Supplements and Sulfasalazine.
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 lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
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.
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.
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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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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