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Arthritis health centre


BMJ Group Medical Reference


This information is for people who have rheumatoid arthritis. It tells you about sulfasalazine, a treatment used for rheumatoid arthritis. It is based on the best and most up-to-date research.

Does it work?

Yes. Sulfasalazine can reduce the pain and swelling of rheumatoid arthritis.

Sulfasalazine works as well as other drugs used to slow down the disease. But it can cause more side effects than a drug called methotrexate.

What is it?

Sulfasalazine has been used to treat rheumatoid arthritis for more than 50 years. It belongs to a group of drugs that are used to slow down the disease. These drugs are called disease-modifying anti-rheumatic drugs (DMARDs for short). They also help ease the pain and swelling in your joints.

Sulfasalazine is one of the first drugs your doctors may try. You may take it with another drug, probably methotrexate. Sulfasalazine takes a few months to work.

You may need to take a combination of drugs for many months. But once your symptoms improve, you may be able to stop taking some of them. If your arthritis is not getting better or you get severe side effects while taking sulfasalazine, your doctor may advise you to stop taking it.

You take sulfasalazine as a tablet, usually once or twice a day. You may start by taking 500 milligrams once or twice a day. If you have no side effects, then your doctor may increase the dose to 1,000 milligrams twice a day.

Sulfasalazine is also used to treat some bowel diseases, such as ulcerative colitis and Crohn's disease.

How can it help?

Taking sulfasalazine can ease the pain and swelling in your joints. The drug may make it easier for you to do things like going shopping, doing the housework, having sex, seeing your friends and doing other activities you enjoy.

Research shows that taking sulfasalazine helps in the following ways.

  • It reduces joint pain for 6 out of 10 people: [34] If your joints are less painful, you may find it easier to do everyday things like walking or working. If you have rheumatoid arthritis in your hands, you may also find that gripping things, like cups, is easier.

  • It reduces morning stiffness for 6 out of 10 people: [34] Many people find that their joints are more stiff in the morning than later in the day. This makes getting going in the morning hard. Most people who take sulfasalazine find that they have less stiffness in their joints when they wake up.

  • It reduces joint swelling for about half of all people: [34] You may have fewer swollen joints when taking sulfasalazine. You may also find that the swelling in your joints goes down. This should help your joints move more easily. You may find it easier to pick up small things or fasten your buttons.

Studies have compared sulfasalazine with other drugs used for rheumatoid arthritis. [30] [31] We know it works about as well as methotrexate, another DMARD. The two drugs are often used together. This combination also works well, but you might be more likely to get side effects. [30]

Another study showed it worked as well as an antimalarial drug called hydroxychloroquine. [35] It may work better than hydroxychloroquine to stop your joints from wearing down. [36]

Sulfasalazine can be helpful if it's the first drug you try, or if you've tried other drugs and they haven't worked.

Last Updated: August 15, 2013
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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