Sulfasalazine interactions

Sulfasalazine (Azulfidine), a sulfonamide has 67 documented interactions across the FDA labels and fact sheets we index: 20 major, 37 moderate, 10 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Major interactions (20)

  • Bisoprolol and hydrochlorothiazidebeta blockerMajor

    CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)

  • CelecoxibNSAIDMajor

    • In patients who have demonstrated allergic-type reactions to sulfonamides [ see Warnings and Precautions (5.7) ]. (Celecoxib label, Contraindications)

  • Chlorthalidonethiazide diureticMajor

    THALITONE is contraindicated in patients with anuria or hypersensitivity to chlorthalidone or other sulfonamide-derived drugs. (Chlorthalidone label, Contraindications)

  • DiclofenacNSAIDMajor

    Intervention: The concomitant use of diclofenac with other NSAIDs or salicylates is not recommended. (Diclofenac label, Drug interactions)

  • Dutasteride and tamsulosin5-alpha reductase inhibitorMajor

    If a patient reports a serious or life-threatening sulfa allergy, caution is warranted when administering tamsulosin-containing products, including JALYN. (Dutasteride and tamsulosin label, Warnings and precautions)

  • GlimepiridesulfonylureaMajor

    Sulfonamide derivatives: Patients who have developed an allergic reaction to sulfonamide derivatives may develop an allergic reaction to glimepiride tablets.Do not use glimepiride tablets in patients who have a history of an allergic reaction to sulfonamide derivatives. (Glimepiride label, Contraindications)

  • GlipizidesulfonylureaMajor

    • Hypersensitivity to sulfonamide derivatives. ▪ Known hypersensitivity to glipizide or any of the product's ingredients ( 4 ). ▪ Hypersensitivity to sulfonamide derivatives ( 4 ). (Glipizide label, Contraindications)

  • Hydrochlorothiazidethiazide diureticMajor

    In patients with hypersensitivity to sulfonamide-derived drugs. (Hydrochlorothiazide label, Contraindications)

  • IbuprofenNSAIDMajor

    Intervention: The concomitant use of ibuprofen with other NSAIDs or salicylates is not recommended. (Ibuprofen label, Drug interactions)

  • Indapamidethiazide diureticMajor

    Known hypersensitivity to indapamide or to other sulfonamide-derived drugs. (Indapamide label, Contraindications)

  • IndomethacinNSAIDMajor

    Intervention: The concomitant use of indomethacin with other NSAIDs or salicylates, especially diflunisal, is not recommended. (Indomethacin label, Drug interactions)

  • Lisinopril and hydrochlorothiazideACE inhibitorMajor

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Lisinopril and hydrochlorothiazide label, Contraindications)

  • MeloxicamNSAIDMajor

    Intervention: The concomitant use of meloxicam with other NSAIDs or salicylates is not recommended. (Meloxicam label, Drug interactions)

  • NaproxenNSAIDMajor

    Intervention: The concomitant use of naproxen with other NSAIDs or salicylates is not recommended. (Naproxen label, Drug interactions)

  • Sofosbuvir and velpatasvirantiviralMajor

    Coadministration of VOSEVI with BCRP substrates (e.g., methotrexate, mitoxantrone, imatinib, irinotecan, lapatinib, rosuvastatin, sulfasalazine, topotecan) is not recommended [see Clinical Pharmacology (12.3) ]. (Sofosbuvir and velpatasvir label, Drug interactions)

  • Spironolactone and hydrochlorothiazidealdosterone antagonistMajor

    CONTRAINDICATIONS Spironolactone and hydrochlorothiazide tablets are contraindicated in patients with anuria, acute renal insufficiency, significant impairment of renal excretory function, hypercalcemia, hyperkalemia, Addison's disease, and in patients who are allergic to thiazide diuretics or to other sulfonamide-derived drugs. (Spironolactone and hydrochlorothiazide label, Contraindications)

  • Sumatriptan and naproxentriptanMajor

    Intervention: The concomitant use of naproxen with other NSAIDs or salicylates is not recommended. (Sumatriptan and naproxen label, Drug interactions)

  • Tamsulosinalpha blockerMajor

    If a patient reports a serious or life-threatening sulfa allergy, caution is warranted when administering tamsulosin hydrochloride capsules. (Tamsulosin label, Warnings and precautions)

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticMajor

    Hypersensitivity Hypersensitivity to either drug in the preparation or to other sulfonamide-derived drugs is a contraindication. (Triamterene and hydrochlorothiazide label, Contraindications)

  • Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Major

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)

Moderate interactions (37)

  • AdapaleneretinoidModerate

    Particular caution should be exercised in using preparations containing sulfur, resorcinol, or salicylic acid in combination with Adapalene Cream, 0.1%. (Adapalene label, Drug interactions)

  • CiprofloxacinfluoroquinoloneModerate

    NSAIDs Use with caution Non-steroidal anti-inflammatory drugs (but not acetyl salicylic acid) in combination of very high doses of quinolones have been shown to provoke convulsions in pre-clinical studies and in postmarketing. (Ciprofloxacin label, Drug interactions)

  • DexamethasonecorticosteroidModerate

    The clearance of salicylates may be increased with concurrent use of corticosteroids. (Dexamethasone label, Drug interactions)

  • Digoxindigitalis glycosideModerate

    Drug Interactions: Reduced absorption of folic acid and digoxin have been reported when those agents were administered concomitantly with sulfasalazine. (Sulfasalazine label, Drug interactions)

  • Dorzolamidecarbonic anhydrase inhibitorModerate

    High-Dose Salicylate Therapy Although acid-base and electrolyte disturbances were not reported in the clinical trials with dorzolamide hydrochloride ophthalmic solution, these disturbances have been reported with oral carbonic anhydrase inhibitors and have, in some instances, resulted in drug interactions (e.g., toxicity associated with high-dose salicylate therapy). (Dorzolamide label, Drug interactions)

  • Dorzolamide and timololcarbonic anhydrase inhibitorModerate

    High-Dose Salicylate Therapy Although acid-base and electrolyte disturbances were not reported in the clinical trials with dorzolamide hydrochloride ophthalmic solution, these disturbances have been reported with oral carbonic anhydrase inhibitors and have, in some instances, resulted in drug interactions (e.g., toxicity associated with high-dose salicylate therapy). (Dorzolamide and timolol label, Drug interactions)

  • EtanerceptimmunosuppressantModerate

    Sulfasalazine Patients in a clinical study who were on established therapy with sulfasalazine, to which Enbrel was added, were noted to develop a mild decrease in mean neutrophil counts in comparison to groups treated with either Enbrel or sulfasalazine alone. (Etanercept label, Drug interactions)

  • FludrocortisonecorticosteroidModerate

    Rarely salicylate toxicity may occur in patients who discontinue steroids after concurrent high-dose aspirin therapy. (Fludrocortisone label, Drug interactions)

  • Folic acid (folate)Vitamin and mineralModerate

    Drug Interactions: Reduced absorption of folic acid and digoxin have been reported when those agents were administered concomitantly with sulfasalazine. (Sulfasalazine label, Drug interactions)

  • Furosemideloop diureticModerate

    Salicylates : Risk of salicylate toxicity ( 7.1 ) (Furosemide label, Drug interactions)

  • GlyburidesulfonylureaModerate

    …Interactions The hypoglycemic action of sulfonylureas may be potentiated by certain drugs including nonsteroidal anti-inflammatory agents, ACE inhibitors, disopyramide, fluoxetine, clarithromycin, and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, monoamine oxidase inhibitors, and beta adrenergic blocking agents. (Glyburide label, Drug interactions)

  • GriseofulvinantifungalModerate

    Serum salicylate concentrations may be decreased when griseofulvin is given concomitantly with salicylates. (Griseofulvin label, Drug interactions)

  • HydrocortisonecorticosteroidModerate

    The clearance of salicylates may be increased with concurrent use of corticosteroids; this could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when corticosteroid is withdrawn. (Hydrocortisone label, Drug interactions)

  • Insulin aspartinsulinModerate

    Drugs That May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulfonamide antibiotics. (Insulin aspart label, Drug interactions)

  • Insulin degludecinsulinModerate

    …May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analogs (e.g., octreotide), and sulfonamide antibiotics, GLP-1 receptor agonists, DPP-4 inhibitors, SGLT-2 inhibitors. (Insulin degludec label, Drug interactions)

  • Insulin detemirinsulinModerate

    …May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analogs (e.g., octreotide), and sulfonamide antibiotics, GLP-1 receptor agonists, DPP-4 inhibitors, SGLT-2 inhibitors. (Insulin detemir label, Drug interactions)

  • Insulin glargineinsulinModerate

    …May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analogs (e.g., octreotide), sulfonamide antibiotics, GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT-2 inhibitors. (Insulin glargine label, Drug interactions)

  • Insulin lisproinsulinModerate

    Clinically Significant Drug Interactions with LYUMJEV Drugs That May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analogs (e.g., octreotide), and sulfonamide antibiotics. (Insulin lispro label, Drug interactions)

  • Insulin regular (human)insulinModerate

    …Receptor Blocking Agents, Disopyramide, Fibrates, Fluoxetine, Monoamine Oxidase Inhibitors, Pentoxifylline, Pramlintide, Salicylates, Somatostatin Analogs (e.g., octreotide), and Sulfonamide Antibiotics Prevention or Management Monitor blood glucose more frequently and modify AFREZZA dosage, as clinically indicated, when used concomitantly with these drugs. (Insulin regular (human) label, Drug interactions)

  • KetorolacNSAIDModerate

    Warfarin, Digoxin, Salicylate, and Heparin The in vitro binding of warfarin to plasma proteins is only slightly reduced by ketorolac tromethamine (99.5% control vs 99.3%) when ketorolac plasma concentrations reach 5 to 10 mcg/mL. (Ketorolac label, Drug interactions)

  • Levonorgestrel and ethinyl estradioloral contraceptiveModerate

    Other Drugs Clinical effect Concomitant use of CHCs may decrease systemic exposure of acetaminophen, morphine, salicylic acid, and temazepam. (Levonorgestrel and ethinyl estradiol label, Drug interactions)

  • Levothyroxinethyroid hormoneModerate

    An initial increase in serum FT 4 is followed by return of FT 4 to normal levels with sustained therapeutic serum salicylate concentrations, although total T 4 levels may decrease by as much as 30%. (Levothyroxine label, Drug interactions)

  • Lidocaine and prilocainelocal anestheticModerate

    …prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, isofamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sufonamides Antimalarials chloroquine, primaquine Anticonvulsants Phenobarbital, phenytoin, sodium valproate Other drugs acetaminophen, metoclopramide, quinine, sulfasalazine (Lidocaine and prilocaine label, Drug interactions)

  • Liothyroninethyroid hormoneModerate

    An initial increase in serum FT4 is followed by return of FT4 to normal levels with sustained therapeutic serum salicylate concentrations, although total T4 levels may decrease by as much as 30%. (Liothyronine label, Drug interactions)

  • Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Losartan and hydrochlorothiazide label, Warnings and precautions)

  • MethotrexateimmunosuppressantModerate

    When daily doses of sulfasalazine 2 g and weekly doses of methotrexate 7.5 mg were coadministered to 15 rheumatoid arthritis patients in a drug-drug interaction study, the pharmacokinetic disposition of the drugs was not altered. (Sulfasalazine label, Drug interactions)

  • MethylprednisolonecorticosteroidModerate

    The clearance of salicylates may be increased with concurrent use of corticosteroids. (Methylprednisolone label, Drug interactions)

  • Metolazonethiazide diureticModerate

    Salicylates And Other Non-Steroidal Anti-Inflammatory Drugs May decrease the antihypertensive effects of metolazone tablets, USP. (Metolazone label, Drug interactions)

  • NizatidineH2 blockerModerate

    In patients given very high doses (3,900 mg) of aspirin daily, increases in serum salicylate levels were seen when nizatidine, 150 mg b.i.d., was administered concurrently. (Nizatidine label, Drug interactions)

  • Norgestimate and ethinyl estradioloral contraceptiveModerate

    COCs have been shown to decrease plasma concentrations of acetaminophen, clofibric acid, morphine, salicylic acid, temazepam and lamotrigine. (Norgestimate and ethinyl estradiol label, Drug interactions)

  • PhenytoinanticonvulsantModerate

    …voriconazole Antineoplastic agents Capecitabine, fluorouracil Antidepressants Fluoxetine, fluvoxamine, sertraline Gastric acid reducing agents H 2 antagonists (cimetidine), omeprazole Sulfonamides Sulfamethizole, sulfaphenazole, sulfadiazine, sulfamethoxazole-trimethoprim Other Acute alcohol intake, amiodarone, chloramphenicol, chlordiazepoxide, disulfiram, estrogen,… (Phenytoin label, Drug interactions)

  • PrednisolonecorticosteroidModerate

    NSAIDS, including aspirin and salicylates: Concomitant use of aspirin or other non-steroidal anti-inflammatory agents and corticosteroids increases the risk of gastrointestinal side effects. (Prednisolone label, Drug interactions)

  • PrednisonecorticosteroidModerate

    NSAIDs including aspirin and salicylates: Increased risk of gastrointestinal side effects. (Prednisone label, Drug interactions)

  • Sulfamethoxazole and trimethoprimsulfonamideModerate

    Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Torsemideloop diureticModerate

    Nonsteroidal Anti-Inflammatory Drugs Because torsemide and salicylates compete for secretion by renal tubules, patients receiving high doses of salicylates may experience salicylate toxicity when torsemide is concomitantly administered. (Torsemide label, Drug interactions)

  • TriamcinolonecorticosteroidModerate

    The clearance of salicylates may be increased with concurrent use of corticosteroids. (Triamcinolone label, Drug interactions)

  • VortioxetineantidepressantModerate

    Coadministration of aspirin 150 mg/day with multiple daily doses of TRINTELLIX had no significant inhibitory effect on platelet aggregation or pharmacokinetics of aspirin and salicylic acid [see Clinical Pharmacology (12.3) ] . (Vortioxetine label, Drug interactions)

Minor mentions (10)

  • Amoxicillinpenicillin antibioticMinor

    Other Antibacterials Chloramphenicol, macrolides, sulfonamides, and tetracyclines may interfere with the bactericidal effects of penicillin. (Amoxicillin label, Drug interactions)

  • Ampicillinpenicillin antibioticMinor

    Bacteriostatic Antibiotics : Chloramphenicol, erythromycins, sulfonamides, or tetracyclines may interfere with the bactericidal effect of penicillins. (Ampicillin label, Drug interactions)

  • Bumetanideloop diureticMinor

    Allergy to Sulfonamides Patients allergic to sulfonamides may show hypersensitivity to bumetanide. (Bumetanide label, Warnings)

  • EnoxaparinanticoagulantMinor

    These agents include medications such as: anticoagulants, platelet inhibitors including acetylsalicylic acid, salicylates, NSAIDs (including ketorolac tromethamine), dipyridamole, or sulfinpyrazone. (Enoxaparin label, Drug interactions)

  • Glyburide and metforminsulfonylureaMinor

    Examples: Nonsteroidal anti-inflammatory agents and other highly protein-boind drugs, salicylcates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, beta-adrenergic blocking agents; potentially with ciprofloxacin, micronazole. (Glyburide and metformin label, Drug interactions)

  • MesalaminesalicylateMinor

    Although the exact frequency of occurrence has not been determined, it has occurred in 3% of patients in controlled clinical trials of mesalamine or sulfasalazine. (Mesalamine label, Warnings and precautions)

  • Penicillin Gpenicillin antibioticMinor

    Drug Interactions Bacteriostatic antibacterials ( i.e. , chloramphenicol, erythromycins, sulfonamides or tetracyclines) may antagonize the bactericidal effect of penicillin, and concurrent use of these drugs should be avoided. (Penicillin G label, Drug interactions)

  • RepaglinidemeglitinideMinor

    Examples: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, nonsteroidal anti-inflammatory agents (NSAIDs), pentoxifylline, pramlintide, propoxyphene, salicylates, somatostatin analogs (e.g., octreotide), and sulfonamide antibiotics. (Repaglinide label, Drug interactions)

  • RiluzoleMinor

    Hepatotoxic Drugs Clinical trials in ALS patients excluded patients on concomitant medications which were potentially hepatotoxic (e.g., allopurinol, methyldopa, sulfasalazine). (Riluzole label, Drug interactions)

  • Silver sulfadiazinesulfonamideMinor

    There is a potential cross-sensitivity between silver sulfadiazine and other sulfonamides. (Silver sulfadiazine label, Warnings and precautions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.