INFO - Sulfasalazine-induced taste disorders

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December 2002

http://www.lareb.nl/documents/kwb_2002_3_sulfa.pdf

Excerpt:

Sulfasalazine-induced taste disorders

Introduction

Sulfasalazine in an azo ester of sulfapyridine and 5-aminosalicylic acid

(mesalamine, 5-ASA). H+-azoreductase, a bacterial enzyme present in the

colon, splits sulfasalazine into equimolar amounts of sulfapyridine and

5-aminosalicylic acid. Sulfapyridine is thought to be responsible for its

anti-rheumatic properties, 5-ASA is thought to be the major therapeutically

active part in the treatment of ulcerative colitis. The Medicines Evaluation

Board approved sulfasalazine in March 1969. Nowadays it is approved for the

indications ulcerative colitis, Crohns disease and progressive rheumatoid

arthritis [1].

Dose related nausea and vomiting are common as well as headache, abdominal

pain, anorexia and reversible oligospermia. Adverse reactions are frequent

and the discontinuation rate for this reason can be as high as 30% [2].

Gastrointestinal adverse reactions occur more commonly in slow acetylators,

and these patients should receive lower doses [2].

Reports

Until September 2002 the Netherlands Pharmacovigilance Centre Lareb received

seven reports concerning sulfasalazine in suspected association with taste

disorders. An overview of the reports that have been received by Lareb is

provided in Table 1. Although paracetamol, indomethacin, ibuprofen,

diclofenac and misoprostol as concomitant medication have been associated

with taste disorders, the time of onset of the suspected ADRs in these

patients is strongly suggestive for a relationship with sulfasalazine [3].

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Mayo Clinic in Rochester

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s Hopkins Medicine

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