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Sulfasalazine for Psoriatic Arthritis User Reviews

Brand names: Azulfidine, Azulfidine EN-tabs

Sulfasalazine has an average rating of 6.4 out of 10 from a total of 36 reviews for the off-label treatment of Psoriatic Arthritis. 47% of reviewers reported a positive experience, while 25% reported a negative experience.

Sulfasalazine rating summary

6.4/10 average rating

36 ratings from 38 user reviews.

Compare all 73 medications used in the treatment of Psoriatic Arthritis.

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19%
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14%
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14%
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8%
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11%
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8%
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3%
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11%
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Reviews for Sulfasalazine

  • Jbm
  • June 25, 2014

"After being on methotrexate and Humira, I experienced no relief as well as a SEVERE LIFE-THREATENING episode called Ludwig's Angina. I ended up in a coma for 4 days and was told that if I had waited 1/2 hour longer to go to the ER, I probably wouldn't have survived! I swore off all arthritic medicines for a year, except for pain medicines. My rheumatologist understood, and after a year suggested we start back very passively as opposed to aggressively to treatment. She suggested SSZ (sulfasalazine), and I reluctantly agreed. I was told it could take up to 3-4 months before I would see any improvement. Within 3 weeks, I felt like a new person. I've been on it for a year and feel wonderful!"

10 / 10
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107 Report
  • pinkh...
  • Taken for 1 to 6 months
  • October 1, 2019

"My doc started me on this since it’s the weakest medication with the least amount of side effects you can be on for autoimmune conditions. Docs aren’t fond of methotrexate in young adult females either (I’m a 23 year old female). I have PsA, and it’s a night and day difference with this medication. I take 3 pills twice daily. My inflammation markers have decreased by 7 points and .2 points on the other. Life changing medication and I no longer feel like garbage. If you don’t like the idea of side effects, start with this first. Every body processes medications different, but you don’t know until you try it."

10 / 10
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54 Report
  • Lora...
  • Taken for 1 to 2 years
  • May 15, 2013

"I LOVE THIS MEDICINE! I had tried many medicines before this including methotrexate which was HORRIBLE - they all made me so ill. I only had loose stools at the start of treatment as a side effect, no others. I take it alone, without NSAIDs, and it manages all my pain and swelling like a champ. I have had no flares and I take 2 in the morning and 2 in the evening. My hair also stopped falling out after the 1st 2 months of taking it. It literally changed my life without shutting down my immune system. I could not be happier."

10 / 10
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99 Report
  • Hilara
  • April 7, 2016

"I was on sulfasalazine after being diagnosed with PSA. My first arthritis medication. I was also experiencing reactive arthritis when first diagnosed. I started at 1 tablet 2 times a day. I had some quite adverse reactions to start, trouble sleeping and nausea. Rheumatologist suggested humeria. After reading up on humeria I decided it was worth trying to soldier through a longer trial period with sulfasalazine before switching, eating plain food etc. to minimise impacts of side effects. So glad I did. Now at 4 tabs/day. All the side effects are now gone and I can eat normally. Sulfasalazine has reduced joint inflammation to the point that I can exercise. I recommend giving sulfasalazine side effects a bit of time to equalize."

8 / 10
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67 Report
  • Shed
  • Taken for 6 months to 1 year
  • January 13, 2017

"Was diagnosed with psoriatic arthritis at 28 years old. In a span of about 8 weeks I had 3 joint flare ups. At first I just thought I jammed a few few fingers, but after having the same issue in my toe (and the fact they weren't healing) I finally saw a doctor who recommended a rheumatologist and I was diagnosed. Took a while to take effect, but I started noticing a difference at 10 weeks. After 10 weeks, sulfasalazine plus 660 mg naproxen sodium was enough for my fingers to feel 85% normal. After 4 months my joints felt 85% on sulfasalazine alone. By 6 months it's as if I don't have arthritis at all. Truly miracle drug."

10 / 10
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53 Report

Are you taking this medicine?

  • Anonymous
  • March 14, 2024

"I’ve been on sulfasalazine for just under two weeks. Prior to this, I spent about 2 months not being able to walk and in constant pain. Since I’ve been on the medication, everything gets a little bit better every day. I’m in so much less pain and have started to be able to walk again. I was so worried about trying this drug after reading reviews. It does make you feel sick now and again, but I’ve found that if I drink plenty of water and eat before taking the pills, I don’t have any side effects. I’m so happy I tried this medication and surprised it worked so quickly!"

9 / 10
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4 Report
  • Danny...
  • September 16, 2015

"I'm a 31 year old male. I've had Little to no side effects. I had loose stool for the first week other than that I've had no problems. I wouldn't say it's a miracle drug but it has relieved my pain significantly within the first 2 weeks. My wife is happy because I complain about a 1/4 as much lol. Still have some lower back pain but my neck pain has pretty much disappeared. The rest of my body feels better but like I said not 100% (that may be because I'm getting older, who knows lol). Very thankful for this drug. I've been on it for about 4 months."

7 / 10
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47 Report
  • Anonymous
  • February 29, 2012

"I never got to the full dosage of 2 pills twice a day. I was slowly increasing the dosage from one pill once to one pill once... that's as far as I got. The side effects were horrible. My mother, a breast cancer survivor, likened my side effects to chemo. My mind couldn't focus. I couldn't sleep, yet I was always drowsy. I always noticed that the side effects would ease about 6 hours after taking, then would show 30 min after taking. I finally gave up, and changed meds."

1 / 10
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49 Report
  • Mumsw...
  • Taken for 10 years or more
  • March 20, 2017

"Been a psoriatic arthritis sufferer these last twenty years. My flare ups are dreadful. After taking them for just two weeks symptoms are abated; it really works for me despite convincing my new GP I knew what I was on about! Methotrexate was awful. No side effects with SULFASALAZINE with me. After three months no pain at all....but one needs to drink lots of water. I've had periods on and off this drug, all due to flare ups..."

9 / 10
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31 Report
  • Anonymous
  • Taken for 1 to 6 months
  • December 14, 2021

"I had a shocking experience with Sufasalazine. For five weeks, the drug did nothing- swelling in my foot remained the same. At the end of week 5, it wiped out my white cells completely (neutropenia/agranulocytosis), which essentially caused my body to die. It caused a very large necrotic abscess (necrotising fasciitis) for which I needed two emergency surgeries, and all my systems were affected (cardiac/digestive etc). I was very close to becoming septic and it was thought I might need a bone marrow transplant. Fortunately, I didn't, however, I was put in to hospital isolation for weeks, and spent months in and out of hospital stays, hooked up to IV antibiotics, blood transfusions etc. Then I had a year long journey of recovery (post surgical wound, hair fell out, 'odd' skin problems that I'd never had before). Fortunately, my digestive and cardiac issues seem to have fixed themselves with time. Still dealing with many immune issues that I'd never had before this saga."

1 / 10
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13 Report
  • Jelly...
  • Taken for 1 to 6 months
  • January 12, 2014

"I slowly increased the dose weekly. I was ok on 2 a day but once increased to 3 my eyesight got a little worse. I reduced them for while then slowly up to 4 a day. The nausea was terrible I also felt really ill and very tired but didn't know why. Had to take time off work I felt so bad. Lowered dose to 2 again and was better but once I tried to increase it again the nausea and ill feelings came back. Stopped them and eventually felt better. Didn't realise just how bad they had affected me until I was back to normal again!"

2 / 10
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36 Report
  • Mumof
  • Taken for 6 months to 1 year
  • September 30, 2018

"Diagnosed with psoriatic arthritis (PsA) at 44, had nail psoriasis since 14 years old. Forced to stop Methotrexate at week 8 due to hair loss. Switched to Sulfasalazine 7 months ago on 2000mg. 4 months on 2000mg per day but no improvement but also no side effects. At 5 months I developed plantar fasciitis, severe fatigue, apathy, low mood and stiffness throughout my whole body. I was told it was the PsA. I put on a stone in weight - I am 5ft 2ins and normally weigh 9 stone. I felt and moved like a woman twice my age. I gave up on sulfasalazine a week ago. The next day, I felt a different person, and have felt better again with each passing day. Fatigue has gone, mood lifted, stiffness lessened and the joint pain significantly reduced. Whilst I still have some joint pain, stiffness and sore feet, I am significantly better in myself since coming off this drug. I start Otezla tomorrow."

1 / 10
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22 Report
  • fight...
  • June 21, 2021

"I have psoriatic arthritis last 10 years at the start sulfasalazine did wonders on my rather bigger joints and but after 1 year of use only relieved up to an extend on my finger joints. After 10 years I had multiple disc herniations because my spine got hit by the disease silently and it progressed without giving any signs. So an annual MRI scan is always recommended. I went back to sulfasalazine. Let me give you some tips on sulfasalazine: pros: *well tolerated on most people *medium efficacy *prevents bone and cartilage erosion unlike NSAID's *can be used long term on a sensible dose *your best bet before biologics *liver toxicity lower than methotrexate cons: *efficiency drops after a year. *does not stop disease progress or new joints added. *does not work on spine or axial joints. *works less on smaller joints such as hands. *affect blood count results. *less anti inflammatory than methotrexate"

8 / 10
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13 Report
  • Andy
  • Taken for 6 months to 1 year
  • October 25, 2018

"This worked great for about 10 days, then I started getting nerve pain and had to discontinue, but it completely cured my Psoriasis and Psoriatic Arthritis after just ten days! I was symptom free for almost two years. Things started drifting back again and I used it at lower doses, it always helps some, but I just can't stay on it due to the nerve pain in my legs."

6 / 10
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19 Report
  • Anonymous
  • Taken for 1 to 2 years
  • July 14, 2023

"Needed 2500mg per day to get to a comfortable level of my wide spread enthesitis. This worked better than methotrexate 20mg injections. Cyclosporin and Leflunomide had even less benefit. No side effects."

9 / 10
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5 Report
  • GMS
  • Taken for 2 to 5 years
  • December 21, 2023

"I started on sulfasalazine 4-5 years ago after being diagnosed with psoriatic arthritis. I had serious inflammation and pain in my right hand and inflammation of some toes. After a few weeks of taking a 500 mg tablet of sulfasalazine twice a day, my symptoms improved substantially. My rheumatologist then increased my dose to 2 tablets twice a day (total of 2 grams per day). My pain disappeared and the only remnant of inflammation is a slight swelling of my right index knuckle. I have had no pain and have negligible stiffness. I have had no side effects at all. I can take the medication on an empty stomach, unlike some people. At my doctor's suggestion, I decreased the dosage a few months ago to 3 500-mg tablets per day. I had no change of symptoms, so they are now suggesting that I try 2 500-mg tablets per day (one in the morning, one at night). I started on this reduced dose a few days ago, so it is too early to tell if symptoms are changing. Overall, I've been very pleased."

10 / 10
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  • RWM
  • Taken for 10 years or more
  • May 16, 2023

"I have taken Sulfasalazine for almost 20 years now with no side effect and it has definitely reduced any episodes to stiffness, skin scaliness or other conditions, associated with Psoriatic Arthritis. I have had no side effects, other than some sun sensitivity early on, but seems to be minimal now."

10 / 10
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5 Report
  • Seaho...
  • Taken for 1 to 6 months
  • March 29, 2019

"Have been on sulfasalazine now for approx 6 weeks, 2000mg/day. Not seeing much improvement, joints still swell badly. Pain in shoulder kept me awake tonight. Acid reflux, which I had prior to this medication, has significantly worsened. Overall not pleased with sulfasalazine."

2 / 10
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15 Report
  • Jazz
  • Taken for less than 1 month
  • May 10, 2018

"Started Sulfasalazine, three weeks ago, I have been feeling quite ill, flu like, drained of energy, mornings are like the worst hangover feeling, my joints are never like before with constant pain, tiredness never leaves me, some diarrhoea, is this drug for me?"

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14 Report
  • Rich...
  • January 13, 2016

"I was recently diagnosed with psoriatic arthritis at the age of 45. Very early stages according to my doctor. He placed me on Sulfasalazine. Started 1 pill per day for 2 weeks then 2 a day the next week then 3x per day the following week. When I made it to the 3x per day I had a terrible reaction. Severe nausea, headaches, and sensitivity to light and noticed I felt weak and was about to go to the emergency room. I stopped immediately and felt better within days. I'm diabetic and tested my blood sugar and did notice a massive drop on this medication. The symptoms I was having could have been low blood sugar. The sulfasalazine may have reacted to my metformin to cause low blood sugar. I was switched to Plaquenil."

2 / 10
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17 Report
  • Papa
  • Taken for 6 months to 1 year
  • April 30, 2023

"Since I’ve been taking sulfasalazine I don’t wake up with my finger joints nearly as swollen and I have more flexibility. My joints don’t ache as bad as they did before taking it. I haven’t had any side effects and I’ve been taking it for several months. I take two tablets in the morning and two at night."

9 / 10
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3 Report
  • person
  • Taken for 1 to 6 months
  • March 27, 2023

"28F, diagnosed with Psoriatic Arthritis one year ago. I had very painful fingers and knees, and taking weekly 25mg methotrexate injections helped, but did not fully eradicate the pain or help me regain function. After a bout of uveitis, and a new onset migraine with aura, sulfasalazine got added (2500mg, titrated up to 500mg a week). Although it took a while to work, it improved my condition dramatically. It feels almost back to normal pain and function wise and general fatigue levels have improved somewhat. The abdominal side effects are the ones that still bother me, with bouts of nausea and painful bloating almost daily. I was advised it may take a few more months to improve, but honestly, I feel I can live with that as long as I get to keep the benefits of it."

8 / 10
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3 Report
  • cmurf
  • Taken for 1 to 6 months
  • May 31, 2018

"I am starting Sulfasalazine for the second time as the first time I ended up coming down with the flu a couple of times so decided to wait. My symptoms have been worse so just started it again. I am on my last day of two pills in the morning and one in the evening. No real bad side effects other than increased joint aching, especially in hip. I had a lot of trouble sleeping last night as I just couldn't get comfortable at all. I'm supposed to increase gradually up to three pills in the morning and three at night. I will have to see how it goes though. I am not really patient when it comes to side effects."

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7 Report
  • Aussie...
  • Taken for 1 to 6 months
  • February 5, 2017

"Trialled this medicine for Psoriatic arthritis for approx 6 months in combination with Methotrexate and Hydroxychloroquinine. While no major side effects there was no clinical efficacy either so therapy was discontinued."

1 / 10
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8 Report
  • overp...
  • Taken for 1 to 6 months
  • August 27, 2023

"Was started on sulfasalazine after a virus caused a flare of what the rheumatologist thought was PsA & fibromyalgia. Dr later determined my PsA wasn't active but still continued the sulfasalazine. The dose was 1000mg twice a day. I believe it caused me headaches & nausea at the start. Dr encourages me to continue the medication. I have stopped & restarted the medication with his 'advice' but still don't think it is doing anything for me."

5 / 10
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1 Report

Reviews may be edited to correct grammar/spelling or to remove inappropriate language and content. Reviews that appear to be created by parties with a vested interest are not published. This information is not intended to endorse any particular medication. While these reviews may be helpful, they are not a substitute for the expertise, knowledge, and judgement of healthcare professionals.

Learn more about Psoriatic Arthritis

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