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The following safety information outlines important risks and precautions associated with the use of sulfasalazine (Azulfidine). Please review these details carefully and consult your healthcare provider if you have any concerns.

• Liver, Kidney, and Blood Risks: Sulfasalazine may cause serious liver, kidney, or blood conditions, which in rare cases can be fatal. Inform your healthcare provider if you have a history of liver damage, kidney issues, or blood disorders. Additionally, individuals with glucose-6 phosphate dehydrogenase deficiency (G6PD deficiency) may be at increased risk.

• Effects on Sperm Count: This medication might reduce sperm count, potentially affecting fertility. This effect is usually reversible upon discontinuation of the drug. Discuss family planning with your provider if this is a concern.

• Serious Infections: Some individuals on sulfasalazine have developed serious infections like pneumonia or blood infections. Your healthcare provider will monitor for signs of infection during treatment. Report any symptoms such as fever, chills, sweating, difficulty breathing, nausea, vomiting, or weakness immediately. Increased risk exists if you have a history of infections, are on immunosuppressants, or have a weakened immune system.

• Severe Allergic Reactions: This medication can cause severe skin reactions including rashes, blistering, or peeling skin, and in rare cases, hospitalization. The risk is higher if you are allergic to sulfasalazine, sulfa drugs, or salicylates (e.g., aspirin). Seek immediate medical attention if you experience severe skin reactions or difficulty breathing.

Contraindications: Avoid using sulfasalazine if you have the following conditions, as it may pose serious health risks:

• Gut or bladder blockages.
• Porphyria, a liver disease causing porphyrin buildup.
• Allergies to sulfasalazine, sulfa drugs, or salicylates.

Always discuss any pre-existing conditions or concerns with your healthcare provider before starting treatment.

When taking this medication, you might experience some common side effects, such as nausea, vomiting, stomach upset, reduced appetite, headache, dizziness, or unusual tiredness. These effects are generally mild, but if they persist or worsen, it's advisable to consult your healthcare provider. Additionally, you may notice that your skin and urine turn an orange-yellow color. This change is harmless and should subside once you stop the medication.

In rare cases, some users have observed delayed-release tablets appearing whole or partially dissolved in the stool. It's important to report this to your healthcare provider as it may require an adjustment in your treatment. Serious side effects, although uncommon, include hearing changes, mood alterations, signs of kidney problems, new growths in the neck, numbness or tingling in the extremities, and symptoms of low blood sugar. If you notice any of these, seek medical advice promptly.

Very serious side effects, which are rare, necessitate immediate medical attention. These include severe headaches, skin rash or blisters, mouth sores, swelling (especially of the face, tongue, or throat), severe dizziness, difficulty breathing, chest pain, signs of infection, easy bruising or bleeding, extreme tiredness, muscle pain, pale or blue skin, joint pain, confusion, neck stiffness, seizures, and symptoms of liver issues. If any unexplained side effects occur, it's crucial to contact your healthcare provider for guidance. This list is not exhaustive, so always be vigilant and communicate any unusual reactions to your healthcare provider.

When taking Sulfasalazine (Azulfidine), be aware that it can interact with various medications and supplements. It is crucial to inform your doctor and pharmacist about all prescribed, over-the-counter medications, vitamins, and dietary or herbal supplements you are currently using to avoid potential interactions.

Certain medications should not be used with Sulfasalazine, such as Ketorolac and Methenamine, due to the risk of adverse effects. Your doctor might opt to discontinue one of these medications or adjust your treatment plan.

There are other medications that are generally not recommended to be taken with Sulfasalazine but might be necessary in specific cases. If your doctor prescribes them together, they may adjust the dosage or frequency to manage potential risks. This group includes drugs like Mesalamine, Azathioprine, and Ibuprofen, among others.

Additionally, using Sulfasalazine with some medications can increase the risk of side effects. However, your doctor may determine that the benefits of combining them outweigh the risks. In such cases, they might modify the dosage or administration schedule. Examples of these medications are Digoxin, Cyclosporine, and Warfarin.

Sulfasalazine can also interfere with certain laboratory tests, potentially causing false results. It is important to inform lab personnel and your healthcare providers that you are using this medication.