Drug interactions
Folic acid + Sulphasalazine
Severity: Moderate
Folic acid and Sulphasalazine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Sulfasalazine inhibits absorption of dietary and supplemental folate and can also interfere with folate metabolism, which may lead to folate deficiency and macrocytic anemia. This is why supplementation is often given alongside it.
What this interaction means in plain words
Folic acid and Sulphasalazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Folic acid belongs to Miscellaneous; Sulphasalazine belongs to Gastrointestinal Tract.
Why it happens
Impaired intestinal folate absorption and inhibition of folate-conjugase and related folate metabolism by sulfasalazine.
What to do
Monitor full blood count and folate status during long-term therapy. Give folic acid supplementation if deficiency or macrocytosis develops.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Sulphasalazine
- Deferiprone + Sulphasalazine Major
- Pexidartinib + Sulphasalazine Major
- Sepiapterin + Sulphasalazine Major
- Acalabrutinib + Sulphasalazine Moderate
- Aceclofenac + Sulphasalazine Moderate
- Asciminib + Sulphasalazine Moderate
Other interactions of Folic acid
- Ethotoin + Folic acid Moderate
- Folic acid + Fosphenytoin Moderate
- Folic acid + Glucarpidase Moderate
- Folic acid + Methotrexate Moderate
- Folic acid + Pafolacianine Moderate
- Folic acid + Phenobarbital Moderate
Frequently asked questions
Can I take Folic acid with Sulphasalazine?
MediHelp rates the interaction as moderate. Folic acid and Sulphasalazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Sulfasalazine inhibits absorption of dietary and supplemental folate and can also interfere with folate metabolism, which may lead to folate deficiency and macrocytic anemia. This is why supplementation is often given alongside it.
How serious is the interaction between Folic acid and Sulphasalazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor full blood count and folate status during long-term therapy. Give folic acid supplementation if deficiency or macrocytosis develops.
What other medicines interact with Sulphasalazine?
MediHelp also lists interactions of Sulphasalazine with, for example, Deferiprone, Pexidartinib, Sepiapterin. The full list is on the Sulphasalazine page.
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