Sulfasalazine

Date: November 2024, Version 4.0

Quick read

Sulfasalazine can be used in pregnancy if recommended by a specialist.

What is it?

Sulfasalazine (Salazopyrin®) is used to treat ulcerative colitis, Crohn’s disease, and rheumatoid arthritis.

Benefits

What are the benefits of taking sulfasalazine in pregnancy?

Use of sulfasalazine can keep autoimmune conditions under control and help you stay well. Good control of your illness may also reduce the risk of some adverse pregnancy outcomes, including miscarriage and your baby having a low birth weight.

Risks

Are there any risks of taking sulfasalazine during pregnancy?

There are no clear risks of taking sulfasalazine in pregnancy. Sulfasalazine can reduce your folic acid levels so you will be offered high dose folic acid if you are taking sulfasalazine during pregnancy or if you are planning to conceive.

Alternatives

Are there any alternatives to taking sulfasalazine in pregnancy?

Possibly. Other drugs work in a similar way to sulfasalazine. However, if sulfasalazine is working for you, your doctor may advise that staying on it is the best option.

No treatment

What if I prefer not to take medicines in pregnancy?

It is important to continue medicines to treat autoimmune disease in pregnancy to avoid serious complications for you and your baby.

Will my baby need extra monitoring during pregnancy?

Women in the UK should be offered a very detailed scan at around 20 weeks of pregnancy as part of their routine antenatal care. Taking sulfasalazine in pregnancy is not expected to cause problems that would require extra monitoring of your baby. However, women with the illnesses that sulfasalazine is used to treat may be more closely monitored during pregnancy to ensure that they remain well throughout and that their baby is growing and developing as expected.

Are there any risks to my baby if the father has taken sulfasalazine?

Only a few men (less than 100) who were taking sulfasalazine around the time of conception have been studied. The findings do not raise concern of a link with birth defects or miscarriage.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.