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Recommendations made
pediatrician - Dr. Victоr Аbdоw
Rоckville, МD, USА.


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Is it allowed to take Sulfasalazine during lactation?
Is it safe for a nursing mother and a child?

Prodrug of Mesalazine: medication compounded by union of Sulfapyridine and 5-ASA which is degraded into Mesalazine by bacteria in the large intestine. Mesalazine is badly absorbed by the intestine, serum levels are low with scant excretion into breast milk. Inactive metabolite N-acetyl-5-ASA was found in small amount in the milk with a relative infant dose not higher than 10%. No harm effects among breastfed infants from treated mothers have been reported, except for rare cases of diarrhea reported in the 80's with the use of Sulfasalazine. In a review of 121 cases and 121 controls, the authors failed to observe those findings. (Moretti, 1989). Expert consensus supports the compatibility of Mesalazine and/or its prodrugs during breastfeeding. Sulfapyridine released in the large intestine is 60% absorbed with a protein-binding capacity of 90%, both being a reason for low excretion into breast milk. Mesalazine derivatives that not contain Sulfapyridine are recommended by some authors for use while breastfeeding (see alternative drugs).

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Types of risk

VERY LOW RISK
It is allowed while breastfeeding. It is not dangerous for a baby. It is moderately safe. more...

LOW RISK PROBABLE
Possible presence in breast milk is allowed. Follow the doctor's recommendation. more...

HIGH RISK PROBABLE
An unsafe drug, it is necessary to assess the risks while taking. Use safer analogs. more...

VERY HIGH RISK
It is not recommended. You need to stop breastfeeding or choose a safe analog. more...

Scientific literature

The level of risk for breastfeeding is confirmed in these scientific publications:
  1. http://www.ncbi.nlm.nih.gov/pubmed/26750124
  2. http://rheumatology.oxfordjournals.org/content/early/2016/01/12/rheumatology.kev404.full.pdf
  3. http://www.ncbi.nlm.nih.gov/pubmed/26888948
  4. http://ard.bmj.com/content/early/2016/02/17/annrheumdis-2015-208840.full.pdf
  5. http://www.ncbi.nlm.nih.gov/pubmed/26688268
  6. http://www.gastrojournal.org/article/S0016-5085(15)01773-4/pdf
  7. http://www.ncbi.nlm.nih.gov/pubmed/25602023
  8. http://ecco-jcc.oxfordjournals.org/content/eccojc/9/2/107.full.pdf
  9. http://www.ncbi.nlm.nih.gov/pubmed/26129693
  10. http://www.ncbi.nlm.nih.gov/pubmed/24614280
  11. http://www.ncbi.nlm.nih.gov/pubmed/23897285
  12. http://www.ncbi.nlm.nih.gov/pubmed/24625373
  13. http://www.pdr.net/drug-summary/azulfidine?druglabelid=1862
  14. http://www.ncbi.nlm.nih.gov/pubmed/24707132
  15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974516/pdf/WJG-20-3495.pdf
  16. http://www.ncbi.nlm.nih.gov/pubmed/25200000
  17. http://onlinelibrary.wiley.com/doi/10.1111/apt.12949/epdf
  18. http://www.ncbi.nlm.nih.gov/pubmed/23897285
  19. http://www.ncbi.nlm.nih.gov/pubmed/23474350
  20. http://www.dldjournalonline.com/article/S1590-8658(13)00050-9/pdf
  21. http://www.ncbi.nlm.nih.gov/pubmed/23749699
  22. http://medwiekurozwoj.pl/articles/2013-1-10.pdf
  23. http://www.ncbi.nlm.nih.gov/pubmed/23749699
  24. http://www.ncbi.nlm.nih.gov/pubmed/22690068
  25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369996/pdf/WJG-18-2600.pdf
  26. http://www.ncbi.nlm.nih.gov/pubmed/22221203
  27. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04967.x/epdf
  28. http://www.ncbi.nlm.nih.gov/pubmed/22772888
  29. http://www.ncbi.nlm.nih.gov/pubmed/22387837
  30. http://pdf.medrang.co.kr/Kjg/059/Kjg059-02-05.pdf
  31. http://www.ncbi.nlm.nih.gov/pubmed/21985166
  32. http://www.ncbi.nlm.nih.gov/pubmed/21371350
  33. http://www.ncbi.nlm.nih.gov/pubmed/21144482
  34. http://www.ncbi.nlm.nih.gov/pubmed/21122553
  35. http://ecco-jcc.oxfordjournals.org/content/eccojc/4/5/493.full.pdf
  36. http://www.ncbi.nlm.nih.gov/pubmed/20671559
  37. http://www.ncbi.nlm.nih.gov/pubmed/21122490
  38. http://www.ncbi.nlm.nih.gov/pubmed/21172284
  39. http://download.journals.elsevierhealth.com/pdfs/journals/1873-9946/PIIS1873994609000269.pdf
  40. http://www.ncbi.nlm.nih.gov/pubmed/18799245
  41. http://www.ncbi.nlm.nih.gov/pubmed/18799245
  42. http://www.ncbi.nlm.nih.gov/pubmed/17599074
  43. http://www.ncbi.nlm.nih.gov/pubmed/18239407
  44. http://www.ncbi.nlm.nih.gov/pubmed/17661756
  45. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2007.03397.x/epdf
  46. http://www.ncbi.nlm.nih.gov/pubmed/17599074
  47. http://www.ncbi.nlm.nih.gov/pubmed/16831611
  48. http://www.gastrojournal.org/article/S0016-5085(06)00865-1/pdf
  49. http://www.ncbi.nlm.nih.gov/pubmed/16712713
  50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1526635/pdf/ar1957.pdf
  51. http://www.ncbi.nlm.nih.gov/pubmed/15591526
  52. http://www.ncbi.nlm.nih.gov/pubmed/16194696
  53. http://www.ncbi.nlm.nih.gov/pubmed/14752725
  54. http://www.ncbi.nlm.nih.gov/pubmed/12721680
  55. http://www.ncbi.nlm.nih.gov/pubmed/12833232
  56. http://whqlibdoc.who.int/hq/2002/55732.pdf
  57. http://www.ncbi.nlm.nih.gov/pubmed/11533352
  58. http://pediatrics.aappublications.org/content/108/3/776.full.pdf
  59. http://www.ncbi.nlm.nih.gov/pubmed/11847854
  60. http://www.ncbi.nlm.nih.gov/pubmed/10724046
  61. http://archinte.jamanetwork.com/data/Journals/INTEMED/11959/ira90005.pdf
  62. http://www.collectionscanada.gc.ca/obj/s4/f2/dsk1/tape11/PQDD_0010/MQ40845.pdf
  63. http://www.ncbi.nlm.nih.gov/pubmed/9928503
  64. http://www.ncbi.nlm.nih.gov/pubmed/23282454
  65. http://www.ncbi.nlm.nih.gov/pubmed/8809243
  66. http://www.ncbi.nlm.nih.gov/pubmed/8009971
  67. http://www.ncbi.nlm.nih.gov/pubmed/8408729
  68. http://www.ncbi.nlm.nih.gov/pubmed/8102746
  69. http://www.ncbi.nlm.nih.gov/pubmed/1285866
  70. http://www.ncbi.nlm.nih.gov/pubmed/1288560
  71. http://www.ncbi.nlm.nih.gov/pubmed/2309691
  72. http://www.ncbi.nlm.nih.gov/pubmed/2563532
  73. http://www.ncbi.nlm.nih.gov/pubmed/2657891
  74. http://www.ncbi.nlm.nih.gov/pubmed/2882643
  75. http://www.ncbi.nlm.nih.gov/pubmed/2892343
  76. http://www.ncbi.nlm.nih.gov/pubmed/3101825
  77. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1245238/pdf/bmjcred00004-0046.pdf
  78. http://www.ncbi.nlm.nih.gov/pubmed/2870147
  79. http://www.ncbi.nlm.nih.gov/pubmed/2864155
  80. http://www.ncbi.nlm.nih.gov/pubmed/6108198
  81. http://www.ncbi.nlm.nih.gov/pubmed/44005
  82. http://www.ncbi.nlm.nih.gov/pubmed/43760

Comments  

+3 #2 Reviewer: kene, 55-64 Male (Patient) 2018-12-19 05:06
Just started taking mediacation
+3 #1 Reviewer: Erisman, 45-54 on Treatment for 1 to 6 months (Patient) 2017-05-31 11:21
Overall pain has decreased to almost none, but feel like I just got done with 10 rounds of boxing, or just ran 20 miles, my legs and feet feel like they are full of lead takes every bit of energy I have to take 20 steps, I have never felt so wore out and exhausted in my life, has anyone else felt this way?

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