Please help , What effect is sulfasalazine supposed to have? Joints seem to be getting worse

hannah07
hannah07 Member Posts: 8
edited 31. Jan 2025, 10:44 in Living with arthritis

Hi everyone,

I was recently diagnosed with RA and am currently on two sulfasalazine tablets a day, I have my first appointment with a rheumatology nurse on Tuesday.

They mentioned the full does of the tablet will be 6 a day so I am building up to that but what effect does sulfasalazine have on you? I still wake up with painful hands, feet, knees and now my neck hurts as well although that usually passes after the first couple of hours of the day. Is sulfasalazine supposed to take away the pain or has it got a different purpose and should I be on painkillers as well?

I know I’m not on the full dose yet but I had hoped that by starting these meds I would stop having my RA symptoms and be pain free, currently I’ve only been taking them for 4 weeks so when I’ve been taking them longer will I stop having pain? At the moment my fingers are just as sore and swollen as when I wasn’t taking the meds.

Any advice or personal experience is appreciated.

Thanks,

Hannah

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Comments

  • stickywicket
    stickywicket Member Posts: 27,764

    Sulfasalazine is a DMARD (Disease Modifying Ant-Rheumatic Drug). I guess there's a clue there ie these drugs modify the disease: they don't eliminate it. Furthermore, they all take up to three months to work properly. Not every drug will work for every patient. Usually we're started on a fairly low dose to ensure we're tolerating it well and then it is upped. I expect this will happen on Tuesday for you.

    But there are no guarantees. The drugs are to hold back the disease and try to prevent its worst excesses. Some lucky people find they also eliminate pain but, for most of us, pain is always around to a greater or lesser extent. Whether or not the drug is working is determined by our blood tests rather than pain levels. If necessary you can take pain relief but, if buying over the counter, do ensure that the pharmacist is aware of all other meds you take to guard against nteractions.

    You are at a very early stage so the sulfasalazine won't, yet be doing a great deal. The bad side is that things are still bad. The good side is that there is plenty of scope for them to improve. I hope they do.

    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • Brynmor
    Brynmor Member Posts: 1,755

    Hi @hannah07

    I've taken a quick look around and found this page on our website:

    https://www.versusarthritis.org/about-arthritis/treatments/drugs/sulfasalazine/

    Do take a look through the information which is pretty comprehensive but doesn't include people's personal experience of taking sulfasalazine. However, here's a recent conversation on the subject: https://community.versusarthritis.org/discussion/54040/sulfasalazine

  • cazgreeny
    cazgreeny Member Posts: 2

    Hi i have been on sulfasalazine for a fee years i take 6 a day but also take paracetamol for pain it does on time settle with flares every so often good luvk n keep trying ot.

  • sparks
    sparks Member Posts: 2

    I have just started on sulfasalazine about 7 weeks ago.I had increased to 4 a day "2×2" x day however I am suffering with a massive acid Reflux problem.

    So much so I am seriously considering not taking them

    I have a hiatus hernia which doesn't help.

    I also take Hydroxachloraquine and methotrexate

    I guess my question is can anyone else had this and of so what helps with the acid

  • deny63
    deny63 Member Posts: 7

    when I started them years ago they did the same to me they changed them to gastro resistant

  • Ellen
    Ellen Moderator Posts: 1,898

    Good Morning @sparks welcome to the online community.

    'Heartburn is listed as a common side effect of sulfasalazine unfortunately and as you say you already have a hiatus hernia.

    https://www.versusarthritis.org/about-arthritis/treatments/drugs/sulfasalazine/

    Some excellent advice from @deny63 there. I was also going to suggest a call to your rheumatology nurses for advice. It may be that they can request your prescription be changed to gastro resistant too. Definitely worth a phone cal given that you are considering stopping your treatment due to the side effects.

    Best wishes

    Ellen.

  • sparks
    sparks Member Posts: 2

    Many thanks!! I had no idea that there was an alternative

  • mosborn11
    mosborn11 Member Posts: 50
    edited 29. Jan 2025, 10:25

    I found sulfasalazine didn't work for me, but for other people it can be helpful. I didn't find the side effects too bad though

  • Airwave!
    Airwave! Member Posts: 2,479

    I felt like crap, only way I can describe it after a few weeks. Don’t worry about stuff like that, they’ll soon move you on to the next treatment.

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