Drug interactions
Sulphasalazine + Warfarin
Severity: Moderate
Sulphasalazine and Warfarin: 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 has been reported to increase the anticoagulant effect of warfarin in some patients, raising INR and bleeding risk. The evidence is limited to case reports and the mechanism is uncertain.
What this interaction means in plain words
Sulphasalazine and Warfarin 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.
Sulphasalazine belongs to Gastrointestinal Tract; Warfarin belongs to Cardiovascular.
Why it happens
Mechanism is not firmly established; possible displacement from protein binding or altered vitamin K handling by gut flora changes.
What to do
Check INR when starting, changing or stopping sulfasalazine, and adjust warfarin dose according to results.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Sulphasalazine and Warfarin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Frequently asked questions
Can I take Sulphasalazine with Warfarin?
MediHelp rates the interaction as moderate. Sulphasalazine and Warfarin 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 has been reported to increase the anticoagulant effect of warfarin in some patients, raising INR and bleeding risk. The evidence is limited to case reports and the mechanism is uncertain.
How serious is the interaction between Sulphasalazine and Warfarin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check INR when starting, changing or stopping sulfasalazine, and adjust warfarin dose according to results.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
