How long does sulphasalazine take to kick in?

taylor04

Hi, I'm 30 years old and was diagnosed with RA last September. Started taking sulphasalazine at the end of November and had built up to the full dose by 17th Dec (just 4 weeks ago). I'm still having to take prednisolone and diclofenic as well and symptoms are still not fully under control. My (new, temporary consultant) thinks the sulphasalazine isn't going to work on its own and wants to start me on methatrexate as well right away but I've read that the sulphasalazine can take about 12 weeks to work so I'm inclined to wait and see if that works and then start taking the methatrexate if it's still not doing much. My main reluctance to start the methatrexate is not being allowed to get pregnant whilst taking it, although of course I will if I have to. Just wondering what other people's experience has been. Thanks!

YellowFish

Hi,

Sorry to hear you're having a hard time of it. I am 30 too, also thinking about possibly having a baby, and was diagnosed about 2 years ago - lots of similarities!

I am very, very lucky because my symptoms have become a lot milder. For about 6 months I was in a bad way but managed to keep on working (although walking was hard!). They put me on sulphasalazine for a short while - I remember them telling me to brace myself because it would take about 12 weeks before I saw any improvement - so they gave me steroids for the first time which was such a blissful discovery!! But the salpha made me feel very sick so we stopped that and I went on hydroxycholoroquinine. The swelling improved but I had random pain that didn't really fit any patterns, and the steroids weren't helping any more, and eventually the consultant admitted that sometimes the hydroxychloroquinine can cause the kind of symptoms I was getting - so we tried coming off that to see if the situation improved - and it did.

I am so glad I didn't go onto the methotrexate - because, on balance, I can manage to have a normal life, most of the time, without. I have times when it's very difficult to walk, but I have a lot more times when it's OK. I am active - pilates, a bit of running, cycling, walking club etc. Basically, at the point when I was having real difficulties we almost made the decision for me to take it, and if I had, now I would think I was OK because of the methotrexate, and would carry on taking it.

So, there is a lot to be said for taking a deep breath, and waiting and seeing what happens. However, everyone is different. I suspect from what you've said, you are having a more difficult time than I was, esepcially as the steroids aren't keeping you tickety boo, and you have to do what is right for you. Your joints need protection, and the sooner you get it under control, the better things will be in the long term. If you are thinking about children, first of all you need to get the RA under control.

But perhaps it's worth having that conversation with your Dr too - are there alternatives?

Don't feel under any pressure to make decisions. You are doing exactly the right thing - get more information, find things out for yourself and make the decision that you feel comfortable with in your own time. Is you GP any good? I've moved recently but my previous GP was wonderful and I could talk through these decisions with her.

All the best.

Sparkys6887

As a man with chronic RA I was very reluctant to take sulpasalazine and definately didn't want to take methotrexate whilst there was any chance I wanted to father a child. I was off sulpasalazine for three maybe four years before my wife and I were successful with our daughter now aged four was born :-) And we had two miscarriages in that time too! sulphasalazine effects sperm morphology whi h may or may not have been the cause of the miscarriages. Only last November after another two years of trying to conceive, (my wife is 45 and I'm now 42) did I/we decide to try sulpasalazine and hydroxychlorine and give up trying to conceive. We are now trying to adopt. Since being on sulpasalazine and hydroxychlorine I'v had dreadful stomach problems and pounding headaches that made work nearly impossible. I stopped taking them with RA Nurse approval and am starting to take them again building up very slowly!!!!!

I would research thoroughly the effect of DMARDS on fertility and even ask at your local fertility clinic or sub fertility dept at your local hospital. As well as anyone involved in natural fertility maybe an accupinturist. My Rheumatologist did also say that aggressive RA will effect fertility. Sadly there are no easy answers and many women and men go on to sucessful pregnancies after taking DMARDS. Good luck!!!

lynnemarie1123

Hiya,

I am sorry that you also have the dreaded arthur!

Sulfa took a good 6 months to get into my system and have any effect at all, in between times I took diflofenic (still do when needed) and co-codamol.,

although i had already had my 2 children when I got diagnosed, i wasnt ready to finish my family which is why my consultant put me on sulfa - it has worked really well for me - (i still have flares tho) and have been told i would be able to get pregnant and carry successfully whilst been on the dmard.

i wouldn't rush into taking anything else as yet if i was you.

Good luck with everything xx

taylor04

Thanks so much everyone for your replies - really appreciated them. Feel better equipped for my appointment tomorrow