Main uses in hair loss: alopecia areata

What is Sulfasalazine?

  • Sulfasalazine is a medication which is commonly used in treating inflammatory bowel disease and rheumatoid arthritis but has been shown to be helpful in a proportion of patients with the hair loss conditions called alopecia areata

How is it Sulfasalazine prescribed?

  • Your doctor will advise how this is to be used
  • Baseline blood tests will be ordered BEFORE you start sulfasalazine (complete blood counts, kidney and liver, folate, B12 levels, urinalysis with microscopy, G6PD)
  • Blood tests will be checked every few weeks for a couple of months, then less often afterwards.

Who should not take Sulfasalazine?

  • Do not take sulfasalazine if you are allergic to sulfa drugs or aspirin
  • Do not take sulfasalazine if you have a disorder known as porphyria
  • Do not take sulfasalazine if you are pregnant

Do any medications interact with Sulfasalazine?

  • Tell your doctor if you are on any of these medications.
  1. Digoxin
  2. Imuran, methotrexate, cyclosporine
  3. Ibuprofen
  4. Coumadin

What are the side effects of Sulfasalazine?

More common:

  • Nausea and headache  (often the earliest side effects and can be treated by lowering the dose)
  • Diarrhea, vomiting, loss of appetite are common (GI side effects are common – taking with food or using enteric coated tablets can reduce these side effects); dyspepsia can be treated with antiacids.
  • Dizziness
  • Increased sensitivity of the skin to the light
  • May cause urine  & skin to turn dark yellow or orange (this is harmless)
  • Rashes
  • Aching joints

Less Common or rare:

  • Drop in blood counts
  • Irritation of the lungs, liver, pancreas
  • Lowered platelet counts
  • Mood changes, including severe depression
  • Men are infertile while on the drug, but it is reversed when the drug is stopped

Serious side effects:

  • Bruising of the skin, jaundiced skin and eyes, pale skin
  • Difficulty swallowing
  • Weakness

Under what situations should I stop Sulfasalazine ?

  • Stop the drug if you feel unwell and seek medical attention
  • Stop the drug if you develop  sore throat, fever, pallor, bruising, or jaundice (yellowing of the skin), abdominal pain as these may be indications of serious problems - get medical attention right away.