Sulfasalazine nausea

I had PsA diagnosed during the first Covid lockdown and started methotrexate. After a recent flare in my finger joint I've had methotrexate bumped up to 25mg and sulfasalazine prescribed. After increasing my dose over 4 weeks I had to stop the sulfasalazine because of headaches and nausea. Advised to have a break and restart building up the dose more slowly and adding in more folic acid. I've had 3 weeks of 1500mg and the side effects are starting again. No headaches this time but nausea and food tasting funny. I'm a dedicated coffee drinker but it's just not appealing at the moment and tea is weird. Has anyone else experienced this effect and does it get better?


  • MrDJ
    MrDJ Member Posts: 266


    I know drugs affect us all differently but ive been on sulfasalazine for over 30 years and never had any side effects what so ever except for yellow pee.

    i was on 6 a day from 1985-2001 until they started me on methatrexate and been on 20mg since then as well as 2 sulfhasalazine and 6 weekly anti tnf infusion infliximab now changed to bio similar remsima.

    now methotrexate is known to cause nausea, headaches and mouth ulcers and especially as your on 25mg that a largeish dose for arthritis. they wanted me to up to 25mg when i had a bad flare up but i refused so they upped my sulpha instead and it settled the flair up.

    looking at the side effects sulpha can cause nausea and sickness.

    were you given a nurse helpline phone number. my hospital had one for years but then they stopped due to short staffed. luckily not had to call them.

    hope it settles down for you soon.

  • Moira
    Moira Member Posts: 71

    I had sulfaslazine and it was evil!!! I had a metal taste in my mouth and felt sick all day. Yes, my food and coffee tasted weird too.

    My rhumatology nurse who checked me, brought me off it and said that different drugs will react differently on people.

    Methotrexate seemed to suit me better, although I had to watch my liver count. Never had ulcers with it, even although I had been prone to ulcers in my mouth all my life.

    Good luck with finding what suits you.

  • CCM
    CCM Member Posts: 113

    It was Hydroxy that got me, sulfasalazine was fine. Now on the biologics.

    There's 'nout so odd as drugs as someone once (nearly) said.