It is a well known fact that breastfeeding is best source of nutrition for infants. Breast milk provides minerals, vitamins and antibodies in most acceptable format when they need it. Nutrition taken by mother passes to breast-milk and same thing applies to medicines taken by mothers. Not all drugs cause problem for baby but some do. Lets analyze if Sulfasalazine 500 Mg is safe for baby while breastfed.
What is Sulfasalazine 500 Mg used for?
Sulfasalazine Delayed-Release Tablets, USP, 500 mg are indicated: in the treatment of mild to moderate ulcerative colitis, and as adjunctive therapy in severe ulcerative colitis; for the prolongation of the remission period between acute attacks of ulcerative colitis; in the treatment of patients with rheumatoid arthritis who have responded inadequately to salicylates or other nonsteroidal anti-inflammatory drugs (e.g., an insufficient therapeutic response to, or intolerance of, an adequate trial of full doses of one or more nonsteroidal anti-inflammatory drugs); and in the treatment of pediatric patients with polyarticular-course1 juvenile rheumatoid arthritis who have responded inadequately to salicylates or other nonsteroidal anti-inflammatory drugs. Sulfasalazine Delayed-Release Tablets, USP, 500 mg is particularly indicated in patients with ulcerative colitis who cannot take uncoated sulfasalazine tablets because of gastrointestinal intolerance, and in whom there is evidence that this intolerance is not primarily the result of high blood levels of sulfapyridine and its metabolites, e.g., patients experiencing nausea and vomiting with the first few doses of the drug, or patients in whom a reduction in dosage does not alleviate the adverse gastrointestinal effects. In patients with rheumatoid arthritis or juvenile rheumatoid arthritis, rest and physiotherapy as indicated should be continued. Unlike anti-inflammatory drugs, Sulfasalazine Delayed-Release Tablets, USP, 500 mg does not produce an immediate response. Concurrent treatment with analgesics and/or nonsteroidal anti-inflammatory drugs is recommended at least until the effect of Sulfasalazine Delayed-Release Tablets, USP, 500 mg is apparent.
Is Sulfasalazine 500 Mg usage safe while breastfeeding? If a lactating mother is using it can there be any effect on growth or development of infant?
Sulfasalazine is the only one ingredient used in manufacturing of Sulfasalazine 500 Mg, Which makes it easier to analyze its effect in breastfeeding. As per our analysis of Sulfasalazine it is safe to use Sulfasalazine 500 Mg while lactating. We suggest you to check further details below about Sulfasalazine usage in breastfeeding.
Statement of Manufacturer/Labeler about breastfeeding usage
Nursing Mothers: Caution should be exercised when Sulfasalazine Delayed-Release Tablets, USP, 500 mg is administered to a nursing mother. Sulfonamides are excreted in the milk. In the newborn, they compete with bilirubin for binding sites on the plasma proteins and may cause kernicterus. Insignificant amounts of uncleaved sulfasalazine have been found in milk, whereas the sulfapyridine levels in milk are about 30% to 60% of those in the maternal serum. Sulfapyridine has been shown to have a poor bilirubin-displacing capacity.
Sulfasalazine 500 Mg Breastfeeding Analsys
Sulfasalazine while Breastfeeding Safe
CAS Number: 599-79-1
Prodrug of Mesalazine: medication compounded by union of Sulfapyridine and 5-ASA which is degraded into Mesalazine by bacteria in the large intestine. Mesalazine is badly absorbed by the intestine, serum levels are low with scant excretion into breast milk. Inactive metabolite N-acetyl-5-ASA was found in small amount in the milk with a relative infant dose not higher than 10%. No harm effects among breastfed infants from treated mothers have been reported, except for rare cases of diarrhea reported in the 80's with the use of Sulfasalazine. In a review of 121 cases and 121 controls, the authors failed to observe those findings. (Moretti, 1989). Expert consensus supports the compatibility of Mesalazine and/or its prodrugs during breastfeeding. Sulfapyridine released in the large intestine is 60% absorbed with a protein-binding capacity of 90%, both being a reason for low excretion into breast milk. Mesalazine derivatives that not contain Sulfapyridine are recommended by some authors for use while breastfeeding (see alternative drugs).
Sulfasalazine 500 Mg Breastfeeding Analsys - 2
Sulfasalazine while Breastfeeding
CAS Number: 599-79-1
Sulfasalazine and its active metabolite mesalamine are poorly excreted into breastmilk. However, rather high levels of the mesalamine metabolite N-acetyl-5-ASA appear in breastmilk and its effects on breastfed infants are unknown. Another sulfasalazine metabolite, sulfapyridine, also appears in milk and infant serum and might cause hemolysis, especially in newborn infants and in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The time of greatest risk for hemolysis in fullterm newborns without G6PD deficiency might be as short as 8 days after birth. Bloody diarrhea has occurred in an infant whose mother was taking sulfasalazine and a few cases of diarrhea have been reported in infants exposed to mesalamine in breastmilk, although the rate is not high. Most experts consider mesalamine derivatives to be safe during breastfeeding. If sulfasalazine is required by the mother, it is not a reason to discontinue breastfeeding, but carefully observe breastfed infants for diarrhea. Other mesalamine derivatives that do not contain a sulfonamide are preferred.
What should I do if already breastfed my kid after using Sulfasalazine 500 Mg?
It is always a good idea to keep your healthcare provider or doctor informed about your drug usage during pregnancy and breastfeeding but if you have not informed your doctor about Sulfasalazine 500 Mg and have used it then do not panic as Sulfasalazine 500 Mg is mostly safe in breastfeeding and should not cause any harm to your baby.
I am nursing mother and my doctor has suggested me to use Sulfasalazine 500 Mg, is it safe?
Definitely, Sulfasalazine 500 Mg is safe in lactation for baby. No wonder your doctor has recommended it.
If I am using Sulfasalazine 500 Mg, will my baby need extra monitoring?
No extra baby monitoring required while mother is using Sulfasalazine 500 Mg
Who can I talk to if I have questions about usage of Sulfasalazine 500 Mg in breastfeeding?
National Womens Health and Breastfeeding Helpline: 800-994-9662 (TDD 888-220-5446) 9 a.m. and 6 p.m. ET, Monday through Friday
National Breastfeeding Helpline: 0300-100-0212 9.30am to 9.30pm, daily
Association of Breastfeeding Mothers: 0300-330-5453
La Leche League: 0345-120-2918
The Breastfeeding Network supporter line in Bengali and Sylheti: 0300-456-2421
National Childbirth Trust (NCT): 0300-330-0700
National Breastfeeding Helpline: 1800-686-268 24 hours a day, 7 days a week
Telehealth Ontario for breastfeeding: 1-866-797-0000 24 hours a day, 7 days a week