Medication · aminosalicylate

Supplements and Sulfasalazine.

Every documented pair, every citation. Below: 2 documented pairs grouped by mechanism.

Sulfasalazine, sold under the brand names Salazopyrin EN-tabs, Salazopyrin, Azulfidine, is an aminosalicylate: it acts topically on inflamed colonic mucosa in inflammatory bowel disease.

Sulfasalazine is an aminosalicylate (5-ASA), used in ulcerative colitis and some forms of Crohn disease. The class acts locally on inflamed colonic mucosa, with mesalazine as the dominant agent in current UK prescribing. Sulfasalazine remains in use for rheumatoid arthritis. Mechanism is local inhibition of prostaglandin and leukotriene synthesis at the colonic epithelium. The supplement surface is small because the drug acts locally with limited systemic absorption. Folate depletion can occur with sulfasalazine (the sulpha moiety competes with folate metabolism), and folate supplementation is sometimes given alongside. Iron deficiency is common in active inflammatory bowel disease and may need supplementation, with the standard separation rules for oral iron and oral 5-ASA. Probiotic use during active IBD is studied but the evidence base for specific strains remains modest. NSAIDs warrant care given the IBD relapse signal.

Below are the 2 documented pairs we have explicitly assessed against Sulfasalazine in the Distil database: 2 amber. The pairs cluster around 1 mechanism: Absorption interference. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.

Documented interactions

Last reviewed 14 June 2026. Each interaction below is assessed against PubMed-indexed evidence.

Absorption interference

Amber Does Curcumin interact with ?

Curcumin can raise the amount of sulfasalazine absorbed from the gut, which may increase sulfasalazine levels and the chance of its side effects. If you take sulfasalazine, mention any curcumin or turmeric supplement to your GP or rheumatology team rather than adding it silently.

Evidence: Supported by human study data.

PMID 25587128 · PMID 29358184 · BNF: Sulfasalazine

Amber Does Folate interact with ?

Sulfasalazine reduces how well the gut absorbs folate, so people on it long-term can become low in folate. This is a reason to supplement rather than avoid, and folate is often recommended for people taking sulfasalazine, particularly for inflammatory bowel disease or rheumatoid arthritis. There is no need to space the doses apart in a complicated way: the issue is ongoing absorption, so the usual approach is simply to take a folate supplement and let your prescriber keep an eye on your folate level.

Evidence: Supported by human study data.

PMID 6113848 · PMID 23295695 · BNF: Sulfasalazine

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP or pharmacist, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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