Sulfasalazine for Ankylosing Spondylitis

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Sulfasalazine for Ankylosing Spondylitis


Generic Name

Sulfasalazine is a medicine made from salicylic acid—the same active ingredient found in ASA—plus an antibiotic called sulfapyridine. The medicine comes in time-release tablets taken by mouth.

How It Works

Sulfasalazine reduces inflammation, but the exact way this happens is not known. It has been used to decrease bowel inflammation in inflammatory bowel diseases such as Crohn's and joint inflammation in rheumatoid arthritis. More recently, it has been used to fight inflammation in ankylosing spondylitis, but it does not seem to work on the spine. It is more effective if ankylosing spondylitis is causing symptoms in other areas such as the shoulders and the heels.

Why It Is Used

Ankylosing spondylitis causes pain, stiffness, and swelling of the spine and sometimes other areas such as the hips, chest wall, and heels. Many people who have ankylosing spondylitis also have inflammatory bowel disease. Sulfasalazine helps by decreasing bowel inflammation and abdominal (belly) pain.

How Well It Works

Sulfasalazine may help control pain and inflammation for some people in areas other than the spine. Its effectiveness is still being studied.1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with the medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change the medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Hives.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

  • Aching joints.
  • A continuing headache.
  • Itching or a rash.

Common side effects of this medicine include:

  • Skin sensitivity to sunlight.
  • Stomach pain, nausea, loss of appetite.
  • Diarrhea.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Tell your doctor if you are allergic to ASA, sulfa drugs, or any other drug. And be sure he or she knows about any other medicines, vitamins, or other supplements you are taking.

You could be sensitive to sunlight while taking sulfasalazine. Wear sunglasses, and use sunscreen.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.



  1. Arnett FC (2005). Seronegative spondyloarthritis. In DC Dale, DD Federman, eds., ACP Medicine, section 15, chap. 3. New York: WebMD.


By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Primary Medical Reviewer Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine
Specialist Medical Reviewer Stanford M. Shoor, MD - Rheumatology
Last Revised July 8, 2011

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.