WhaleRoad Member Posts: 32
edited 2. Oct 2017, 15:42 in Living with Arthritis archive
Hi. I was taking hydroxychloroquine twice a day for inflammatory arthritis. Rheumatologist has now added sulfasalazine and reduced the HCQ to once a day as I was apparently taking a little too much for my weight.

I'm a bit nervous about cutting down on the drug that has helped me a lot (though evidently not quite enough, hence the new medication) while waiting for the sulfasalazine to kick in.

I've also heard about sulfasalazine causing depression in some people, which is a huge concern for me due to previous history.

But I need to try something as things aren't quite right at the moment. So, I will take it with some trepidation and I suppose I'm just looking for some reassurance or advice from others who have tried it.

Thanks! x


  • dibdab
    dibdab Member Posts: 1,498
    edited 30. Nov -1, 00:00
    Hi there,

    We take all sorts of medications between us. I take a cocktail of 3 disease modifiers at present. Like you I started with hydroxychloroquine, it's the mildest drug I think. Adding sulphasalazine helped for a while. I'd suggest you try to take your sulphasalazine with or after food to make it easier on your tummy, and make sure you get regular bloods done to make sure all is well. I certainly haven't had depression from it, but it does occasionally give me an upset tummy, in which case I miss it out for 24 hours whilst things settle then add it back in.

    The drugs you mention are widely used and generally well tolerated, so hopefully all will be well for you. No doubt others will be along over the weekend to share their thoughts.

    Deb xx
  • stickywicket
    stickywicket Member Posts: 27,429
    edited 30. Nov -1, 00:00
    I've not taken sulph but maybe I can reassure you a little on the hydroxy front. I took two per days for ages - years, I think, until a new rheumatologist asked why. I said that I'd always taken two. (Weight was never mentioned. I'm never above 10 stone) I was told that two was the normal staring dose but only for the first six months. I reduced mine to one daily and have never noticed a difference. I should add that I was also, and am still, on methotrexate.
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    I was started on sulph in 2002 and took it for many years. Initially it caused quite severe bruising on my legs but that duly settled. It was too lazy to tackle my PsA but I think it helped to keep my skin clear of what little psoriasis I had. I stopped taking it because I felt that the humira and meth were doing enough and didn't require its feeble assistance - I felt better in myself for stopping it but that was probably psychological: six tablets less per day makes a noticeable difference to a medicated life.

    A friend of mine who also has PsA is wonderfully controlled on six sulph tablets per day and has been for years. He is still working full-time as a bespoke kitchen fitter and relaxes with cycling and running. DD
  • WhaleRoad
    WhaleRoad Member Posts: 32
    edited 30. Nov -1, 00:00
    The doctor told me dosing guidelines for hydroxychloroquine had recently changed. I'd been taking it twice a day since I was first prescribed it more than a year ago - partly because my rheumatology appointments were repeatedly cancelled so there was nobody to instruct me otherwise.

    I'm not entirely happy about suddenly cutting my dose in half (I've noticed quite quickly when I've skipped the odd dose due to illness) so think I will alternate one to two daily for a while, until the sulfasalazine has a chance to work.
  • stickywicket
    stickywicket Member Posts: 27,429
    edited 30. Nov -1, 00:00
    I really don't know if that would be a good thing to do. Why not check with a pharmicist?
  • MrDJ
    MrDJ Member Posts: 247
    edited 30. Nov -1, 00:00
    ive been on sulfasalazine since 1987 and was told at the time it would be short term. back then i was on 6 a day until 2001.
    30 years later im still on 2 a day. they cut me down back in 2001 when i started anti tnf infusion and also started on methotrexate at 20mg a week and ive been on that same dose ever since.

    me personally ive never noticed any side effects from the sulfa until they stopped me for a trial on cox2 drugs and all hell broke lose so within 3 weeks i was back on them so they seemed to be doing something.
    ive never been on hydroxy so no idea how they work together.
    if your in any doubt and as mentioned ask at your chemist and gp and then ask the rhumy when you next see the specialist.