Sulfasalazine

Identification

Summary

Sulfasalazine is a salicylate used to treat Crohn's disease, ulcerative colitis, and rheumatoid arthritis.

Brand Names

Azulfidine, Salazopyrin, Salazopyrin En-tabs

Generic Name

Sulfasalazine

DrugBank Accession Number

DB00795

Background

Sulfasalazine is an anti-inflammatory drug structurally related to salicylates and other non-steroidal anti-inflammatory drugs. It is indicated for managing inflammatory diseases such as ulcerative colitis and rheumatoid arthritis (RA).^16,10 Metabolized by intestinal bacteria, sulfasalazine is broken down into mesalazine and sulfapyridine, 2 compounds that carry out the main pharmacological activity of sulfasalazine.¹⁰

Sulfasalazine was first used in 1940 for rheumatic polyarthritis, and has been firmly established itself as one fo the most useful disease-modifying antirheumatic drug (DMARD).¹⁰ Compared to the first line treatment of RA like methotrexate, sulfasalazine is almost as efficacious as methotrexate although with slightly less tolerability. However, sulfasalazine has less teratogenic side effects and faster onset of action compared to conventional DMARD.¹⁰ Sulfasalazine fell out of favor as the drug of choice for RA due to poorly designed clinical trials in 1950 but regained interest from the clinical community in the late 1970.¹⁰

Although sulfasalazine is only approved by the FDA for ulcerative colitis, research have shown that sulfasalazine is also beneficial for patients with Crohn's disease.¹¹ Meta-analysis of 19 randomized controlled trials indicated that sulfasalazine is superior to placebo in inducing remission; however, with no supported evidence of mucosal healing, sulfasalazine is not FDA-recommmended for treatment of Crohn's disease.^12,13,14

Type

Small Molecule

Groups

Approved

Structure

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MOLSDFPDBSMILESInChI

Similar Structures

Structure for Sulfasalazine (DB00795)

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Weight

Average: 398.393
Monoisotopic: 398.068490268

Chemical Formula

C₁₈H₁₄N₄O₅S

Synonyms

• 2-Hydroxy-5-((4-((2-pyridinylamino)sulfonyl)phenyl)azo)benzoic acid
• 2-Hydroxy-5-[4-(pyridin-2-ylsulfamoyl)-phenylazo]-benzoic acid
• 4-(Pyridyl-2-amidosulfonyl)-3'-carboxy-4'-hydroxyazobenzene
• 5-((p-(2-Pyridylsulfamoyl)phenyl)azo)salicylic acid
• 5-(4-(2-Pyridylsulfamoyl)phenylazo)-2-hydroxybenzoic acid
• 5-(p-(2-Pyridylsulfamyl)phenylazo)salicylic acid
• Azopyrin
• Salazosulfapiridina
• Salazosulfapyridine
• Salazosulfapyridinum
• Salicylazosulfapyridine
• Sulfasalazin
• Sulfasalazina
• Sulfasalazine
• Sulfasalazinum

External IDs

• NSC-203730
• NSC-667219
• SSZ

Pharmacology

Indication

In the US, sulfasalazine is indicated to treat mild to moderate ulcerative colitis and to prolong the remission period between acute attacks of ulcerative colitis.¹⁶ Sulfasalazine is also indicated as an adjunct therapy in severe ulcerative colitis.¹⁶For the delayed-release tablet formulation, sulfasalazine is also indicated to treat rheumatoid arthritis in pediatric patients who have responded inadequately to salicylates or other nonsteroidal anti-inflammatory drugs or polyarticular-course juvenile rheumatoid arthritis with the same patients' characteristics.¹⁶

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Associated Conditions

• Crohn's Disease (CD)
• Distal Ulcerative Colitis
• Mild to Moderate Ulcerative Colitis
• Polyarticular juvenile rheumatoid arthritis, chronic or unspecified
• Proctitis
• Rheumatoid Arthritis
• Severe Ulcerative Colitis
• Ulcerative Colitis in Remission

Contraindications & Blackbox Warnings

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Pharmacodynamics

The mode of action of sulfasalazine or its metabolites, 5-aminosalicylic acid and sulfapyridine, is still under investigation but may be related to the anti-inflammatory and/or immunomodulatory properties that have been observed in animal and in vitro models, to its affinity for connective tissue, and/or to the relatively high concentration it reaches in serous fluids, the liver, and intestinal walls, as demonstrated in autoradiographic studies in animals. In ulcerative colitis, clinical studies utilizing rectal administration of sulfasalazine, sulfapyridine, and 5-aminosalicylic acid have indicated that the major therapeutic action may reside in the 5-aminosalicylic acid moiety. The relative contribution of the parent drug and the major metabolites in rheumatoid arthritis is unknown.¹⁶

Mechanism of action

Although the exact mechanism of action of sulfasalazine is not fully understood, it is thought to be mediated through the inhibition of various inflammatory molecules.¹⁹ Research have found that sulfasalazine and its metabolites, mesalazine and sulfapyridine, can inhibit leukotrienes and prostaglandins by blocking the cyclo-oxygenase and lipoxygenase pathway.¹ Specific enzymes that were investigated include phospholipase A2, cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX2), and arachidonate 5-lipoxygenase.^6,3,4,5 Inhibitory activities on other non-arachidonic acid derivatives have also been observed, including PPAR gamma, NF-Kb, and IkappaB kinases alpha and beta.^2,7,8,9

Target	Actions	Organism
AArachidonate 5-lipoxygenase	inhibitor	Humans
AProstaglandin G/H synthase 2	inhibitor	Humans
AProstaglandin G/H synthase 1	inhibitor	Humans
AAcetyl-CoA acetyltransferase, mitochondrial	inhibitor	Humans
APhospholipase A2	antagonist	Humans
UCystine/glutamate transporter	inhibitor	Humans
UNuclear factor NF-kappa-B p105 subunit	inhibitor	Humans
UNuclear factor NF-kappa-B p100 subunit	inhibitor	Humans
AInhibitor of nuclear factor kappa-B kinase subunit beta	inhibitor	Humans
UInhibitor of nuclear factor kappa-B kinase subunit alpha	Not Available	Humans
UPeroxisome proliferator-activated receptor gamma	agonist	Humans

Absorption

Following oral administration of 1 g of sulfasalazine to 9 healthy males, less than 15% of a dose of sulfasalazine is absorbed as the parent drug. Detectable serum concentrations of sulfasalazine have been found in healthy subjects within 90 minutes after ingestion. Maximum concentrations of sulfasalazine occur between 3 and 12 hours post-ingestion, with the mean peak concentration (6 μg/mL) occurring at 6 hours.¹⁶

Volume of distribution

Following intravenous injection, the calculated volume of distribution for sulfasalazine was 7.5 ± 1.6 L.¹⁶

Protein binding

Sulfasalazine is highly bound to albumin (>99.3%) while sulfapyridine is only about 70% bound to albumin. Acetylsulfapyridine, the principal metabolite of sulfapyridine, is approximately 90% bound to plasma proteins.¹⁶

Metabolism

In the intestine, sulfasalazine is metabolized by intestinal bacteria to sulfapyridine and 5-aminosalicylic acid. Of the two species, sulfapyridine is relatively well absorbed from the intestine and highly metabolized, while 5-aminosalicylic acid is much less well absorbed.¹⁶Approximately 15% of a dose of sulfasalazine is absorbed as the parent drug and is metabolized to some extent in the liver to the same two species.¹⁶Sulfapyridine can also be metabolized to 5-hydroxysulfapyridine and N-acetyl-5-hydroxy sulfapyridine. 5-aminosalicylic acid is primarily metabolized in both the liver and intestine to N-acetyl-5 aminosalicylic acid via a non-acetylation phenotype-dependent route.¹⁶

Hover over products below to view reaction partners

• Sulfasalazine
  • Mesalazine + Sulfapyridine
    • 5'-hydroxysulfapyridine
      • 5'-hydroxysulfapyridine-O-glucuronide
        • N4-acetyl-5'-hydroxysulfapyridine-O-glucuronide
      • N4-acetyl-5'-hydroxysulfapyridine
        • N4-acetyl-5'-hydroxysulfapyridine-O-glucuronide
    • N4-acetylsulfapyridine
      • N4-acetyl-5'-hydroxysulfapyridine
        • N4-acetyl-5'-hydroxysulfapyridine-O-glucuronide
    • N-acetyl-5-ASA (Ac-5-ASA)

Route of elimination

Absorbed sulfapyridine and 5-aminosalicylic acid and their metabolites are primarily eliminated in the urine either as free metabolites or as glucuronide conjugates. The majority of 5-ASA stays within the colonic lumen and is excreted as 5-aminosalicylic acid and acetyl-5-aminosalicylic acid in the feces.¹⁶

Half-life

The observed plasma half-life for intravenous sulfasalazine is 7.6 ± 3.4 hours.¹⁶In fast acetylators, the mean plasma half-life of sulfapyridine is 10.4 hours while in slow acetylators, it is 14.8 hours.¹⁶Due to low plasma levels produced by 5-aminosalicylic acid after oral administration, reliable estimates of plasma half-life are not possible.¹⁶

Clearance

The calculated clearance of sulfasalazine following intravenous administration was 1 L/hr. Renal clearance was estimated to account for 37% of total clearance.¹⁶

Adverse Effects

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Toxicity

Two-year oral carcinogenicity studies were conducted in male and female F344/N rats and B6C3F1 mice. Sulfasalazine was tested at 84 (496 mg/m2), 168 (991 mg/m2), and 337.5 (1991 mg/m2) mg/kg/day doses in rats. A statistically significant increase in the incidence of urinary bladder transitional cell papillomas was observed in male rats. In female rats, two (4%) of the 337.5 mg/kg rats had transitional cell papilloma of the kidney. The increased incidence of neoplasms in the urinary bladder and kidney of rats was also associated with an increase in renal calculi formation and hyperplasia of transitional cell epithelium. For the mouse study, sulfasalazine was tested at 675 (2025 mg/m2), 1350 (4050 mg/m2), and 2700 (8100 mg/m2) mg/kg/day. The incidence of hepatocellular adenoma or carcinoma in male and female mice was significantly greater than the control at all doses tested.¹⁶

Sulfasalazine did not show mutagenicity in the bacterial reverse mutation assay (Ames test) and in L51784 mouse lymphoma cell assay at the HGPRT gene. However, sulfasalazine showed an equivocal mutagenic response in the micronucleus assay of mouse and rat bone marrow and mouse peripheral RBC and in the sister chromatid exchange, chromosomal aberration, and micronucleus assays in lymphocytes obtained from humans.¹⁶

Impairment of male fertility was observed in reproductive studies performed in rats at a dose of 800 mg/kg/day (4800 mg/m2). Oligospermia and infertility have been described in men treated with sulfasalazine. Withdrawal of the drug appears to reverse these effects.¹⁶

There are no adequate and well-controlled studies of sulfasalazine in pregnant women. Reproduction studies have been performed in rats and rabbits at doses up to 6 times the human maintenance dose of 2 g/day based on body surface area and have revealed no evidence of impaired female fertility or harm to the fetus due to sulfasalazine. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.¹⁶

There have been case reports of neural tube defects (NTDs) in infants born to mothers who were exposed to sulfasalazine during pregnancy, but the role of sulfasalazine in these defects has not been established. However, oral sulfasalazine inhibits the absorption and metabolism of folic acid which may interfere with folic acid supplementation (see Drug Interactions) and diminish the effect of periconceptional folic acid supplementation that has been shown to decrease the risk of NTDs.¹⁶

A national survey evaluated the outcome of pregnancies associated with inflammatory bowel disease (IBD). In a group of 186 women treated with sulfasalazine alone or sulfasalazine and concomitant steroid therapy, the incidence of fetal morbidity and mortality was comparable to that for 245 untreated IBD pregnancies as well as to pregnancies in the general population. A study of 1,455 pregnancies associated with exposure to sulfonamides indicated that this group of drugs, including sulfasalazine, did not appear to be associated with fetal malformation. A review of the medical literature covering 1,155 pregnancies in women with ulcerative colitis suggested that the outcome was similar to that expected in the general population.¹⁶

No clinical studies have been performed to evaluate the effect of sulfasalazine on the growth development and functional maturation of children whose mothers received the drug during pregnancy.¹⁶

Pathways

Not Available

Pharmacogenomic Effects/ADRs

Interacting Gene/Enzyme	Allele name	Genotype(s)	Defining Change(s)	Type(s)	Description	Details
Arylamine N-acetyltransferase 1	NAT1*14A	Not Available	G > A | T > A | C > A	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 1	NAT1*14B	Not Available	G > A	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 1	NAT1*15	Not Available	C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 1	NAT1*17	Not Available	C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 1	NAT1*19A	Not Available	C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 1	NAT1*19B	Not Available	C > T | C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 1	NAT1*22	Not Available	A > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5A	Not Available	T > C | C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5B	Not Available	T > C | C > T | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5C	Not Available	T > C | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5D	Not Available	T > C	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5E	Not Available	T > C | G > A	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5F	Not Available	T > C | C > T | C > T | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5G	Not Available	T > C | C > T | C > T | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5H	Not Available	T > C | C > T | A > G | S287 Frameshift	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5I	Not Available	T > C | C > T | A > T | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*5J	Not Available	T > C | C > T | G > A	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*6A	Not Available	G > A | C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*6B	Not Available	G > A	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*6C	Not Available	G > A | C > T | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*6D	Not Available	G > A | C > T | T > C	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*6E	Not Available	G > A | C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*7A	Not Available	G > A	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*7B	Not Available	G > A | C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*10	Not Available	G > A	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*12D	Not Available	G > A | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*14A	Not Available	G > A	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*14B	Not Available	G > A | C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*14C	Not Available	G > A | T > C | C > T | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*14D	Not Available	G > A | C > T | G > A	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*14E	Not Available	G > A | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*14F	Not Available	G > A | T > C | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*14G	Not Available	G > A | C > T | A > G	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*17	Not Available	A > C	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Arylamine N-acetyltransferase 2	NAT2*19	Not Available	C > T	ADR Inferred	Increased risk of Sulfapyridine dose related adverse effects, including skin rash.	Details
Glucose-6-phosphate 1-dehydrogenase	Villeurbanne	Not Available	1000_1002delACC	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Torun	Not Available	1006A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Sunderland	Not Available	105_107delCAT	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Iwatsuki	Not Available	1081G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Serres	Not Available	1082C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Tondela	Not Available	1084_1101delCTGAACGAGCGCAAGGCC	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Loma Linda	Not Available	1089C->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Aachen	Not Available	1089C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Tenri	Not Available	1096A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Montpellier	Not Available	1132G>A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Calvo Mackenna	Not Available	1138A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Riley	Not Available	1139T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Olomouc	Not Available	1141T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Tomah	Not Available	1153T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Lynwood	Not Available	1154G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Madrid	Not Available	1155C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Iowa, Walter Reed, Springfield	Not Available	1156A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Beverly Hills, Genova, Iwate, Niigata, Yamaguchi	Not Available	1160G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Hartford	Not Available	1162A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Praha	Not Available	1166A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Krakow	Not Available	1175T>C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Wisconsin	Not Available	1177C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Nashville, Anaheim, Portici	Not Available	1178G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Alhambra	Not Available	1180G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Bari	Not Available	1187C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Puerto Limon	Not Available	1192G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Covao do Lobo	Not Available	1205C>A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Clinic	Not Available	1215G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Utrecht	Not Available	1225C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Suwalki	Not Available	1226C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Riverside	Not Available	1228G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Japan, Shinagawa	Not Available	1229G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Kawasaki	Not Available	1229G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Munich	Not Available	1231A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Georgia	Not Available	1284C->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Sumare	Not Available	1292T->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Telti/Kobe	Not Available	1318C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Santiago de Cuba, Morioka	Not Available	1339G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Harima	Not Available	1358T->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Figuera da Foz	Not Available	1366G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Amiens	Not Available	1367A>T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Bangkok Noi	Not Available	1376G->T, 1502T->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Fukaya	Not Available	1462G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Campinas	Not Available	1463G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Buenos Aires	Not Available	1465C>T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Arakawa	Not Available	1466C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Brighton	Not Available	1488_1490delGAA	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Kozukata	Not Available	159G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Amsterdam	Not Available	180_182delTCT	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	No name	Not Available	202G->A, 376A->G, 1264C>G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Swansea	Not Available	224T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Urayasu	Not Available	281_283delAGA	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Vancouver	Not Available	317C->G544C->T592C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Mt Sinai	Not Available	376A->G, 1159C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Plymouth	Not Available	488G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Volendam	Not Available	514C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Shinshu	Not Available	527A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Chikugo	Not Available	535A->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Tsukui	Not Available	561_563delCTC	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Pedoplis-Ckaro	Not Available	573C>G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Santiago	Not Available	593G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Minnesota, Marion, Gastonia, LeJeune	Not Available	637G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Cincinnati	Not Available	637G->T, 1037A->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Harilaou	Not Available	648T->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	North Dallas	Not Available	683_685delACA	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Asahikawa	Not Available	695G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Durham	Not Available	713A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Stonybrook	Not Available	724_729delGGCACT	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Wayne	Not Available	769C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Aveiro	Not Available	806G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Cleveland Corum	Not Available	820G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Lille	Not Available	821A>T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Bangkok	Not Available	825G>C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Sugao	Not Available	826C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	La Jolla	Not Available	832T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Wexham	Not Available	833C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Piotrkow	Not Available	851T>C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	West Virginia	Not Available	910G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Omiya	Not Available	921G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Nara	Not Available	953_976delCCACCAAAGGGTACCTGGAC GACC	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Manhattan	Not Available	962G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Rehevot	Not Available	964T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Honiara	Not Available	99A->G / 1360C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Tokyo, Fukushima	Not Available	1246G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Chatham	Not Available	1003G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Fushan	Not Available	1004C->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Partenope	Not Available	1052G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Ierapetra	Not Available	1057C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Anadia	Not Available	1193A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Abeno	Not Available	1220A->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Surabaya	Not Available	1291G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Pawnee	Not Available	1316G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	S. Antioco	Not Available	1342A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Cassano	Not Available	1347G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Hermoupolis	Not Available	1347G->C / 1360C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Union,Maewo, Chinese-2, Kalo	Not Available	1360C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Andalus	Not Available	1361G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Cosenza	Not Available	1376G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Canton, Taiwan- Hakka, Gifu-like, Agrigento-like	Not Available	1376G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Flores	Not Available	1387C->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Kaiping, Anant, Dhon, Sapporo-like, Wosera	Not Available	1388G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Kamogawa	Not Available	169C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Costanzo	Not Available	179T>C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Amazonia	Not Available	185C->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Songklanagarind	Not Available	196T->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Hechi	Not Available	202G->A / 871G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Namouru	Not Available	208T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Bao Loc	Not Available	352T>C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Crispim	Not Available	375G->T, 379G->T383T->C384C>T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Acrokorinthos	Not Available	376A->G / 463C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Santa Maria	Not Available	376A->G / 542A->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Ananindeua	Not Available	376A->G / 871G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Vanua Lava	Not Available	383T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Valladolid	Not Available	406C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Belem	Not Available	409C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Liuzhou	Not Available	442G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Shenzen	Not Available	473G>A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Taipei “Chinese- 3”	Not Available	493A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Toledo	Not Available	496C>T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Naone	Not Available	497G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Nankang	Not Available	517T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Miaoli	Not Available	519C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Mediterranean, Dallas, Panama‚ Sassari, Cagliari, Birmingham	Not Available	563C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Coimbra Shunde	Not Available	592C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Nilgiri	Not Available	593G>A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Radlowo	Not Available	679C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Roubaix	Not Available	811G>C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Haikou	Not Available	835A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Chinese-1	Not Available	835A->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Mizushima	Not Available	848A>G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Osaka	Not Available	853C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Viangchan, Jammu	Not Available	871G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Seoul	Not Available	916G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Ludhiana	Not Available	929G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Farroupilha	Not Available	977C->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Chinese-5	Not Available	1024C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Rignano	Not Available	130G>A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Orissa	Not Available	131C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	G6PDNice	Not Available	1380G>C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Kamiube, Keelung	Not Available	1387C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Neapolis	Not Available	1400C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Aures	Not Available	143T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Split	Not Available	1442C->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Kambos	Not Available	148C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Palestrina	Not Available	170G>A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Metaponto	Not Available	172G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Musashino	Not Available	185C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Asahi	Not Available	202G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	A- (202), Ferrara I	Not Available	202G->A / 376A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Murcia Oristano	Not Available	209A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Ube Konan	Not Available	241C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Lagosanto	Not Available	242G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Guangzhou	Not Available	274C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Hammersmith	Not Available	323T->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Sinnai	Not Available	34G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	A- (680)	Not Available	376A->G / 680G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	A- (968), Betica,Selma, Guantanamo	Not Available	376A->G / 968T->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Salerno Pyrgos	Not Available	383T>G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Quing Yan	Not Available	392G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Lages	Not Available	40G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Ilesha	Not Available	466G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Mahidol	Not Available	487G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Malaga	Not Available	542A->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Sibari	Not Available	634A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Mexico City	Not Available	680G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Nanning	Not Available	703C->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Seattle, Lodi, Modena, Ferrara II, Athens-like	Not Available	844G->C	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Bajo Maumere	Not Available	844G->T	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Montalbano	Not Available	854G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Kalyan-Kerala, Jamnaga, Rohini	Not Available	949G->A	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details
Glucose-6-phosphate 1-dehydrogenase	Gaohe	Not Available	95A->G	ADR Inferred	Increased risk of dose-related hemolytic anemia.	Details

Interactions

Drug Interactions

This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

• Approved
• Vet approved
• Nutraceutical
• Illicit
• Withdrawn
• Investigational
• Experimental
• All Drugs

Drug	Interaction
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Abacavir	Sulfasalazine may decrease the excretion rate of Abacavir which could result in a higher serum level.
Abatacept	The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Abatacept.
Abciximab	The risk or severity of bleeding and hemorrhage can be increased when Sulfasalazine is combined with Abciximab.
Abemaciclib	Sulfasalazine may decrease the excretion rate of Abemaciclib which could result in a higher serum level.
Acarbose	Sulfasalazine may increase the hypoglycemic activities of Acarbose.
Acebutolol	Sulfasalazine may decrease the antihypertensive activities of Acebutolol.
Aceclofenac	The therapeutic efficacy of Sulfasalazine can be decreased when used in combination with Aceclofenac.
Acemetacin	The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Acemetacin.
Acenocoumarol	The risk or severity of bleeding and hemorrhage can be increased when Sulfasalazine is combined with Acenocoumarol.
Acetaminophen	The risk or severity of adverse effects can be increased when Acetaminophen is combined with Sulfasalazine.

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Food Interactions

• Drink plenty of fluids. Inadequate fluid intake is associated with crystalluria and stone formation.

Products

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Product Images

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International/Other Brands

Asasurfan (Choseido Pharmaceutical) / Azulfdidina (Pfizer) / Azulfin (Apsen) / Bomecon (Fu Seng) / Colo-Pleon (Sanofi-Aventis) / Disalazin (AC Farma) / Eminapyrin (Taiyo Pharmaceutical) / Flogostop (Ivax) / Iwata (Cadila) / Lanofen (Taisho Yakuhin) / Lazafin (Novell) / Pleon (Sanofi-Aventis) / Pyralin EN (Pfizer) / Reumazin (Aristopharma) / Saaz (Ipca) / Saaz-DS (Ipca) / Salasopyrine (Upjohn) / Salazar (Cadila) / Salazidin (Helcor) / Salazine (Opsonin) / Salazopirina (Jaba Recordati) / Salazoprin (Cazi) / Salazopyrin (Pfizer) / Salazopyrin EN (Pfizer) / Salazopyrin EN-Tabs (Pharmacia) / Sulcolon (Bernofarm) / Sulfacol (Drug International) / Weiliufen (Sunve) / Zopyrin (Han Lim)

Brand Name Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End	Region	Image
Azulfidine	Tablet	500 mg/1	Oral	Physicians Total Care, Inc.	1995-11-06	2011-06-30
Azulfidine	Tablet	500 mg/1	Oral	Pfizer Laboratories Div Pfizer Inc	1950-06-20	Not applicable
Azulfidine EN-tabs	Tablet, delayed release	500 mg/1	Oral	Pfizer Laboratories Div Pfizer Inc	1950-06-20	Not applicable
S.A.S. Enteric 500mg	Tablet, delayed release	500 mg	Oral	Icn Pharmaceuticals	1979-12-31	2005-04-26
Salazopyrin En-tabs 500 mg	Tablet, delayed release	500 mg	Oral	Pfizer Canada Ulc	1995-12-31	Not applicable
Salazopyrin Enema 3.0gm/100ml	Suspension	3 g / 100 mL	Rectal	Kabi Pharmacia Canada Inc.	1994-12-31	1996-09-10
Salazopyrin Enema 3gm/100ml	Enema	3 g / 100 mL	Rectal	Pfizer Canada Ulc	1996-12-31	2006-08-02
Salazopyrin Tab 500mg	Tablet	500 mg	Oral	Pfizer Canada Ulc	1995-12-31	Not applicable
Sas Enema 3gm/100ml	Enema	3 g / 100 mL	Rectal	Icn Pharmaceuticals	1984-12-31	2005-04-26
Sas Tab 500mg	Tablet	500 mg	Oral	Icn Pharmaceuticals	1973-12-31	2005-04-26

Generic Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End	Region	Image
Apo Sulfasalazine Tab 500mg	Tablet	500 mg	Oral	Apotex Corporation	1978-12-31	Not applicable
Orb-sulfasalazine EC	Tablet, delayed release	500 mg	Oral	Orbus Pharma Inc	Not applicable	Not applicable
PMS-sulfasalazine 500mg/tab USP	Tablet	500 mg	Oral	Pharmascience Inc	1984-12-31	Not applicable
PMS-sulfasalazine-E.C. Tab 500mg	Tablet, delayed release	500 mg	Oral	Pharmascience Inc	1984-12-31	Not applicable
Ratio-sulfasalazine En	Tablet, delayed release	500 mg	Oral	Ratiopharm Inc Division Of Teva Canada Limited	1986-12-31	2008-08-01
Ratio-sulfasalazine Tab 500mg	Tablet	500 mg	Oral	Ratiopharm Inc Division Of Teva Canada Limited	1986-12-31	2008-08-01
Sulfasalazine	Tablet	500 mg/1	Oral	KAISER FOUNDATION HOSPITALS	2015-04-07	2019-02-28
Sulfasalazine	Tablet	500 mg/1	Oral	REMEDYREPACK INC.	2023-05-22	Not applicable
Sulfasalazine	Tablet	500 mg/1	Oral	Aidarex Pharmaceuticals LLC	2002-01-11	Not applicable
Sulfasalazine	Tablet, delayed release	500 mg/1	Oral	Greenstone LLC	2005-05-05	Not applicable

Categories

ATC Codes

G01AE10 — Combinations of sulfonamides

• G01AE — Sulfonamides
• G01A — ANTIINFECTIVES AND ANTISEPTICS, EXCL. COMBINATIONS WITH CORTICOSTEROIDS
• G01 — GYNECOLOGICAL ANTIINFECTIVES AND ANTISEPTICS
• G — GENITO URINARY SYSTEM AND SEX HORMONES

A07EC01 — Sulfasalazine

• A07EC — Aminosalicylic acid and similar agents
• A07E — INTESTINAL ANTIINFLAMMATORY AGENTS
• A07 — ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS
• A — ALIMENTARY TRACT AND METABOLISM

Drug Categories

• Agents causing hyperkalemia
• Agents that produce hypertension
• Alimentary Tract and Metabolism
• Amides
• Aminosalicylate
• Anti-Inflammatory Agents
• Anti-Inflammatory Agents, Non-Steroidal
• Anti-Inflammatory Agents, Non-Steroidal (Non-Selective)
• Antidiarrheals, Intestinal Antiinflammatory/antiinfective Agents
• Antirheumatic Agents
• BCRP/ABCG2 Inhibitors
• BCRP/ABCG2 Substrates
• Gastrointestinal Agents
• Immunosuppressive Agents
• Intestinal Antiinflammatory Agents
• Methemoglobinemia Associated Agents
• Nephrotoxic agents
• Non COX-2 selective NSAIDS
• NTCP Inhibitors
• OATP1B1/SLCO1B1 Inhibitors
• OATP1B3 inhibitors
• Organic Anion Transporting Polypeptide 2B1 Inhibitors
• Salicylates
• Sulfonamides
• Sulfones
• Sulfur Compounds

Chemical TaxonomyProvided by Classyfire

Description

This compound belongs to the class of organic compounds known as azobenzenes. These are organonitrogen aromatic compounds that contain a central azo group, where each nitrogen atom is conjugated to a benzene ring.

Kingdom

Organic compounds

Super Class

Organoheterocyclic compounds

Class

Azobenzenes

Sub Class

Not Available

Direct Parent

Azobenzenes

Alternative Parents

Salicylic acids / Benzenesulfonamides / Benzenesulfonyl compounds / Benzoic acids / Benzoyl derivatives / 1-hydroxy-2-unsubstituted benzenoids / Pyridines and derivatives / Organosulfonamides / Imidolactams / Vinylogous acids / Aminosulfonyl compounds / Heteroaromatic compounds / Azo compounds / Carboxylic acids / Monocarboxylic acids and derivatives / Azacyclic compounds / Propargyl-type 1,3-dipolar organic compounds / Hydrocarbon derivatives / Organic oxides / Organooxygen compounds / Organopnictogen compounds

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Substituents

1-hydroxy-2-unsubstituted benzenoid / Aminosulfonyl compound / Aromatic heteromonocyclic compound / Azacycle / Azo compound / Azobenzene / Benzenesulfonamide / Benzenesulfonyl group / Benzenoid / Benzoic acid / Benzoic acid or derivatives / Benzoyl / Carboxylic acid / Carboxylic acid derivative / Heteroaromatic compound / Hydrocarbon derivative / Hydroxybenzoic acid / Imidolactam / Monocarboxylic acid or derivatives / Monocyclic benzene moiety / Organic 1,3-dipolar compound / Organic nitrogen compound / Organic oxide / Organic oxygen compound / Organic sulfonic acid or derivatives / Organonitrogen compound / Organooxygen compound / Organopnictogen compound / Organosulfonic acid amide / Organosulfonic acid or derivatives / Organosulfur compound / Phenol / Propargyl-type 1,3-dipolar organic compound / Pyridine / Salicylic acid / Salicylic acid or derivatives / Sulfonyl / Vinylogous acid

show 28 more

Molecular Framework

Aromatic heteromonocyclic compounds

External Descriptors

sulfonamide, azobenzenes, pyridines (CHEBI:9334)

Affected organisms

• Humans and other mammals

Chemical Identifiers

UNII

3XC8GUZ6CB

CAS number

599-79-1

InChI Key

NCEXYHBECQHGNR-QZQOTICOSA-N

InChI

InChI=1S/C18H14N4O5S/c23-16-9-6-13(11-15(16)18(24)25)21-20-12-4-7-14(8-5-12)28(26,27)22-17-3-1-2-10-19-17/h1-11,23H,(H,19,22)(H,24,25)/b21-20+

IUPAC Name

2-hydroxy-5-[(E)-2-{4-[(pyridin-2-yl)sulfamoyl]phenyl}diazen-1-yl]benzoic acid

SMILES

OC(=O)C1=CC(=CC=C1O)\N=N\C1=CC=C(C=C1)S(=O)(=O)NC1=NC=CC=C1

References

General References

1. Hoult JR: Pharmacological and biochemical actions of sulphasalazine. Drugs. 1986;32 Suppl 1:18-26. doi: 10.2165/00003495-198600321-00005. [Article]
2. Weber CK, Liptay S, Wirth T, Adler G, Schmid RM: Suppression of NF-kappaB activity by sulfasalazine is mediated by direct inhibition of IkappaB kinases alpha and beta. Gastroenterology. 2000 Nov;119(5):1209-18. [Article]
3. Generini S, Fiori G, Matucci Cerinic M: Therapy of spondylarthropathy in inflammatory bowel disease. Clin Exp Rheumatol. 2002 Nov-Dec;20(6 Suppl 28):S88-94. [Article]
4. Allgayer H: Review article: mechanisms of action of mesalazine in preventing colorectal carcinoma in inflammatory bowel disease. Aliment Pharmacol Ther. 2003 Sep;18 Suppl 2:10-4. [Article]
5. Pruzanski W, Stefanski E, Vadas P, Ramamurthy NS: Inhibition of extracellular release of proinflammatory secretory phospholipase A2 (sPLA2) by sulfasalazine: a novel mechanism of anti-inflammatory activity. Biochem Pharmacol. 1997 Jun 15;53(12):1901-7. [Article]
6. Nielsen OH, Bukhave K, Elmgreen J, Ahnfelt-Ronne I: Inhibition of 5-lipoxygenase pathway of arachidonic acid metabolism in human neutrophils by sulfasalazine and 5-aminosalicylic acid. Dig Dis Sci. 1987 Jun;32(6):577-82. [Article]
7. Rousseaux C, Lefebvre B, Dubuquoy L, Lefebvre P, Romano O, Auwerx J, Metzger D, Wahli W, Desvergne B, Naccari GC, Chavatte P, Farce A, Bulois P, Cortot A, Colombel JF, Desreumaux P: Intestinal antiinflammatory effect of 5-aminosalicylic acid is dependent on peroxisome proliferator-activated receptor-gamma. J Exp Med. 2005 Apr 18;201(8):1205-15. Epub 2005 Apr 11. [Article]
8. Cevallos SA, Lee JY, Velazquez EM, Foegeding NJ, Shelton CD, Tiffany CR, Parry BH, Stull-Lane AR, Olsan EE, Savage HP, Nguyen H, Ghanaat SS, Byndloss AJ, Agu IO, Tsolis RM, Byndloss MX, Baumler AJ: 5-Aminosalicylic Acid Ameliorates Colitis and Checks Dysbiotic Escherichia coli Expansion by Activating PPAR-gamma Signaling in the Intestinal Epithelium. mBio. 2021 Jan 19;12(1):e03227-20. doi: 10.1128/mBio.03227-20. [Article]
9. Wahl C, Liptay S, Adler G, Schmid RM: Sulfasalazine: a potent and specific inhibitor of nuclear factor kappa B. J Clin Invest. 1998 Mar 1;101(5):1163-74. doi: 10.1172/JCI992. [Article]
10. Rains CP, Noble S, Faulds D: Sulfasalazine. A review of its pharmacological properties and therapeutic efficacy in the treatment of rheumatoid arthritis. Drugs. 1995 Jul;50(1):137-56. doi: 10.2165/00003495-199550010-00009. [Article]
11. Peppercorn MA: Sulfasalazine. Pharmacology, clinical use, toxicity, and related new drug development. Ann Intern Med. 1984 Sep;101(3):377-86. doi: 10.7326/0003-4819-101-3-377. [Article]
12. Lim WC, Wang Y, MacDonald JK, Hanauer S: Aminosalicylates for induction of remission or response in Crohn's disease. Cochrane Database Syst Rev. 2016 Jul 3;7(7):CD008870. doi: 10.1002/14651858.CD008870.pub2. [Article]
13. Croke L: Crohn's Disease: ACG Releases Updated Management Guidelines. Am Fam Physician. 2018 Dec 15;98(12):756-757. [Article]
14. Lichtenstein GR: Highlights From the New ACG Guideline on Crohn's Disease Management. Gastroenterol Hepatol (N Y). 2018 Aug;14(8):482-484. [Article]
15. William M. Haynes (2014). CRC Handbook of Chemistry and Physics (95th ed., pp. 3-490). CRC Press. [ISBN:978-1482208672]
16. FDA Approved Drug Products: Azulfidine (sulfasalazine) tablets for oral use [Link]
17. Health Canada Approved Drug Proucts: SALAZOPYRIN (Sulfasalazine) and SALAZOPYRIN EN (Sulfasalazine) tablet for oral use [Link]
18. Sulfasalazine MSDS [Link]
19. Sulfasalazine [Link]
20. Sulfasalazine [Link]
21. FDA Approved Drug Products: Azulfidine (sulfasalazine) tablets for oral use 2022 [Link]

External Links

Human Metabolome Database

HMDB0014933

KEGG Drug

D00448

KEGG Compound

C07316

PubChem Compound

5359476

PubChem Substance

46505451

ChemSpider

10605946

BindingDB

50103596

RxNav

9524

ChEBI

9334

ChEMBL

CHEMBL421

ZINC

ZINC000003831490

Therapeutic Targets Database

DAP000153

PharmGKB

PA451547

PDBe Ligand

SAS

RxList

RxList Drug Page

Drugs.com

Drugs.com Drug Page

Wikipedia

Sulfasalazine

PDB Entries

13gs / 4j7x / 5acl / 6g0g / 6r7s / 7er8

MSDS

Download (72.8 KB)

Clinical Trials

Clinical Trials

Phase	Status	Purpose	Conditions	Count
4	Completed	Basic Science	Rheumatoid Arthritis	1
4	Completed	Treatment	Ankylosing Spondylitis (AS)	1
4	Completed	Treatment	Psoriatic Arthritis	1
4	Completed	Treatment	Rheumatoid Arthritis	7
4	Not Yet Recruiting	Treatment	Rheumatoid Arthritis	1
4	Recruiting	Treatment	Cardiovascular Risk / Endothelial Dysfunction / Rheumatoid Arthritis / Stiffness, Aortic	1
4	Recruiting	Treatment	Insufficient Response to Methotrexate or Leflunomide / Rheumatoid Arthritis	1
4	Recruiting	Treatment	Psoriatic Arthritis	1
4	Terminated	Treatment	Rheumatoid Arthritis	1
4	Terminated	Treatment	Rheumatoid Arthritis, Juvenile	1

Pharmacoeconomics

Manufacturers

• Pharmacia and upjohn co
• Vintage pharmaceuticals inc
• Watson laboratories inc
• Solvay pharmaceuticals
• Heritage pharmaceuticals inc
• Mutual pharmaceutical co inc
• Sandoz inc
• Superpharm corp

Packagers

• Amerisource Health Services Corp.
• A-S Medication Solutions LLC
• Carlisle Laboratories Inc.
• Darby Dental Supply Co. Inc.
• Direct Dispensing Inc.
• Dispensing Solutions
• Greenstone LLC
• Kaiser Foundation Hospital
• Kemwell AB
• Major Pharmaceuticals
• Medisca Inc.
• Murfreesboro Pharmaceutical Nursing Supply
• Mutual Pharmaceutical Co.
• Nucare Pharmaceuticals Inc.
• Patheon Inc.
• PD-Rx Pharmaceuticals Inc.
• Pfizer Inc.
• Pharmacia Inc.
• Pharmedix
• Physicians Total Care Inc.
• Prepak Systems Inc.
• Qualitest
• Remedy Repack
• Tya Pharmaceuticals
• United Research Laboratories Inc.
• Vintage Pharmaceuticals Inc.
• Watson Pharmaceuticals

Dosage Forms

Form	Route	Strength
Tablet	Oral	500.000 mg
Tablet, coated	Oral	500 mg
Tablet, film coated	Oral	500 mg
Tablet, delayed release	Oral	500 mg
Suspension	Rectal	3 g / 100 mL
Enema	Rectal	3 g / 100 mL
Tablet	Oral	500 mg
Tablet	Oral
Tablet, delayed release	Oral
Powder	Not applicable	1 g/1g
Tablet	Oral	500 mg/1
Tablet, film coated	Oral	500 mg/1
Tablet, delayed release	Oral	500 mg/1

Prices

Unit description	Cost	Unit
Sulfasalazine powder	2.14USD	g
Azulfidine EN-tabs 500 mg Enteric Coated Tabs	0.73USD	tab
Azulfidine entab 500 mg	0.69USD	tablet
Azulfidine 500 mg tablet	0.59USD	tablet
Salazopyrin En-Tabs 500 mg Enteric-Coated Tablet	0.45USD	tablet
Sulfasalazine 500 mg Enteric Coated Tabs	0.4USD	tab
Pms-Sulfasalazine 500 mg Enteric-Coated Tablet	0.34USD	tablet
Salazopyrin 500 mg Tablet	0.28USD	tablet
Sulfasalazine 500 mg tablet	0.25USD	tablet
Sulfazine 500 mg tablet	0.25USD	tablet
Pms-Sulfasalazine 500 mg Tablet	0.22USD	tablet

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

Patents

Not Available

Properties

State

Solid

Experimental Properties

Property	Value	Source
melting point (°C)	220 dec °C	T867
water solubility	Practically insoluble in water	L44567
Caco2 permeability	-6.33	ADME Research, USCD
pKa	0.6	Not Available

Predicted Properties

Property	Value	Source
Water Solubility	0.0464 mg/mL	ALOGPS
logP	2.92	ALOGPS
logP	4.25	Chemaxon
logS	-3.9	ALOGPS
pKa (Strongest Acidic)	3.23	Chemaxon
pKa (Strongest Basic)	0.55	Chemaxon
Physiological Charge	-2	Chemaxon
Hydrogen Acceptor Count	8	Chemaxon
Hydrogen Donor Count	3	Chemaxon
Polar Surface Area	141.31 Å2	Chemaxon
Rotatable Bond Count	5	Chemaxon
Refractivity	104.6 m3·mol-1	Chemaxon
Polarizability	39.69 Å3	Chemaxon
Number of Rings	3	Chemaxon
Bioavailability	1	Chemaxon
Rule of Five	Yes	Chemaxon
Ghose Filter	Yes	Chemaxon
Veber's Rule	No	Chemaxon
MDDR-like Rule	No	Chemaxon

Predicted ADMET Features

Property	Value	Probability
Human Intestinal Absorption	+	0.9156
Blood Brain Barrier	-	0.7294
Caco-2 permeable	-	0.6893
P-glycoprotein substrate	Non-substrate	0.8405
P-glycoprotein inhibitor I	Non-inhibitor	0.9096
P-glycoprotein inhibitor II	Non-inhibitor	0.853
Renal organic cation transporter	Non-inhibitor	0.8956
CYP450 2C9 substrate	Non-substrate	0.6445
CYP450 2D6 substrate	Non-substrate	0.9116
CYP450 3A4 substrate	Non-substrate	0.7557
CYP450 1A2 substrate	Non-inhibitor	0.9046
CYP450 2C9 inhibitor	Inhibitor	0.8948
CYP450 2D6 inhibitor	Non-inhibitor	0.9231
CYP450 2C19 inhibitor	Non-inhibitor	0.923
CYP450 3A4 inhibitor	Non-inhibitor	0.8309
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.8895
Ames test	Non AMES toxic	0.9133
Carcinogenicity	Non-carcinogens	0.6468
Biodegradation	Not ready biodegradable	0.9472
Rat acute toxicity	1.4383 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.939
hERG inhibition (predictor II)	Non-inhibitor	0.821

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)

Not Available

Spectra

Spectrum	Spectrum Type	Splash Key
Predicted GC-MS Spectrum - GC-MS	Predicted GC-MS	Not Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
MS/MS Spectrum - , positive	LC-MS/MS	splash10-0002-0239100000-5bf223e6e250eb77105a

Targets

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Details1. Arachidonate 5-lipoxygenase

Kind

Protein

Organism

Humans

Pharmacological action

Yes

Actions

Inhibitor

General Function

Iron ion binding

Specific Function

Catalyzes the first step in leukotriene biosynthesis, and thereby plays a role in inflammatory processes.

Gene Name

ALOX5

Uniprot ID

P09917

Uniprot Name

Arachidonate 5-lipoxygenase

Molecular Weight

77982.595 Da

References

1. Nielsen OH, Bukhave K, Elmgreen J, Ahnfelt-Ronne I: Inhibition of 5-lipoxygenase pathway of arachidonic acid metabolism in human neutrophils by sulfasalazine and 5-aminosalicylic acid. Dig Dis Sci. 1987 Jun;32(6):577-82. [Article]
2. Allgayer H, Eisenburg J, Paumgartner G: Soybean lipoxygenase inhibition: studies with the sulphasalazine metabolites N-acetylaminosalicylic acid, 5-aminosalicylic acid and sulphapyridine. Eur J Clin Pharmacol. 1984;26(4):449-51. [Article]
3. Sircar JC, Schwender CF, Carethers ME: Inhibition of soybean lipoxygenase by sulfasalazine and 5-aminosalicylic acid: a possible mode of action in ulcerative colitis. Biochem Pharmacol. 1983 Jan 1;32(1):170-2. [Article]

Binding Properties

×

Property	Measurement	pH	Temperature (°C)	References
Ki (nM)	>10000	N/A	N/A	A27471

Details

Binding Properties2. Prostaglandin G/H synthase 2

Kind

Protein

Organism

Humans

Pharmacological action

Yes

Actions

Inhibitor

General Function

Prostaglandin-endoperoxide synthase activity

Specific Function

Converts arachidonate to prostaglandin H2 (PGH2), a committed step in prostanoid synthesis. Constitutively expressed in some tissues in physiological conditions, such as the endothelium, kidney and...

Gene Name

PTGS2

Uniprot ID

P35354

Uniprot Name

Prostaglandin G/H synthase 2

Molecular Weight

68995.625 Da

References

1. Mifflin RC, Saada JI, Di Mari JF, Valentich JD, Adegboyega PA, Powell DW: Aspirin-mediated COX-2 transcript stabilization via sustained p38 activation in human intestinal myofibroblasts. Mol Pharmacol. 2004 Feb;65(2):470-8. [Article]
2. Generini S, Fiori G, Matucci Cerinic M: Therapy of spondylarthropathy in inflammatory bowel disease. Clin Exp Rheumatol. 2002 Nov-Dec;20(6 Suppl 28):S88-94. [Article]
3. Distrutti E, Sediari L, Mencarelli A, Renga B, Orlandi S, Russo G, Caliendo G, Santagada V, Cirino G, Wallace JL, Fiorucci S: 5-Amino-2-hydroxybenzoic acid 4-(5-thioxo-5H-[1,2]dithiol-3yl)-phenyl ester (ATB-429), a hydrogen sulfide-releasing derivative of mesalamine, exerts antinociceptive effects in a model of postinflammatory hypersensitivity. J Pharmacol Exp Ther. 2006 Oct;319(1):447-58. Epub 2006 Jul 19. [Article]
4. Cipolla G, Crema F, Sacco S, Moro E, de Ponti F, Frigo G: Nonsteroidal anti-inflammatory drugs and inflammatory bowel disease: current perspectives. Pharmacol Res. 2002 Jul;46(1):1-6. [Article]
5. Pruzanski W, Stefanski E, Vadas P, Ramamurthy NS: Inhibition of extracellular release of proinflammatory secretory phospholipase A2 (sPLA2) by sulfasalazine: a novel mechanism of anti-inflammatory activity. Biochem Pharmacol. 1997 Jun 15;53(12):1901-7. [Article]

Details3. Prostaglandin G/H synthase 1

Kind

Protein

Organism

Humans

Pharmacological action

Yes

Actions

Inhibitor

General Function

Prostaglandin-endoperoxide synthase activity

Specific Function

Converts arachidonate to prostaglandin H2 (PGH2), a committed step in prostanoid synthesis. Involved in the constitutive production of prostanoids in particular in the stomach and platelets. In gas...

Gene Name

PTGS1

Uniprot ID

P23219

Uniprot Name

Prostaglandin G/H synthase 1

Molecular Weight

68685.82 Da

References

1. Allgayer H: Review article: mechanisms of action of mesalazine in preventing colorectal carcinoma in inflammatory bowel disease. Aliment Pharmacol Ther. 2003 Sep;18 Suppl 2:10-4. [Article]

Details4. Acetyl-CoA acetyltransferase, mitochondrial

Kind

Protein

Organism

Humans

Pharmacological action

Yes

Actions

Inhibitor

General Function

Metal ion binding

Specific Function

Plays a major role in ketone body metabolism.

Gene Name

ACAT1

Uniprot ID

P24752

Uniprot Name

Acetyl-CoA acetyltransferase, mitochondrial

Molecular Weight

45199.2 Da

References

1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [Article]
2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [Article]
3. Faison LD, White HL: Sulfasalazine inhibits lyso-PAF: acetyl-COA acetyltransferase. Prostaglandins. 1992 Sep;44(3):245-9. [Article]

Details5. Phospholipase A2

Kind

Protein

Organism

Humans

Pharmacological action

Yes

Actions

Antagonist

General Function

Receptor binding

Specific Function

PA2 catalyzes the calcium-dependent hydrolysis of the 2-acyl groups in 3-sn-phosphoglycerides, this releases glycerophospholipids and arachidonic acid that serve as the precursors of signal molecules.

Gene Name

PLA2G1B

Uniprot ID

P04054

Uniprot Name

Phospholipase A2

Molecular Weight

16359.535 Da

References

1. Pruzanski W, Stefanski E, Vadas P, Ramamurthy NS: Inhibition of extracellular release of proinflammatory secretory phospholipase A2 (sPLA2) by sulfasalazine: a novel mechanism of anti-inflammatory activity. Biochem Pharmacol. 1997 Jun 15;53(12):1901-7. [Article]

Details6. Cystine/glutamate transporter

Kind

Protein

Organism

Humans

Pharmacological action

Unknown

Actions

Inhibitor

General Function

Cystine:glutamate antiporter activity

Specific Function

Sodium-independent, high-affinity exchange of anionic amino acids with high specificity for anionic form of cystine and glutamate.

Gene Name

SLC7A11

Uniprot ID

Q9UPY5

Uniprot Name

Cystine/glutamate transporter

Molecular Weight

55422.44 Da

References

1. Gout PW, Buckley AR, Simms CR, Bruchovsky N: Sulfasalazine, a potent suppressor of lymphoma growth by inhibition of the x(c)- cystine transporter: a new action for an old drug. Leukemia. 2001 Oct;15(10):1633-40. [Article]

Details7. Nuclear factor NF-kappa-B p105 subunit

Kind

Protein

Organism

Humans

Pharmacological action

Unknown

Actions

Inhibitor

General Function

Transcriptional repressor activity, rna polymerase ii transcription regulatory region sequence-specific binding

Specific Function

NF-kappa-B is a pleiotropic transcription factor present in almost all cell types and is the endpoint of a series of signal transduction events that are initiated by a vast array of stimuli related...

Gene Name

NFKB1

Uniprot ID

P19838

Uniprot Name

Nuclear factor NF-kappa-B p105 subunit

Molecular Weight

105355.175 Da

References

1. Wahl C, Liptay S, Adler G, Schmid RM: Sulfasalazine: a potent and specific inhibitor of nuclear factor kappa B. J Clin Invest. 1998 Mar 1;101(5):1163-74. doi: 10.1172/JCI992. [Article]

Details8. Nuclear factor NF-kappa-B p100 subunit

Kind

Protein

Organism

Humans

Pharmacological action

Unknown

Actions

Inhibitor

General Function

Transcriptional activator activity, rna polymerase ii core promoter proximal region sequence-specific binding

Specific Function

NF-kappa-B is a pleiotropic transcription factor present in almost all cell types and is the endpoint of a series of signal transduction events that are initiated by a vast array of stimuli related...

Gene Name

NFKB2

Uniprot ID

Q00653

Uniprot Name

Nuclear factor NF-kappa-B p100 subunit

Molecular Weight

96748.355 Da

References

1. Wahl C, Liptay S, Adler G, Schmid RM: Sulfasalazine: a potent and specific inhibitor of nuclear factor kappa B. J Clin Invest. 1998 Mar 1;101(5):1163-74. doi: 10.1172/JCI992. [Article]

Details9. Inhibitor of nuclear factor kappa-B kinase subunit beta

Kind

Protein

Organism

Humans

Pharmacological action

Yes

Actions

Inhibitor

General Function

Scaffold protein binding

Specific Function

Serine kinase that plays an essential role in the NF-kappa-B signaling pathway which is activated by multiple stimuli such as inflammatory cytokines, bacterial or viral products, DNA damages or oth...

Gene Name

IKBKB

Uniprot ID

O14920

Uniprot Name

Inhibitor of nuclear factor kappa-B kinase subunit beta

Molecular Weight

86563.245 Da

References

1. Weber CK, Liptay S, Wirth T, Adler G, Schmid RM: Suppression of NF-kappaB activity by sulfasalazine is mediated by direct inhibition of IkappaB kinases alpha and beta. Gastroenterology. 2000 Nov;119(5):1209-18. [Article]
2. Wahl C, Liptay S, Adler G, Schmid RM: Sulfasalazine: a potent and specific inhibitor of nuclear factor kappa B. J Clin Invest. 1998 Mar 1;101(5):1163-74. doi: 10.1172/JCI992. [Article]
3. Allgayer H: Review article: mechanisms of action of mesalazine in preventing colorectal carcinoma in inflammatory bowel disease. Aliment Pharmacol Ther. 2003 Sep;18 Suppl 2:10-4. [Article]
4. Bantel H, Berg C, Vieth M, Stolte M, Kruis W, Schulze-Osthoff K: Mesalazine inhibits activation of transcription factor NF-kappaB in inflamed mucosa of patients with ulcerative colitis. Am J Gastroenterol. 2000 Dec;95(12):3452-7. [Article]

Details10. Inhibitor of nuclear factor kappa-B kinase subunit alpha

Kind

Protein

Organism

Humans

Pharmacological action

Unknown

General Function

Scaffold protein binding

Specific Function

Serine kinase that plays an essential role in the NF-kappa-B signaling pathway which is activated by multiple stimuli such as inflammatory cytokines, bacterial or viral products, DNA damages or oth...

Gene Name

CHUK

Uniprot ID

O15111

Uniprot Name

Inhibitor of nuclear factor kappa-B kinase subunit alpha

Molecular Weight

84638.88 Da

References

1. Wahl C, Liptay S, Adler G, Schmid RM: Sulfasalazine: a potent and specific inhibitor of nuclear factor kappa B. J Clin Invest. 1998 Mar 1;101(5):1163-74. doi: 10.1172/JCI992. [Article]
2. Weber CK, Liptay S, Wirth T, Adler G, Schmid RM: Suppression of NF-kappaB activity by sulfasalazine is mediated by direct inhibition of IkappaB kinases alpha and beta. Gastroenterology. 2000 Nov;119(5):1209-18. [Article]
3. Bantel H, Berg C, Vieth M, Stolte M, Kruis W, Schulze-Osthoff K: Mesalazine inhibits activation of transcription factor NF-kappaB in inflamed mucosa of patients with ulcerative colitis. Am J Gastroenterol. 2000 Dec;95(12):3452-7. [Article]
4. Allgayer H: Review article: mechanisms of action of mesalazine in preventing colorectal carcinoma in inflammatory bowel disease. Aliment Pharmacol Ther. 2003 Sep;18 Suppl 2:10-4. [Article]

Details11. Peroxisome proliferator-activated receptor gamma

Kind

Protein

Organism

Humans

Pharmacological action

Unknown

Actions

Agonist

General Function

Zinc ion binding

Specific Function

Nuclear receptor that binds peroxisome proliferators such as hypolipidemic drugs and fatty acids. Once activated by a ligand, the nuclear receptor binds to DNA specific PPAR response elements (PPRE...

Gene Name

PPARG

Uniprot ID

P37231

Uniprot Name

Peroxisome proliferator-activated receptor gamma

Molecular Weight

57619.58 Da

References

1. Rousseaux C, Lefebvre B, Dubuquoy L, Lefebvre P, Romano O, Auwerx J, Metzger D, Wahli W, Desvergne B, Naccari GC, Chavatte P, Farce A, Bulois P, Cortot A, Colombel JF, Desreumaux P: Intestinal antiinflammatory effect of 5-aminosalicylic acid is dependent on peroxisome proliferator-activated receptor-gamma. J Exp Med. 2005 Apr 18;201(8):1205-15. Epub 2005 Apr 11. [Article]
2. Cevallos SA, Lee JY, Velazquez EM, Foegeding NJ, Shelton CD, Tiffany CR, Parry BH, Stull-Lane AR, Olsan EE, Savage HP, Nguyen H, Ghanaat SS, Byndloss AJ, Agu IO, Tsolis RM, Byndloss MX, Baumler AJ: 5-Aminosalicylic Acid Ameliorates Colitis and Checks Dysbiotic Escherichia coli Expansion by Activating PPAR-gamma Signaling in the Intestinal Epithelium. mBio. 2021 Jan 19;12(1):e03227-20. doi: 10.1128/mBio.03227-20. [Article]
3. Schwab M, Reynders V, Loitsch S, Shastri YM, Steinhilber D, Schroder O, Stein J: PPARgamma is involved in mesalazine-mediated induction of apoptosis and inhibition of cell growth in colon cancer cells. Carcinogenesis. 2008 Jul;29(7):1407-14. doi: 10.1093/carcin/bgn118. Epub 2008 Jun 9. [Article]
4. Linard C, Gremy O, Benderitter M: Reduction of peroxisome proliferation-activated receptor gamma expression by gamma-irradiation as a mechanism contributing to inflammatory response in rat colon: modulation by the 5-aminosalicylic acid agonist. J Pharmacol Exp Ther. 2008 Mar;324(3):911-20. Epub 2007 Dec 12. [Article]
5. Desreumaux P, Ghosh S: Review article: mode of action and delivery of 5-aminosalicylic acid - new evidence. Aliment Pharmacol Ther. 2006 Sep;24 Suppl 1:2-9. [Article]

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Drug created at June 13, 2005 13:24 / Updated at December 01, 2023 08:05