Sulfasalazine or salofalk which is better. Release forms and composition

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Sulfasalazine is one of the most effective and popular drugs with an anti-inflammatory effect. The product helps with Crohn's disease and NUC.

The drug Sulfasalazin is manufactured in China by Zhejiang Jiuzhou Pharmaceutical Co. Especially for the Slovenian-Russian company KRKA. International non-proprietary name The INN drug is called a mesalazine derivative under the ATC code A07EC01. The product has antimicrobial properties. According to its chemical structure, it is a combination of aminosalicylic acid and sulfapyridine substance. thirty% taken drug adsorbed from the intestinal lumen. Then it penetrates into connective tissue. The drug is affected by intestinal microflora. The molecules of the main component begin to disintegrate.

The main component is sulfasalazine, which belongs to pharmacological group sulfonamides.

Only 10% of it is absorbed gastrointestinal tract. Has binding to plasma proteins. May undergo biotransformation in the liver. 5% is excreted through feces and 67% through the kidneys. 91% of the substance is eliminated within three days.

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Irina Martynova. Graduated from Voronezh State University medical University them. N.N. Burdenko. Clinical resident and neurologist of the BUZ VO \"Moscow Polyclinic\".

Release forms and composition

Pills Sulfasalazine has an amber-brown tint. Available in an unusual shape with a beveled edge. Small inclusions are allowed in the tablets. One blister contains ten tablets. One paper box contains from one to five blisters. The cost of the drug depends on the markup of resellers. The cost is 310 rubles or more.

One tablet contains 500 milligrams of the main active ingredient. Also includes:

• Starch;
• Magnesium salt;
• Amorphous substance silicon monoxide;
• Hypromellose;
• Organic compound propylene glycol;

Candles Sulfasalazine must be injected into the rectum twice a day.

One suppository contains the main active ingredient sulfasalazine and cocoa butter. One package contains from five to twenty candles. The cost of the drug is 300 rubles and more.

Sulfasalazine and Sulfasalazine EH: what is the difference?

Sulfasalazine EH is different from regular Sulfalazine chemical structure film coating of tablets. The new generation drug EH has a special enteric coating. Thanks to the new formula, this drug has the best bioavailability. The absorption effect of the main active component has also been increased. 90% of the total dosage taken can directly reach the colon. The absorption of regular Sulfalazine reaches only 70%.

But new uniform The drug is produced by the American company Pfizer. That's why this medicine stands 1/3 higher than its conventional predecessor.

Dosages, application regimen

For Crohn's disease, ulcerative colitis:

• For adults and adolescents over sixteen years of age, the first daily dosage should be two grams. It is divided into four doses.
• The second daily dosage should be four grams. As in the first case, it is divided into four steps.
• The third and subsequent dosages should be equal to six or eight grams. They are divided into four or five receptions.

At initial stage diseases, when clinical manifestations subside in acute and chronic form, it is necessary to take a maintenance daily dosage of 1.5-2.0 grams. It is divided into three or four doses. This maintenance course of therapy can last from one month to six months. But for children and adolescents under sixteen years of age, a maintenance course is not recommended. Such therapy may have a negative impact on the development child's body. Also this therapy not recommended for patients whose weight is less than 65 kilograms.

The maximum daily dosage depends on the patient's age. Adults should not take more than eight grams of the component per day. In children, the dosage should not exceed two grams.

For distal localization of the lesion on the left side, patients are recommended to use suppositories and special microenemas. They are introduced into the intestines no more than twice a day. The recommended daily dosage of sulfasalazine should be at least one gram, cocoa butter - at least 1.6 grams.

Sulfasalazine for rheumatoid arthritis:

• Recommended daily dosage for adult patients and adolescents over sixteen years of age in the first seven days of therapy should be at least five hundred milligrams.
• From 8 to 15 days of therapy, you need to take 1000 milligrams of the component per day. This dosage is divided into two doses.
• From days 16 to 21 of therapy, the daily dosage should exceed 1500 milligrams. It is divided into three even doses.

The therapeutic dosage can be 1.5-3.0 milligrams. The most accurate information on dosing of the product should be obtained from a specialist. In order to achieve clinical effect, the course of therapy should last at least six to ten weeks.

Treatment of the disease can last more than six months.

Sulfasalazine instructions for use in pediatrics:

• Small children from six to eight years old with a body weight of 20 to 29 kilograms should take one tablet twice a day;
• Children from six to twelve years old weighing from 30 to 39 kilograms professional specialists It is recommended to take one tablet three times a day;
• Adolescents from twelve to sixteen years old with a body weight of 40 to 45 kilograms can take one tablet three times a day or two tablets twice a day;
• Adults, adolescents over sixteen years of age and children weighing over 50 kilograms should take two tablets twice a day;

For reactive arthritis:
The course of therapy begins with one tablet per day. The dosage is gradually increased. Max daily dosage for treatment of this disease There should not be more than four to six tablets. The medicine must be taken thirty minutes before meals. The product is washed down with distilled water without gas. The duration of therapy is three months or more.

You should consult your doctor for the most accurate information.

For ankylosing spondylitis:

If treatment with non-steroidal anti-inflammatory drugs and hormones is ineffective, then doctors prescribe therapy with Sulfasalazine. It is used as a base medicine. The medicine easily stops inflammation in the joints. The product must be drunk for three to six months. The drug is taken until the patient's condition improves. After the formation of a healing effect, dosages are increased to the maximum. At the same time as therapy, treatment with other drugs is discontinued. Their dosages are reduced gradually.

Pathological processes in this disease cannot be stopped. But the maximum effect can last for two to three months. As a supportive effect, patients take non-steroidal anti-inflammatory drugs in small dosages.

After the condition worsens, the therapeutic course is re-prescribed.

Sulfasalazine indications for use:

• Maintenance course of therapy for remission of ulcerative colitis;
• Heavy chronic illness intestines, manifested in the form of severe inflammation;
• Systemic disease connective tissue with joint damage, with the formation of erosions and destructive polyarthritis;
• Rheumatoid arthritis developing in children and adolescents;

Contraindications

The drug Sulfasalazine is contraindicated in the following cases:

• For any hematopoietic diseases;
• With a hereditary disorder of pigment metabolism;
• For any allergic reactions;
• Lack of G6PD enzyme;
• In case of malfunction of the liver and kidneys;

special instructions

• The drug is not recommended for patients with problems with the functioning of the kidneys and liver. The product is prohibited for people undergoing hemodialysis.
• The drug can cause Negative consequences in people suffering bronchial asthma.
• The product is not recommended for use together with similar drugs similar action;

Application nuances

• The drug contains components that may adversely affect the development of the fetus. That's why this remedy not recommended for pregnant girls in the first and second trimester. When using the medicine in the third trimester, newborns develop kernicterus. If it is necessary to use the product for nursing mothers, the child must be switched to artificial nutrition.
• The drug is not recommended for people over 65 years of age. In especially severe cases, patients should undergo therapy under the supervision of a physician.
• The product can be used by children and adolescents over two years of age. But giving the entire recommended dosage at once is not recommended. The therapeutic course should be gradual. The exact dosage and duration of treatment should be prescribed by a specialist.

Overdose and side effects

Patients may feel:

• Headaches of various manifestations;
• Migraine;
• Depression;
• Irritability;
• Manifestation of nausea;
• Vomiting;
• Limb spasms;
• Insomnia;
• Sense of anxiety;
• Noise in ears;

There may be a malfunction of the kidneys and liver, manifestation interstitial nephritis. May be affected lung tissue. Thrombocytopenia may develop. In girls, reproductive functions are disrupted and infertility occurs.

Hypersensitive people experience allergic reactions.

Interaction with other drugs

Is it possible to use Sulfasalazine simultaneously with prebiotics?? Prebiotics must be used in therapy with other drugs. The interaction effect of Sulfasalazine increases with simultaneous administration probiotics. Are decreasing painful sensations, inflammation is eliminated.

Is it possible to drink Mesacol after Sulfasalazine?? In especially severe cases, when the drug Mesacol is poorly effective, it is replaced with other similar drugs, including Sulfasalazine. But experienced specialists do not recommend interrupting the recommended course of therapy.

Interaction with alcohol

Sulfasalazine and alcohol are incompatible. While undergoing therapy with this drug, consuming any alcoholic beverages is not recommended. Otherwise, they may form side effects up to fatal outcome. But there are no specific studies or reliable data, since each person reacts individually to chemical reactions. If there is a need to consume alcohol, then taking the drug is allowed only after eight to ten hours. In this case, the dose of alcoholic beverages taken should be minimal.

This period of time is necessary to ensure that there is no contact between two incompatible substances.

Storage, release from pharmacies

The drug Sulfasalazine can only be purchased upon provision prescription form specialist The drug must be stored in a dry room at a temperature not exceeding 25°C. It is not recommended to store the drug in the refrigerator. The shelf life is five years from the date of production. It is prohibited to use the medicine after the expiration date. The year of the last adjustment of the means is 2010.

Analogs

Sulfasalazine analogues differ in cost, main active component, effectiveness, and duration of therapy.

Reviews

Most reviews about the drug are positive. But in order to achieve maximum effect, you must take this medicine for a long period. The effectiveness of Sulfasalazine reaches 95% after two to four weeks. The medicine has an antimicrobial effect. Easily relieves any inflammatory processes. Eliminates pain effects. Designed for both adults and children. Negative reviews published by patients exceeding recommended dosages. In this case, side effects are detected. There is information about the low effectiveness of the drug in therapy lasting less than one week.

Before starting to take the medicine, you should consult with a professional specialist in advance.

FAQ

Is the drug effective for UC?? The drug stops the development of the disease. The duration of the course of therapy should be prescribed by a specialist. The recommended daily dosage should be at least five hundred milligrams.

Sulfasalazine or Methotrexate, which is better?? Both drugs have antirheumatic effects. Both are manufactured in two release forms. They are used for rheumatoid arthritis. The difference between the funds is in the cost and duration of the course.

Use of Sulfasalazine in the treatment of prostatitis. A course of this drug along with antibiotic therapy is necessary. The minimum daily dosage for the treatment of prostatitis should be at least 1000 milligrams.

Which is better Mesacol or Sulfasalazine? Both drugs treat ulcerative colitis. Suitable for both adult patients and children. Mesacol is good for preventing and treating diseases. The cost of the drug is more than a thousand rubles.

Which is better Sulfasalazine or Salofalk? Both drugs are the same in purpose. But the combination of drugs is incompatible. Salofalk is the newest, most effective and safest remedy, unlike its predecessor.

Sulfasalazine is an effective and popular drug intended for long-term treatment. It is prescribed to both adult patients and children over two years of age.

Easily relieves inflammation and any pain in joints and muscles.

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Alexandra

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Paul

A large number of diseases cannot be treated without the use of antimicrobial drugs. After all, these remedies help to cope either with the consequences of pathology, or with the cause of the development of the disease - microbes. This group of drugs is very extensive, and Sulfasalazine is one of these drugs, the instructions for use of which are discussed below.

Pharmacological affiliation of the drug

For an antimicrobial to work, its active ingredient must be certain substance, capable of fighting pathogens. The drug "Sulfasalazine" has quite positive reviews in the treatment of a certain group of diseases. IN medical practice This drug belongs to the group of sulfonamides, which are the first chemotherapy drugs that can fight microorganisms that cause diseases.

In what form is the drug available?

The medicine "Sulfasalazine" has had quite positive reviews from patients and specialists for more than a decade. This drug is sold in pharmacies in the form of film-coated tablets.

What does the medicine consist of?

The drug "Sulfasalazine" contains one component, after which it is named - sulfasalazine (Sulfasalazinum). This substance belongs to sulfonamides. The remaining components included in the antimicrobial tablets have only formative functionality, making up the mass of the tablet and its shell in the form of an enteric film.

How does the medicine work?

For the antimicrobial drug "Sulfasalazine", the instructions for use describe the prerequisites for prescribing it in treatment. They are based on the potential effect of the drug in solving certain problems that have arisen against the background of microbial activity. The drug works due to the action of one substance - sulfasalazine. It exhibits maximum activity in the intestines, helping to get rid of pathogens such as gonococci, diplococci, streptococci and E. coli. In the intestine, the drug goes through two phases of functional activity - in small intestine Sulfasalazine itself is absorbed in an amount of about 30%, the rest of the drug, passing into the large intestine, is metabolized into working components: 5-aminosalicylic acid, which has an anti-inflammatory effect, and sulfaperidine, which blocks the synthesis of folates in microbial cells, which has an antibacterial effect. Metabolites are excreted in feces and urine within 3 days.

For the drug "Sulfasalazine" the indications for use will be as follows:

• nonspecific ulcerative colitis (UC);
• Crohn's disease;
• rheumatoid arthritis.

This dispersion in the activity of the drug is not yet fully understood by specialists, although its positive effect both in the treatment of joints and in the treatment of intestinal problems is obvious from many years of practice.

When should you not take the product?

The antimicrobial drug "Sulfasalazine", like the vast majority of such drugs, has certain contraindications for use. These include:

• anemia;
• obvious disturbances in liver function;
• disorders of the kidneys;
• hypersensitivity to the components of the drug, including sulfonamides and salicylic acid derivatives;
• deficiency of glucose-6-phosphate dehydrogenase;
• blood diseases;
• porphyria.

This medicine is not prescribed for the treatment of diseases in children. younger age- up to 5 years, since research in this aspect has not been carried out and potential negative reaction child's body on medicinal substance not installed.

The drug should not be taken by pregnant women 6-9 months old, as well as by those who are breastfeeding a newborn. If it is necessary to carry out treatment with Sulfasalazine, then breast-feeding stop, transferring the baby to artificial nutrition.

Patients with bronchial asthma and allergies who are prescribed treatment with this drug require maximum attention due to the potential intensification of the underlying disease.

How to take the drug?

For the drug "Sulfasalazine", the instructions for use recommend the following treatment regimens.

In the treatment of ulcerative colitis and granulomatous enteritis, otherwise called Crohn's disease, the treatment algorithm for adults and children over 16 years of age is the same:

• the first day - use the drug four times in the amount of 0.5 grams per dose, that is, you need to take 2 grams of the drug per day;
• second day - 1 gram 4 times a day;
• starting from the third day, you need to take 6 to 8 grams of medicine per day, dividing them into 4 doses.

The exact dose and duration of treatment with this amount of the drug is determined by the attending physician. Once sharp clinical manifestations the diseases will subside, treatment is carried out in a maintenance daily dosage of 1.5-2 g, divided into 4 doses. It should be noted that such maintenance treatment with this drug is not recommended for children whose body weight is less than 65 kilograms. For adults, the duration of therapy is determined by the doctor, and it can last several months. For children under 16 years of age, the maximum daily dose, divided into 4 doses, is only 2 grams.

This drug can also be used in the treatment of rheumatoid arthritis, including juvenile arthritis. It is prescribed by the attending physician according to this algorithm. Adults and children over 16 years of age take the medicine at a dosage of 500 mg per day in the first week of treatment, in the second week 1000 mg per day, in the third - 1500 mg per day. Recommended daily amount The drug is divided into two or three servings. In some cases maximum amount daily dose may be 3 grams. Treatment in this case is a course of treatment, which can last more than six months, as determined by a specialist.

If it is necessary for a child to undergo Sulfasalazine therapy, the following recommendations should be taken into account:

• children weighing more than 29 kilograms aged 6 to 8 years can take 1 tablet of the drug 2 times a day;
• if the child’s weight is no more than 39 kilograms, and this age is from 8 to 12 years, then the daily dosage is 3 tablets - 1 in the morning, at lunch and in the evening;
• if the body weight of a child 12-16 years old is in the range of 40-45 kilograms, then treatment is carried out either 1 tablet 3 times a day, or 2 tablets in 2 doses per day, the decision remains with the doctor.

In some cases, treatment with Sulfasalazine is indicated for ankylosing spondylitis. This occurs when therapy with non-steroidal anti-inflammatory drugs is ineffective and hormonal agents. Then this antibiotic becomes the basis of treatment, as it inhibits the processes of joint inflammation. This therapy is very long - from 3-6 months until the patient’s condition significantly improves. In this case, when the maximum daily dose of the drug is reached, other medications are first discontinued, and then Sulfasalazine is gradually discontinued. It should be remembered that this drug is not able to cure the disease itself, it only helps fight inflammatory manifestations in the joints, improving the patient’s quality of life, and therefore traditional therapy should be continued after 2-3 months.

In any treatment, Sulfasalazine tablets are taken immediately after meals with water.

Possible side effects

Like almost any other antimicrobial drug, Sulfasalazine has side effects. These include:

• agranulocytosis;
• anaphylactic shock;
• hemolytic anemia;
• anorexia;
• ataxia;
• transient infertility;
• epigastric pain;
• hallucinations;
• hepatitis;
• headache;
• dizziness;
• diarrhea;
• jaundice skin, sclera, urine;
• leukopenia;
• fever;
• flatulence;
• kidney dysfunction;
• sleep disorders;
• peripheral neuropathy;
• interstitial nephritis;
• oligospermia is transient;
• pancreatitis;
• interstitial pneumonitis;
• vomit;
• Stevens-Johnson syndrome;
• convulsions;
• rash;
• nausea;
• thrombocytopenia;
• fatigue;
• photosensitivity;
• noise in ears.

There is no specific antidote to this drug, so if necessary, treatment is symptomatic.

Drug overdose

One of antimicrobials, in demand in the treatment of diseases of the joints and gastrointestinal tract - "Sulfasalazine". Its use must be prescribed by a specialist and carried out in strict accordance with the dosage and regimen chosen by the attending physician.

In case of overdose or poisoning with this medicine, abdominal pain, dizziness, nausea, and vomiting occur. The patient needs health care, consisting of gastric lavage and forced diuresis. Specific symptomatic therapy is also necessary.

Possible joint treatment

In some cases, the drug "Sulfasalazine" is indicated for rheumatoid arthritis. The patient and the doctor prescribing it for use should remember that it enhances the effect of immunosuppressants, hepato- and nephrotoxic drugs, as well as cytostatics. "Sulfasalazine" inhibits the absorption of digoxin and folic acid, but enhances the functional activity of anticoagulants, anticonvulsants and oral hypoglycemic drugs.

Some treatment features

Sulfasalazine is widely used in the treatment of joint diseases. Its analogues, like the drug itself, require the use of large amounts of water during the course of treatment. But alcohol, despite the absence of a strict prohibition, should not be taken, as it is very potential danger serious liver damage.

What do they say about the drug?

Antimicrobial tablets "Sulfasalazine" reviews are mostly quite positive. Experts note the effective effect of the drug in the treatment of certain diseases, and patients note that the drug helped them get rid of painful sensations. The only drawback of the medicine, which many of those who took these pills talk about, is the frequent manifestation of dyspeptic symptoms - abdominal pain, flatulence, diarrhea. But the quality of treatment compensates for these side effects- notes the majority who left responses about “Sulfasalazine”.

Are there any analogues?

For the antimicrobial drug "Sulfasalazine", analogues may contain both the same active substance, and its derivatives, for example, mesalazine. The synonym for the drug is “Salazopyrine”, but its analogues are “Pentasa”, “Asacol”, “Samezil”, “Mesakol” or the generic “Mesalazine”. For the drug "Sulfasalazine", the instructions for use indicate the dosage of the active component contained in the tablets. The same applies to analogues. The specialist treating the patient will decide which specific drug to choose.

Antimicrobial drugs help solve many problems caused by pathogenic inhabitants of the microworld. One of them is Sulfasalazine. The instructions for its use contain all the information necessary for the doctor and the patient, and therefore must be read carefully. Following the recommendations of the instructions and the attending physician will help provide adequate and high-quality treatment for the existing problem.

Nonspecific ulcerative colitis is relatively rare disease. Nonspecific ulcerative colitis is a diffuse inflammation of the colon mucosa, initiated in the rectum and spreading proximally. The disease has a chronic undulating course with alternating exacerbations and remissions. However, over the past ten years there has been an increase in its incidence among both adults and children. At the same time, attention is drawn to the fact that the disease has become much younger and occurs already from 2 years of age. According to I.A. Bodnya (1986), of all cases, 0.9-12% are children aged 0 to 17 years. The prevalence of this disease among the European population is 5.8-14 per 100,000 population, in Russia 1-4.7 per 100,000, in Russian children 3.4 per 100,000 child population.

Regions characterized by high frequency ulcerative colitis include the UK, USA, Northern Europe, Australia. Low incidence is observed in Asia, Japan, and South America.

Ulcerative colitis is characterized by the presence of changes in chromosomes 6 and 12. The disease is also associated with the II.-1ra gene. Concordance for the proband with ulcerative colitis is 6.3% versus 58.3% with Crohn's disease.

This paper presents the results of a study of the clinical activity of drugs of two groups that were used in children and adolescents in the treatment of ulcerative colitis (UC) during exacerbation and subremission. We took two basic ones from the entire range of drugs used by pediatricians and gastroenterologists for the treatment of UC: sulfasalazine and mesalazine (mesacol).

The best known is sulfasalazine, which is used in children from 5 years of age at a dose of 50-80 mg. For 1 kg. body weight per day. This drug is not intended for rectal administration. When taken orally, a third of patients develop side effects associated with its constituent sulfapyridine. Side effects: headache, dizziness, dyspeptic symptoms: nausea, vomiting, diarrhea, abdominal pain, anorexia; admixture of blood in feces, necrotizing ulcerative colitis, interstitial pneumonitis, drug-induced hepatitis, agranulocytosis, leukopenia, thrombocytopenia, hemolytic anemia, photosensitivity of the skin, orange-yellow coloration of urine, allergic reactions: Lyell's syndrome, Stevens-Johnson syndrome, anaphylactic shock.

Mesacol- a drug of the mesalazine group, practically free of side effects, “pure” 5-aminosalicylic acid. For delivery to the colon, it uses other transport systems without sulfapyridine. Mesacol is coated with Eudragit S. disintegrating at pH 7.0 or higher, salofalk is Eudragit I. dissolving at pH-6.0, pentaka is slowly released even earlier at pH below 6.0. Accordingly, any of these drugs can be used in the treatment of ulcerative colitis, but distal release Mesacol is much preferable.

Mesacol is prescribed from 2 years of age at a dose of 20-50 mg. per 1 kg of body weight per day. Moreover, mesacol is also used rectally in suppositories and enemas. According to many leading clinics, rectal forms of mesalazine (mesacol) have advantages over glucocorticoids (Kanshin O.A., Kanshin N.N. 2000).

It has been established that the tablets leave the stomach unchanged and their dissolution begins in the small intestine 120-180 minutes after administration, 170-230 minutes. The tablets dissolve completely. This process is not affected by changes in the pH of the environment caused by food or other drugs.

Mesacol is released in terminal department small intestine and in the large intestine. In tablets, the active substance (mesalazine) is protected by a coating that is resistant to gastric juice. Dosage form is manufactured in such a way that mesalazine begins to be slowly released only in the terminal part of the small intestine and in the colon.

Due to the relatively low degree of absorption of mesalazine and its rapid conversion to N-acetyl-5-ASA already in the intestinal mucosa, the concentration of mesalazine in the blood plasma remains relatively small; after a single dose of mesacol at a dose of 240 mg, the concentration of mesalazine is 0.5-1.5 mcg/ml. Plasma protein binding of mesalazine is 43%, N-acetyl-5-ASA - 75-83%. IN breast milk 0.1% mesalazine is supplied (in the form of N-acetyl-5-ASA).

In the intestinal mucosa and liver, mesalazine is metabolized to N-acetyl-5-ASA. T1/2 of mesalazine is 0.5-2 hours, depending on the dose taken, clearance is 300 ml/min. Mesalazine is excreted by the kidneys, mainly in the acetylated form.

The number of observed patients was 18, aged from 2 to 19 years. There were 11 men, 7 women. All patients were diagnosed with mild UC - 4, moderate - 13 and 1 severe. 7 patients had left-sided lesions of the colon, 10 had distal lesions in the form of proctosigmoiditis, and 1 had subtotal lesions of the colon.

The patients were divided into 2 groups: group 1 received sulfasalazine, and group 2 received mesacol. Both drugs were prescribed at a therapeutic dose. Treatment was carried out for 1 month.

The criteria for assessing the effectiveness of drugs and their tolerability were: the dynamics of the main clinical symptoms, data laboratory research(total blood, urine, feces (coprogram), biochemical parameters blood, endoscopic data (RRS and colonoscopy).

As a result of therapy with two drugs in two groups, we noted the onset of clinical and endoscopic remission of UC in the 1st group 1 (11.1%) people, in the 2nd group 6 (66.6%) patients, which we assessed as as an excellent effect, in 4 (44.4%) in the 1st group and in the 2nd 5 (55.5%) people, clinical remission was noted in the presence of a minimal degree of activity of the process according to the endoscopic picture - a good effect in 2 (11 .1%) in group 1, 0 patients in group 2, a satisfactory effect was noted when the process subsided according to clinical and endoscopic data.

Clinical symptoms of UC before and after treatment with sulfasalazine and mesacol

Studies have shown a visible advantage of mesacol. The drug is well tolerated. Mesacol is effective for mild, moderate and severe forms Nyaka. Oral administration of mesacol effectively induces and maintains remission in mild and moderate activity UC and can be successfully used as a basic therapy for UC. In case of a moderate course of the process, the initial dose of mesacol should be no lower than 40-50 mg per 1 kg of body weight. In group 1 (sulfasalazine was used), side effects were noted in the form of headache in 5 patients, nausea in 7 patients, increased indirect bilirubin in 3 patients, leukopenia in 2 patients and allergic pinpoint rash in 1 patient.

Benefits of mesacol:

• GMP quality;
• Possibility of appointment from 2 years;
• wide fame active substance;
• proven effectiveness;
• anti-inflammatory effect specifically in the intestines;
• minimization of side effects (eg in comparison with sulfasalazine);
• does not change skin color (compared to sulfasalazine);
• not noted negative influence on reproductive function in men (unlike sulfasalazine).

Conclusions: We believe that in pediatric practice the use of mesacol is a priority and is much more effective, the effect of the drug is less toxic and it can be prescribed from the age of two, which is at this moment necessary due to the development of the disease at an earlier age.

Children's Gastroenterology Center. (Head, doctor of higher education qualification category V.L. Zemlyakov)

Crohn's disease is an intestinal pathology that tends to progress. The inflammatory process spreads transmurally and is characterized by various complications of local and systemic form. The disease affects the entire thickness of the intestinal wall, narrows its lumen, and forms infiltrates, abscesses and ulcers. To stop the disease process, the patient is prescribed anti-inflammatory drugs.

To such effective medicines to eliminate and include medical supplies"Sulfasalazine-EN" and "Sulfasalazine". Medicines are also prescribed for rheumatoid arthritis to relieve pain and inflammation. Like many drugs, they have their contraindications and side effects. What does the drug “Sulfasalazine-EN” consist of? What is its difference from “Sulfasalazine”? All information can be found in the article.

Release form and clinical group of the drug "Sulfasalazine-EN"

The medicine has anti-inflammatory properties and is used to treat Crohn's disease and UC. Produced in tablet form, light brown in color. Unlike the drug Sulfasalazine, Sulfasalazine-EN tablets are coated with a special coating that dissolves only in the intestines. The main substance in the drug is sulfasalazine at a dosage of 500 mg. The product is packaged in blisters of 10 capsules.

Action

Used medicinal product to eliminate the symptoms of Crohn's disease and UC. Sulfasalazine is released to aminosalicylic acid, which has an anti-inflammatory effect at the site of erosion. Sulfapyridine is also formed, which has antimicrobial activity and inhibits the functions of gonococci, streptococci and coli.

When taken orally, the tablets are almost not absorbed in the intestines. Here they are broken down under the influence of intestinal microflora and form sulfapyridine by 75% and aminosalicylic acid by 25%. Over the course of three days, the substances are mainly excreted by the kidneys and only in a tiny percentage by feces. This effect on the patient’s body is exerted by the drug “Sulfasalazine-EN”. The difference from Sulfasalazine, reviews about the drug - all this information should be studied before starting treatment.

When is the medication used?

The medicine is prescribed for the following pathologies:

• Crohn's disease;
• rheumatoid arthritis.

It is prohibited to take the medicine in the following cases:

• kidney and liver disease;
• anemia;
• porphyria;
• pregnancy;
• lactation;
• hypersensitivity to substances included in the drug.

Before starting the treatment process, it is necessary to carefully study all contraindications to taking the drug “Sulfasalazine-EN”. Difference from "Sulfasalazine" special instructions- all information is important. The drug can be used after consultation with a specialist.

What dosage is the treatment prescribed?

After examination, examination and clarification of the diagnosis, the doctor prescribes a remedy for the treatment of Crohn’s disease and the medicine is taken according to a special regimen:

• the first day - 500 mg three or four times;
• second day - 1 gram every six hours;
• All other days the medicine is taken in 2 or 1.5 g doses.

After the patient’s condition improves, the dose is left to be maintained for several more months. The dosage of the medication is 500 mg several times a day. Treatment adjustments can only be made by a specialist.

For children over 5 and under 7 years of age, the medication is prescribed 250-500 mg several times a day. After 7 years of age, the dosage will be 500 mg up to 6 times a day.

For rheumatoid arthritis in adults, the medicine is also dosed according to a certain algorithm:

• first week - 1 tablet at a dose of 500 mg once a day;
• second week - 500 mg twice a day;
• third week - 500 mg three times.

The course of treatment is up to six months or more, depending on the severity of the disease and the individual characteristics of the body.

The daily norm should not be more than 3 g for the drug "Sulfasalazine-EN". The instructions describe the difference from Sulfasalazine in sufficient detail. This also applies to the dosage regimen.

For children with rheumatoid arthritis, the medicine is prescribed at the rate of 50 mg per 1 kg of weight per day, divided into two or three equal doses. For patients over 16 years of age maximum permissible dose is 2 g. The medicine is prescribed orally, after meals. It needs to be washed down big amount liquids and do not chew.

• weakness
• abdominal pain;
• dizziness;

The patient is prescribed symptomatic treatment, gastric lavage. It is important to control urination.

The drug "Sulfasalazine-EN" should be taken according to the instructions. The difference from “Sulfasalazine” (properties, release form) is insignificant. However, it is worth asking your doctor what form is best to take the medicine.

The drug "Sulfasalazine"

The drug belongs to the group of anti-inflammatory drugs, prescribed for the treatment of Crohn's disease and ulcerative colitis. Produced in yellow-brown tablet form. The medicine contains sulfasalazine (500 mg).

The drug has anti-inflammatory and antimicrobial effect. It also has immunosuppressive and antirheumatic effects. The main substance of the tablets, sulfasalazine, has a positive effect on the intestines due to two active components. This is sulfapyridinone and the drug “Sulfasalazine-EN” has a bacteriostatic effect against diplococci, staphylococci and Escherichia coli. Difference from "Sulfasalazine", description of the active ingredient - all information is presented in the instructions.

Indications and contraindications

The medicine is prescribed for the following pathologies:

• Crohn's disease;
• various forms of rheumatoid arthritis.

Contraindications:

• severe pathology of the kidneys and liver;
• blood diseases;
• age up to 5 years;
• increased hypersensitivity to the components.

The drug “Sulfasalazine - EN” has an insignificant difference from “Sulfasalazine”. Instructions for use describe similar indications and contraindications. A specialist will tell you which medication to use in a particular case.

Dosage

On the first day of treatment for adults, the medicine is prescribed in a dose of 500 mg 4 times, then on the second day - 1 g 4 times, then the drug is taken from 1.5 to 2 g per day. The course of treatment depends on the severity of the process and individual characteristics body.

An overdose can lead to the development of the following symptoms:

• migraine;
• convulsions;
• insomnia;
• epigastric pain;
• vomit;
• diarrhea;
• allergy.

The drug Sulfasalazine-EN has less pronounced side effects. The difference from Sulfasalazine is that the medication is coated.

If it was not possible to purchase any of the drugs described at the pharmacy, a specialist will select a high-quality substitute.

The drug "Salofalk"

The medicine has anti-inflammatory properties and is prescribed for Crohn's disease and UC. Available in tablet form yellow color. The drug contains mesalazine in doses of 250 and 500 and 1 g. The drug has an anti-inflammatory, antioxidant effect on the intestinal wall

Indications:

• Crohn's disease

Contraindications:

• blood diseases;
• preschool children;
• hypersensitivity to components.

At the beginning of the treatment process, you should carefully study all the features of the drug “Salofalk” and “Sulfasalazine-EN”. The difference from Sulfasalazine in application is not significant. The drugs are taken according to a similar scheme.

Dosage

Patients are prescribed the medicine 500 mg three times a day. In severe cases, the dose may increase to 3 g per day. The drug is taken for three months.

Medicine "Sulfasalazine-EN". Difference from Sulfasalazine: patient reviews

Two drugs identical in composition. The only difference is that Sulfalazine-EN is coated with a coating that is soluble only in the intestines, unlike Sulfasalazine tablets, which are coated with a film. Also, the first medicine causes more allergic reactions, which manifest themselves in the form of rashes and itching on the skin. If you believe the reviews of patients, the drug "Sulfasalazine" is in great demand.

Experts note that both drugs can lead to the development of side effects. There is nausea, vomiting and stomach pain. At the same time, Sulfasalazine-EN has a slight difference from Sulfasalazine. Photos of medicines are also similar.

Experts note that this group of medications does not help everyone to the same extent. These drugs are not reliable enough for damage to peripheral joints. To avoid development urolithiasis, it is advisable to take the tablets with mineral water V large quantities, drink plenty of fluids throughout the day. What other difference does “Sulfasalazine-EN” have from “Sulfasalazine”? Although the analogue (the drug “Salofalk”) is prescribed for similar pathologies, it has many more discrepancies. This is due to the difference in composition.

Bottom line

If the patient has stomach problems, then it is better for him to take Sulfasalazine-EN, which will not dissolve in the stomach, but only in the intestines. In a small proportion of patients early stages taking drugs from this group may cause fever, skin rashes, which go away on their own after several days of therapy.

Doses of drugs are selected according to individually, depending on the intestinal damage and the stage of development of the disease. During an exacerbation, the dosage of the drug reaches maximum performance, then, as the condition improves, it decreases slightly. If a patient experiences significant side effects while taking medications, this should be reported to the attending physician. According to patients, no significant difference between drugs. The only difference from Sulfasalazine is that the drug dissolves in the stomach and can cause pain in the epigastric region.

If you regularly take the tablets according to the indicated regimen, you can stop the process of bone destruction in rheumatoid arthritis. The medicine can be prescribed to adults and children over 5 years of age. The dosage should not be exceeded so as not to cause side effects that can lead to serious complications in other organs and systems. It is also better to take tablets immediately after meals and wash them down alkaline solutions, for example mineral water. After just one month of treatment, improvement will be observed. The medicine is prescribed for a long period, but does not cause addiction or withdrawal symptoms. The drugs “Sulfasalazine-EN” and “Sulfasalazine” are available at the pharmacy with a prescription.

The drug Sulfasalazine has powerful antimicrobial and anti-inflammatory effects. The medicine can also be used for diseases of the musculoskeletal system (for example, arthritis or ankylosing spondylitis).

Without strict indications, taking the drug is strictly prohibited: Sulfasalazine can have serious side effects, even with a short course of treatment. Before taking Sulfasalazine, you should always consult your doctor.

1 What is Sulfasalazine: general description

The drug Sulfasalazine belongs to the group of anti-inflammatory and antimicrobial drugs. It can be used in the treatment of various diseases of the musculoskeletal system (mostly severe).

It is also used for various autoimmune diseases, occurring with pronounced inflammatory phenomena. For example, with nonspecific ulcerative colitis or proctitis, with some forms of arthritis (including rheumatoid).

Composition of Sulfasalazine:

• main active ingredient – ​​Sulfasalazine (500 mg per tablet);
• colloidal anhydrous silicon;
• propylene glycol;
• gelatinized starch;
• hypromellose;
• magnesium stearate;
• titanium dioxide;
• dyes with code E172 (iron oxide yellow 10).

During treatment with Sulfasalazine, constant monitoring (monitoring) of the patient's condition is required. The fact is that the drug quite often produces unwanted side effects, especially with long-term therapy.

1.1 Release form

There are two versions of Sulfasalazine: classic and with the prefix “EN”. Both versions of the drug have only one release form: tablets.

Regular Sulfasalazine tablets are film-coated and contain 500 mg of active ingredient. One package contains 50 yellow-brown tablets. The tablets are round, biconvex, and have beveled edges. There may be inclusions on the fracture.

Sulfasalazine EH tablets are coated with an enteric soluble coating and contain 500 mg of active ingredient. One package contains 50 yellow-brown or simply yellow tablets. The tablets are round, biconvex, have beveled edges and bad smell. The mass of the tablet at the break has a brownish-orange or orange color.

The tablets should be stored in their packaging, without removing them from the blisters, out of the reach of children and sun rays place. The optimal storage temperature is no more than 25 degrees.

1.2 How does it affect the body?

The drug represents its therapeutic effect and the chemical structure is a combination of sulfapyridine and 5-aminosalicylic acid. The smallest part of the drug is absorbed from the lumen of the colon and then evenly distributed throughout the connective tissues.

The tablet is coated with a film that dissolves under the influence of normal intestinal microflora. After the tablet film disintegrates, sulfapyridine and 5-aminosalicylic acid are released.

It is these substances that create a powerful anti-inflammatory and antimicrobial effect. In terms of anti-inflammatory activity, sulfapyridine is much better, since it has better absorption (about 30% of the dose taken is absorbed by the body).

Half-life products of components are excreted, including by the kidneys. This means that people with kidney diseases (including acute nephritis) either cannot take the drug at all or must take it with caution.

1.3 Where is Sulfasalazine sold and how much does it cost?

You can purchase Sulfasalazine either on specialized medical Internet portals or in pharmacies. The drug is available only with a prescription.

How much does Sulfasalazine cost? Standard packaging for 50 tablets (500 mg) costs 600-700 rubles. Sulfasalazine EH has a slightly higher cost: on average it is 670-750 rubles.

1.4 Sulfasalazine analogues: what can be replaced?

What can replace Sulfasalazine? Medicines for replacement great amount, but Mesacol and Methotrexate have proven themselves best. These are the best and most similar in price/effect analogues.

Other analogues of Sulfasalazine:

1. Tablets Salazopyrine En-Tabs 500 mg.
2. Asacol tablets 800 mg.
3. Long-acting granules and Pentas tablets.
4. Gastro-resistant granules and Salofalk suppositories, 250 and 500 mg.
5. Rectal suspension and enteric tablets Samezil 400 and 800 mg.

Methotrexate is one of the best analogues Sulfasalazine

Prohibited independent choice Sulfasalazine and its replacement with analogues without consulting your doctor. In particular, you cannot replace the drug even in cases where the analogue is a drug with almost identical composition and dosage of use.

It is also impossible to replace the classic Sulfasalazine with a subtype with the prefix “EN” without consulting a doctor.

2 Indications: when is Sulfasalazine used?

The use of Sulfasalazine is justified in cases inflammatory diseases occurring with symptoms of microbial invasion, or the risk of infectious complications. Using the product as an analogue of an antibiotic is inappropriate and in some cases extremely dangerous.

Indications for use:

• nonspecific ulcerative colitis or nonspecific ulcerative proctitis, occurring with mild or average degree severity (the drug is used to relieve exacerbations and as maintenance therapy in the remission phase of the disease);
• Crohn's disease (only moderate or moderately severe forms of the disease during exacerbation, for full treatment the drug is not suitable for this disease);
• rheumatoid arthritis with severe inflammatory processes that are not controlled by non-steroidal anti-inflammatory drugs (you can read about the use separately);
• juvenile idiopathic chronic polyarthritis with resistance to treatment with non-steroidal anti-inflammatory drugs.

Sulfasalazine can be used in combination with various corticosteroid drugs and some antimicrobials (for example, the drug has good compatibility with Metronidazole).

2.1 Contraindications

Using Sulfasalazine correctly means making sure in advance that there are no contraindications. It is almost impossible to do this on your own; a comprehensive examination by doctors is necessary (at least at the level of studying biochemical parameters of blood and urine).

Contraindications to Sulfasalazine:

1. Individual intolerance to one or more components of the drug (presence of allergies).
2. Acute form of porphyria and/or granulocytopenia.
3. Severe deficiency of the enzyme glucose-6-phosphate dehydrogenase.
4. The medication is prohibited for use by children under 5 years of age.
5. Severe liver and/or kidney dysfunction, chronic renal or liver failure.
6. Various types of anemia (including severe iron deficiency anemia), various diseases blood.
7. Intestinal obstruction or compression of the urinary tract.
8. Lactation period (breastfeeding). During pregnancy, the drug is used, but only under the strictest indications.
9. The medication should be used with caution in case of systemic juvenile idiopathic-chronic polyarthritis (the development of serum-like reactions is possible).