There is evidence that the incidence and severity of toxicity following overdosage is directly related to the total serum sulfapyridine concentration. Symptoms of overdosage may include nausea, vomiting, gastric distress and abdominal pains. In more advanced cases, central nervous system symptoms such as drowsiness, convulsions, etc., may be observed. Serum sulfapyridine concentrations may be used to monitor the progress of recovery from overdosage.

There are no documented reports of deaths due to ingestion of large single doses of sulfasalazine. It has not been possible to determine the LD₅₀ in laboratory animals such as mice, since the highest oral daily dose of sulfasalazine which can be given (12 g/kg) is not lethal. Doses of regular sulfasalazine tablets of 16 g per day have been given to patients without mortality.

Instructions for Overdosage

Gastric lavage or emesis plus catharsis as indicated. Alkalinize urine. If kidney function is normal, force fluids. If anuria is present, restrict fluids and salt, and treat appropriately. Catheterization of the ureters may be indicated for complete renal blockage by crystals. The low molecular weight of sulfasalazine and its metabolites may facilitate their removal by dialysis.

AZULFIDINE EN-tabs Tablets are contraindicated in:

Hypersensitivity to sulfasalazine, its metabolites, sulfonamides or salicylates,

Patients with intestinal or urinary obstruction,

Patients with porphyria, as the sulfonamides have been reported to precipitate an acute attack.

Last reviewed on RxList: 10/30/2009
This monograph has been modified to include the generic and brand name in many instances.