreting these results in patients taking sulfasalazine. Results should be interpreted in conjunction with clinical data.
Dosage
On the first day of treatment for adults, the medicine is prescribed in a dose of 500 mg 4 times, then on the second day - 1 g 4 times, then the drug is taken from 1.5 to 2 g per day. The course of treatment depends on the severity of the process and the individual characteristics of the body.
An overdose can lead to the development of the following symptoms:
- migraine;
- convulsions;
- insomnia;
- epigastric pain;
- vomit;
- diarrhea;
- allergy.
The drug Sulfasalazine-EN has less pronounced side effects. The difference from Sulfasalazine is that the medication is coated.
If it was not possible to purchase any of the drugs described at the pharmacy, a specialist will select a high-quality substitute.
The drug "Salofalk"
The medicine has anti-inflammatory properties and is prescribed for Crohn's disease and UC. Available in the form of yellow tablets. The drug contains mesalazine in doses of 250 and 500 and 1 g. The drug has an anti-inflammatory, antioxidant effect on the intestinal wall
Indications:
- UC;
- Crohn's disease
Contraindications:
- blood diseases;
- preschool children;
- hypersensitivity to components.
At the beginning of the treatment process, you should carefully study all the features of the drug “Salofalk” and “Sulfasalazine-EN”. The difference from Sulfasalazine in application is not significant. The drugs are taken according to a similar scheme.
Medicine "Sulfasalazine-EN". Difference from Sulfasalazine: patient reviews
Two drugs identical in composition. The only difference is that Sulfalazine-EN is coated, soluble only in the intestines, unlike Sulfasalazine tablets, which are film-coated. Also, the first medicine causes more allergic reactions, which manifest themselves in the form of rashes and itching on the skin. If you believe the reviews of patients, the drug "Sulfasalazine" is in great demand.
Experts note that both drugs can lead to the development of side effects. There is nausea, vomiting and stomach pain. At the same time, Sulfasalazine-EN has a slight difference from Sulfasalazine. Photos of medicines are also similar.
Experts note that this group of medications does not help everyone to the same extent. These drugs are not reliable enough for damage to peripheral joints. To avoid the development of urolithiasis, it is advisable to take the tablets with plenty of mineral water and drink plenty of fluids throughout the day. What other difference does “Sulfasalazine-EN” have from “Sulfasalazine”? Although the analogue (the drug “Salofalk”) is prescribed for similar pathologies, it has many more discrepancies. This is due to the difference in composition.
