blood dyscrasias and sulphasalazine
Last reviewed 01/2018
Sulphasalazine should be stopped immediately there is suspicion of a blood dyscrasia. It is recommended that full blood counts are performed before treatment and monthly for the first 3 months of therapy.
Blood dyscrasias account for 19% of all reported reactions to sulphasalzine:
- leukopenia occurs in up to 1.5%
- agranulocytosis has a peak incidence of 1 in 700 during the second month of therapy
CSM reports:
- 191 reports of neutropenia, leukopenia or agranulocytosis - 22 fatal
- 44 reports of bone marrow depression or aplastic anaemia - 13 fatal
- 30 reports of thrombocytopenia - 1 fatal
Reactions were reported:
- within 3 months of starting in 14 patient
- 3-6 months in 6 patients
- 6-11 months in 2 patients
Reference:
- Current Problems (1993). CSM, 19, 6
- Amos RS et al (1986). BMJ, 420-3
- Keisu M and Ekman E (1992). Eur J.Clin Pharm, 43, 215-218