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Folbic RF and Sulfazine EC

Determining the interaction of Folbic RF and Sulfazine EC and the possibility of their joint administration.

Check result:

Folbic RF <> Sulfazine EC

Relevance: 25.11.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

Sulfasalazine may impair the intestinal absorption and/or metabolism of folic acid to its physiologically useful form. Folate deficiency, sometimes manifested as megaloblastic or macrocytic anemia, has been reported in patients treated chronically with sulfasalazine. However, those patients generally had inflammatory bowel disease or other risk factors for folate deficiency such as celiac disease, rheumatoid arthritis, or nutritional deficiencies. In healthy patients, the anti-folate effect of sulfasalazine is generally not associated with clinically significant hematologic changes. Data from one study suggested a dose-dependent effect. Specifically, patients with chronic colitis receiving 2 grams or more of sulfasalazine daily had lower mean red blood cell folate levels than patients taking less or nonusers of sulfasalazine (221.2 ng/mL vs 371.7 ng/mL and 330.3 ng/mL, respectively). In any case, clinicians should be mindful of the potential interaction with sulfasalazine in patients receiving folic acid supplementation. Those not responding to folic acid may require folinic acid, whose action is not inhibited by sulfasalazine.

References

Elsborg L, Larsen L "Folate deficiency in chronic inflammatory bowel diseases." Scand J Gastroenterol 14 (1979): 1019-24
Swinson C, Perry J, Lumb M, Levi AJ "Role of sulphasalazine in the aetiology of folate deficiency in ulcerative colitis." Gut 22 (1981): 456-61
Logan EC, Williamson LM, Ryrie DR "Sulphasalazine associated pancytopenia may be caused by acute folate deficiency." Gut 27 (1986): 868-72
Hopkinson ND, Garcia FS, Gumpel JM "Haematological side-effects pf sulphasalazine in inflammatory arthritis." Br J Rheumatol 28 (1989): 414-7
Darcy-Vrillon B, Selhub J, Rosenberg IH "Analysis of sequential events in intestinal absorption of folylpolyglutamate." Am J Physiol 255 (1988): g361-6
Spinel E "Sulfasalazine and folate deficiency." JAMA 250 (1983): 900
Zimmerman J "Drug intractions in intestinal transport of folic acid and methotrexate." Biochem Pharmacol 44 (1992): 1839-42
Robenberg IH "Drugs and folic acid absorption." Gastroenterology 63 (1972): 353-7
"Sulfasalazine inhibits folate absorption." Nutr Rev 46 (1988): 320-3
Longstreth G, Green R "Folate status in patients receiving maintenance doses of sulfasalazine." Arch Intern Med 143 (1983): 902-4
Goldberg J "Sulfasalazine and folate deficiency." JAMA 249 (1983): 729
Franklin J, Rosenberg HH "Impaired folic acid absorption in inflammatory bowel disease: effects of salicylazosulfapyridine (Azulfidine)." Gastroenterology 64 (1973): 517-25
Baum CL, Selhub J, Rosenberg Ihl "Antifolate actions of sulfasalazine on intact lymphocytes." J Lab Clin Med 97 (1981): 779-84
Selhub J, Dhar GJ, Rosenberg IH "Inhibition of folate enzymes by sulfasalazine." J Clin Invest 61 (1978): 221-4
Halsted CH, Gandhi G, Tamura T "Sulfasalazine inhibits the absorption of folates in ulcerative colitis." N Engl J Med 305 (1981): 1513-7

Folbic RF

Generic Name: l-methylfolate

Brand name: Deplin, L-Methylfolate Formula, XaQuil XR, L-Methylfolate Formula 75

Synonyms: L-methylfolate, Methylfolate

What is Folbic RF?

Sulfazine EC

Generic Name: sulfasalazine

Brand name: Azulfidine, Azulfidine EN-tabs, Sulfazine

Synonyms: Sulfazine

What is Sulfazine EC?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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