Generic Name: sulfasalazine
Product Name: Pyralin EN
Indication: What Pyralin EN is used for
Pyralin EN is also used to treat rheumatoid arthritis, which is a painful joint disease.
Pyralin EN helps prevent damage to your joints. It works to slowly reduce the swelling and stiffness in your joints. It is usually given when a group of medicines known as nonsteroidal anti-inflammatory drugs (NSAIDs) is not working.
Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed it for another reason.
This medicine is available only with a doctor’s prescription.
There is no evidence that Pyralin EN is addictive.
Action: How Pyralin EN works
The active substance in Pyralin EN is sulfasalazine. It has a number of effects in the body. It is an immunosuppressive and an anti-inflammatory medicine. It has shown affinity to connective tissue.
Pyralin EN tablets contain 500 mg sulfasalazine per tablet. It also contains also contain silica, magnesium stearate, maize starch, cellacephate, propylene glycol, white beeswax, carnauba wax, glyceryl monostearate, macrogol 20000 and talc.
Pyralin EN tablets do not contain lactose, sucrose, or tartrazine.
Dose advice: How to use Pyralin EN
Before you take Pyralin EN
When you must not take Pyralin EN
Do not take Pyralin EN if you have an allergy to:
- Sulfur-containing medicines:
- e.g. sulfonamides;
- Some oral hypoglycaemics (diabetes medicine) e.g. glipizide;
- Thiazide diuretics e.g. chlorothiazide;
- Salicylates e.g. aspirin;
- Any of the ingredients listed here.
Symptoms of an allergic reaction may include:
- Shortness of breath;
- Wheezing or difficulty breathing;
- Swelling of the face, lips, tongue or other parts of the body;
- Rash, itching or hives on the skin.
If you are not sure if you have or have had an allergic reaction to Pyralin EN, check with your doctor.
Do not take Pyralin EN if you are taking the following medicines:
- Sulfur-containing medicines e.g. sulfonamides; some oral hypoglycaemics (diabetes medicine) e.g. glipizide; thiazide diuretics e.g. chlorothiazide;
- Salicylates e.g. aspirin.
Do not take Pyralin EN if you have the following medical conditions:
- Kidney or liver problems;
- Any form of blood disorder;
- Any form of intestinal or urinary obstruction;
- Porphyria ( a rare disease of blood pigments).
If you are not sure about any of the above, ask your doctor.
Do not take Pyralin EN if:
- The packaging is torn or shows signs of tampering or the tablets do not look quite right;
- The expiry date (Exp.) on the carton has passed. If you take this medicine after the expiry date has passed, it may not work as well.
Do not give Pyralin EN to children under two years of age.
Do not take Pyralin EN to treat any other complaints unless your doctor says to.
See your doctor for a checkup before you start to take Pyralin EN.
Before you start taking Pyralin EN
Tell your doctor if you:
- Are pregnant or trying to become pregnant;
- Are breastfeeding or plan to breastfeed.
Your doctor will discuss the possible risks and benefits of taking Pyralin EN during pregnancy and breastfeeding.
- Are allergic to any other medicines or any other substances such as foods, preservatives or dyes;
- Have a glucose-6-phosphate dehydrogenase (G-6-P) deficiency. This is a rare blood disorder which means that your body cannot get rid of some medicines;
- Have bronchial asthma (wheezing or shortness of breath);
- Have a history of recurring or chronic infections.
If you have not told your doctor about any of the above, tell them before you start taking Pyralin EN.
Your doctor will send you to have blood tests to help assess your liver and kidney function and the levels of various cells in your bloodstream before you start treatment with Pyralin EN. You may also have a urine test to monitor your kidney function.
Your doctor will also send you to have the tests repeated at various times during your treatment with Pyralin EN.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including medicines you buy without a prescription from a pharmacy, supermarket or health food shop.
There may be interference between Pyralin EN and some other medicines including:
- Oral medicines used to prevent blood clots e.g. warfarin;
- Methotrexate, a medicine used to treat arthritis and some cancers;
- Medicines to lower blood sugar or control diabetes;
- Mercaptopurine and azathioprine, medicines used to treat some cancers;
- Antacids, medicines that help to control heartburn or symptoms of indigestion;
- Digoxin, a medicine used to treat heart failure;
- Oxyphenbutazone, phenylbutazone, indomethacin, and sulfinpyrazone which are medicines used to treat arthritis and gout;
- Salicylates, a medicine used to treat minor relief of pain e.g. aspirin;
- Oxacillin and penicillins, which are types of antibiotics;
- Certain local anaesthetics;
- Medicines used to make the urine more acidic;
- Iron tablets.
These medicines may be affected by Pyralin EN or may affect how well it works. You may need different amounts of your medicine or you may need to take different medicines. Your doctor or pharmacist has more information on medicines to be careful with or to avoid while taking Pyralin EN.
How to take Pyralin EN
Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained here.
If you do not understand the instructions on the box, ask your doctor or pharmacist for help.
How much to take
Your doctor will tell you how many tablets you need to take each day. This may depend on your age, your condition and whether or not you are taking any other medicines.
Inflammatory bowel disease
Pyralin EN tablets are usually taken after meals at evenly spaced intervals over a 24 hour period.
Adults: The usual initial dose is 2 to 4 tablets, four times a day. The usual maintenance dose is 4 tablets a day.
Children: Your doctor will determine the proper dose, taking into account the age and weight of the child.
Adults: The usual dose is 2 tablets, two to three times a day. It is usual to start taking Pyralin EN at a lower dose and gradually increase. Your doctor will advise whether you should do this and how to do this.
Pyralin EN is not recommended for treating rheumatoid arthritis in children.
How to take it
Pyralin EN should be swallowed whole after meals with a full glass of water.
It is important to maintain adequate fluid intake while taking Pyralin EN.
Do not crush, break or chew Pyralin EN tablets.
How long to take it
Continue taking Pyralin EN for as long as your doctor recommends.
If you forget to take it
If you forget to take your Pyralin EN take your next dose at the normal time it is due.
Do not try to make up for missed doses by taking more than one dose at a time because this may increase the chance of you getting an unwanted side effect.
If you have trouble remembering when to take your medicine, ask your pharmacist for some hints.
If you take too much (overdose)
Immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26) for advice, or go to Accident and Emergency at your nearest hospital if you think you or anyone else may have taken too much Pyralin EN. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
The symptoms of taking too many Pyralin EN tablets may include stomach discomfort and other effects listed under “Side effects”.
While taking Pyralin EN
Things you must do
Advise your doctor immediately if you notice any unusual symptoms.
Ensure you drink plenty of fluids while on Pyralin EN.
Tell your doctor immediately if you become pregnant while taking Pyralin EN.
Tell all doctors, dentists, and pharmacists who are treating you that you are taking Pyralin EN.
If you are about to start taking any new medicines, tell your doctor or pharmacist that you are taking Pyralin EN.
If you are going to have surgery, tell the surgeon or anaesthetist that you are taking this medicine. It may affect other medicines used during surgery.
Tell your doctor that you are taking this medicine if you are about to have any blood or urine tests. It may interfere with the results of some tests.
Make sure that you keep all doctor’s appointments for check-ups and any tests that your doctor may order for you while you are taking Pyralin EN.
Protect your skin when you are in the sun, especially between 10 am and 3 pm. Pyralin EN may cause your skin to be more sensitive to sunlight than it is normally. If outdoors, wear protective clothing and use a 15+ sunscreen. If your skin does appear to be burning, tell your doctor immediately. Exposure to sunlight may cause a skin rash, itching, redness or severe sunburn.
Things you must not do
Do not take Pyralin EN to treat any other complaints unless your doctor tells you to.
Do not stop taking Pyralin EN or change the dose without first checking with your doctor.
Do not give Pyralin EN to anyone else even if they have the same condition as you.
Things to be careful of
Be careful driving or operating machinery until you know how Pyralin EN affects you. This medicine may cause dizziness or hallucinations in some people. If you have any of these symptoms, do not drive, operate machinery or do anything else that could be dangerous.
After taking Pyralin EN
Keep your tablets where children cannot reach them. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Your Pyralin EN tablets should be stored in their original container in a cool, dry place where the temperature stays below 25°C. If you take your tablets out of their bottle, they may not keep as well.
Make sure the container is closed after use.
Do not store Pyralin EN or any other medicine in a bathroom or near a sink. Do not leave them in the car or on window sills. Heat and dampness can destroy medicines.
If your doctor tells you to stop taking Pyralin EN, or the tablets have passed their expiry date, ask your pharmacist what to do with any tablets left over.
Schedule of Pyralin EN
Pyralin EN is a Schedule 4 – prescription only medicine.
Side effects of Pyralin EN
Check with your doctor as soon as possible if you have any concerns while taking Pyralin EN, even if you do not think the concerns are connected with the medicine or are not listed here. All medicines can have side effects and Pyralin EN may have unwanted side effects in a few people. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if
Tell your doctor if you notice any of the following and they worry you:
- Nausea and vomiting;
- Loss of appetite;
- Raised temperature;
- Sore throat;
- Enlarged glands;
- Stomach pains;
- Change in sense of smell or taste;
- Ringing in the ears;
- Increased sensitivity to light;
If these effects do not go away or they are worrying to you, tell your doctor.
Tell your doctor as soon as possible if
Tell your doctor as soon as possible if you notice any of the following:
- Chest pain;
- Redness and itchiness of the skin;
- Allergic reactions;
- Swelling of the face;
- Loss of hair;
- Signs of liver disease such as yellowing of skin and eyes and dark coloured urine;
- Severe pain in the loins or pain on urination.
The above list includes serious side effects that may require medical attention.
Go to hospital if
If you get a sore throat, fever, pallor, rash and yellow skin tell your doctor immediately. This may mean that you have a serious blood disorder and need urgent medical care.
Other side effects not listed above may also occur in some people. These can only be found when your doctor does tests. These include blood cell changes, reversible low sperm count, swelling of the pancreas, swelling in the mouth, impaired folic acid absorption, peripheral neuropathy and neuritis (which cause tingling, burning or numbness in the hands or feet), changes in kidney function and lung complications.
The above is not a complete list of all possible side effects. Some people may get other side effects while taking Pyralin EN. It is very important to tell your doctor immediately if you notice any side effects while taking Pyralin EN.
It is also important to keep all doctor’s appointments.
For further information talk to your doctor.