Generic name: albuterol (inhalation route) [ al-BUE-ter-ol ]
Drug class: Adrenergic bronchodilators

Medically reviewed by Drugs.com. Last updated on Jan 7, 2023.

Commonly used brand name(s)

In the U.S.

• Accuneb
• ProAir Digihaler
• ProAir HFA
• Proair Respiclick
• Proventil
• Proventil HFA
• ReliOn Ventolin HFA
• Ventolin
• Ventolin HFA

In Canada

• Alti-Salbutamol Inhalation Aerosol
• Apo-Salvent
• Salbutamol
• Salbutamol Nebuamp
• Salbutamol Respirator Solution
• Ventolin Inhaler
• Ventolin Nebules P.F.
• Ventolin Respirator
• Ventolin Rotacaps

Available Dosage Forms:

• Powder
• Solution
• Suspension

Therapeutic Class: Bronchodilator

Pharmacologic Class: Beta-2 Adrenergic Agonist

Uses for Alti-Salbutamol Inhalation Aerosol

Albuterol is used to treat or prevent bronchospasm in patients with asthma, bronchitis, emphysema, and other lung diseases. It is also used to prevent bronchospasm caused by exercise.

Albuterol belongs to the family of medicines known as adrenergic bronchodilators. Adrenergic bronchodilators are medicines that are breathed in through the mouth to open up the bronchial tubes (air passages) in the lungs. They relieve cough, wheezing, and trouble breathing by increasing the flow of air through the bronchial tubes.

This medicine is available only with your doctor''s prescription.

Before using Alti-Salbutamol Inhalation Aerosol

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of ProAir® Digihaler™, ProAir® HFA, ProAir® Respiclick®, Proventil® HFA, and Ventolin® HFA in children 4 years of age and older and Accuneb® in children 2 years of age and older. However, safety and efficacy have not been established for ProAir® Digihaler™, ProAir® HFA, ProAir® Respiclick®, Proventil® HFA, and Ventolin® HFA in children younger than 4 years of age and Accuneb® in children younger than 2 years of age.

Geriatric

Appropriate studies have not been performed on the relationship of age to the effects of Proventil® HFA in the geriatric population. However, elderly patients are more likely to have age-related heart problems, which may require caution in the dose for patients receiving Proventil® HFA.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ProAir® Digihaler™, ProAir® HFA, ProAir® Respiclick®, and Ventolin® HFA in geriatric patients. However, elderly patients are more likely to have age-related heart, kidney, or liver problems, which may require caution and an adjustment in the dose for patients receiving ProAir® Digihaler™, ProAir® HFA, ProAir® Respiclick®, and Ventolin® HFA.

No information is available on the relationship of age to the effects of albuterol inhalation solution (eg, Accuneb®) in geriatric patients.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acebutolol
• Amineptine
• Amitriptyline
• Amitriptylinoxide
• Amoxapine
• Atenolol
• Atomoxetine
• Bemetizide
• Bendroflumethiazide
• Benzthiazide
• Betaxolol
• Bisoprolol
• Bumetanide
• Carteolol
• Carvedilol
• Celiprolol
• Chlorothiazide
• Chlorthalidone
• Clomipramine
• Clopamide
• Cyclopenthiazide
• Cyclothiazide
• Desipramine
• Diazoxide
• Dibenzepin
• Digoxin
• Doxepin
• Esmolol
• Ethacrynic Acid
• Etozolin
• Furosemide
• Hydrochlorothiazide
• Hydroflumethiazide
• Imipramine
• Indapamide
• Iobenguane I 123
• Isocarboxazid
• Labetalol
• Levalbuterol
• Levobunolol
• Linezolid
• Lofepramine
• Melitracen
• Methacholine
• Methyclothiazide
• Methylene Blue
• Metipranolol
• Metolazone
• Metoprolol
• Nadolol
• Nebivolol
• Nortriptyline
• Opipramol
• Oxprenolol
• Ozanimod
• Penbutolol
• Phenelzine
• Pindolol
• Piretanide
• Polythiazide
• Procarbazine
• Propranolol
• Protriptyline
• Quinethazone
• Rasagiline
• Safinamide
• Selegiline
• Sotalol
• Tianeptine
• Timolol
• Torsemide
• Tranylcypromine
• Trichlormethiazide
• Trimipramine
• Xipamide

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy to milk proteins, history or—ProAir® Digihaler™ and ProAir® Respiclick® should not be used in patients with this condition.

• Diabetes or
• Heart or blood vessel disease (eg, coronary insufficiency) or
• Heart rhythm problems (eg, arrhythmia, QT prolongation) or
• Hypertension (high blood pressure) or
• Hyperthyroidism (overactive thyroid) or
• Hypokalemia (low potassium in the blood) or
• Ketoacidosis (high ketones in the blood) or
• Seizures, history of—Use with caution. May make these conditions worse.

• Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper use of Alti-Salbutamol Inhalation Aerosol

This section provides information on the proper use of a number of products that contain albuterol. It may not be specific to Alti-Salbutamol Inhalation Aerosol. Please read with care.

Use this medicine only as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. Also, do not stop using this medicine or any asthma medicine without telling your doctor. To do so may increase the chance for breathing problems.

The albuterol inhalation solution (eg, Accuneb®) should be used with a jet nebulizer that is connected to an air compressor with good air flow. The inhalation solution and nebulizer will come with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

To use the inhalation solution in the nebulizer:

• Use one container of solution or mix the exact amount of solution using the dropper provided for each dose.
• Place the inhalation solution in the medicine reservoir or nebulizer cup on the machine.
• Connect the nebulizer to the face mask or mouthpiece.
• Use the face mask or mouthpiece to breathe in the medicine.
• Use the nebulizer for about 5 to 15 minutes, or until the medicine in the nebulizer cup is gone.
• Clean all the parts of the nebulizer after each use.

The albuterol inhalation aerosol (eg, ProAir® HFA, Proventil® HFA, Ventolinr® HFA) and albuterol inhalation powder (eg, ProAir® Digihaler™, ProAir® Respiclick®) are used with a special inhaler that comes with patient instructions. Read the directions carefully before using this medicine. If you or your child do not understand the directions or are not sure how to use the inhaler, ask your doctor to show you what to do. Also, ask your doctor to check regularly how you or your child use the inhaler to make sure you are using it properly.

To use the inhalation aerosol:

• The inhaler should be at room temperature before you use it.
• Insert the metal canister firmly and fully into the actuator. This actuator should not be used with other inhaled medicines.
• Remove the cap and look at the mouthpiece to make sure it is clean.
• Point the inhaler away from your face. Avoid spraying in your eyes. Shake the inhaler well and test spray it in the air 3 times for ProAir® HFA or 4 times for Proventil® HFA and Ventolin® HFA before using it for the first time or if the inhaler has not been used for more than 2 weeks.
• To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece just in front of your mouth with the canister upright.
• Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down once on the top of the canister.
• Hold your breath for about 10 seconds, then breathe out slowly.
• If you are supposed to use more than one puff, wait 1 minute before inhaling the second puff. Repeat these steps for the second puff, starting with shaking the inhaler.
• When you have finished all of your doses, rinse your mouth with water and spit the water out.
• Clean the inhaler mouthpiece at least once a week with warm running water for 30 seconds, and air dry it completely.
• If you need to use the inhaler before it is completely dry, shake off the excess water, replace the canister, and spray it 2 times in the air away from the face. Use your regular dose.
• After using the inhaler, wash the mouthpiece again and dry it completely.
• If the mouthpiece becomes blocked, washing it will help.
• The Proventil® HFA inhaler has a window that shows the number of doses remaining. This tells you when you are getting low on medicine. The counter will turn red when there are only 20 doses left, to remind you to refill your prescription.

To use the inhalation powder:

• Take the inhaler from the foil pouch before you use it for the first time.
• The inhaler provides about 200 inhalations. The dose counter will change to red when there are "20" doses left. Call your doctor or pharmacist for a refill of prescription or medicine.
• Make sure the cap is closed before using this medicine. Do not open the cap unless you are going to use it.
• Hold the inhaler upright as you open the cap fully until you hear a "click". Your inhaler is now ready to use.
• To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece fully into your mouth and close your lips around it.
• Breathe in through your mouth as deeply as you can until you have taken a full deep breath.
• Do not block the vent above the mouthpiece with your lips or fingers.
• Hold your breath for about 10 seconds or as long as you comfortably can.
• Remove the inhaler from your mouth and check the dose counter to make sure you received the medicine.
• Close the cap firmly over the mouthpiece after using the inhaler. Always close the cap after each use.
• If you are supposed to use more than one puff, repeat these steps for the second puff, starting with opening the cap fully.
• Do not use a spacer or volume holding chamber together with the ProAir® Digihaler™.
• Keep the inhaler clean and dry at all times. Do not wash or put any part of the inhaler in water. Replace the ProAir® Digihaler™ if it has been washed or placed in water.
• If you need to clean the mouthpiece, wipe it gently with a dry cloth or tissue.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor''s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For inhalation aerosol dosage form (inhaler):
  • For treatment or prevention of bronchospasm:
    • Adults and children 4 years of age and older—Two puffs every 4 to 6 hours as needed.
    • Children younger than 4 years of age—Use and dose must be determined by your child''s doctor.
  • For prevention of exercise-induced bronchospasm:
    • Adults and children 4 years of age and older—Two puffs taken 15 to 30 minutes before exercise.
    • Children younger than 4 years of age—Use and dose must be determined by your child''s doctor.
• For inhalation powder dosage form (inhaler):
  • For treatment or prevention of bronchospasm:
    • Adults and children 4 years of age and older—Two puffs every 4 to 6 hours as needed.
    • Children younger than 4 years of age—Use and dose must be determined by your child''s doctor.
  • For prevention of exercise-induced bronchospasm:
    • Adults and children 4 years of age and older—Two puffs taken 15 to 30 minutes before exercise.
    • Children younger than 4 years of age—Use and dose must be determined by your child''s doctor.
• For inhalation solution dosage form (used with a nebulizer):
  • For prevention of bronchospasm:
    • Adults and children older than 12 years of age—2.5 milligrams (mg) in the nebulizer 3 or 4 times per day as needed.
    • Children 2 to 12 years of age—0.63 to 1.25 mg in the nebulizer 3 or 4 times per day as needed.
    • Children younger than 2 years of age—Use and dose must be determined by your child''s doctor.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep the medicine in the foil pouch until you are ready to use it. Store at room temperature, away from heat and direct light. Do not freeze.

Store unopened vials of this medicine at room temperature, away from heat and direct light. Do not freeze. An open vial of medicine must be used right away.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the canister at room temperature, away from heat and direct light. Do not freeze. Do not keep this medicine inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.

Store Proventil® HFA or Ventolin® HFA inhaler with the mouthpiece down.

Throw away the ProAir® Digihaler™ or ProAir® Respiclick® 13 months after opening the foil pouch, when the dose counter reaches "0", or after the expiration date, whichever comes first.

Precautions while using Alti-Salbutamol Inhalation Aerosol

It is very important that your doctor check your or your child''s progress at regular visits. This will allow your doctor to see if the medicine is working properly and to check for any unwanted effects.

Do not use this medicine together with other similar inhaled medicines, including isoproterenol (Isuprel®), levalbuterol (Xopenex™), metaproterenol (Alupent®), pirbuterol (Maxair®), or terbutaline (Brethaire®).

This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. This may be life-threatening. Check with your doctor right away if you or your child have coughing, difficulty breathing, or wheezing after using this medicine.

Talk to your doctor or get medical help right away if:

• Your symptoms do not improve or they become worse after using this medicine.
• Your inhaler does not seem to be working as well as usual and you need to use it more often.

You or your child may also be taking an antiinflammatory medicine, including steroid (cortisone-like medicine), together with this medicine. Do not stop taking the antiinflammatory medicine, even if your asthma seems better, unless your doctor tells you to.

Albuterol may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you or your child develop a skin rash, hives, itching, trouble breathing or swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Hypokalemia (low potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you or your child have decreased urine, dry mouth, increased thirst, irregular heartbeat, loss of appetite, mood changes, muscle pain or cramps, nausea, vomiting, numbness or tingling in the hands, feet, or lips, trouble breathing, seizures, or unusual tiredness or weakness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, and herbal or vitamin supplements.

Alti-Salbutamol Inhalation Aerosol side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Fast, irregular, pounding, or racing heartbeat or pulse
• shakiness in the legs, arms, hands, or feet
• trembling or shaking of the hands or feet

Less common

• Bladder pain
• bloody or cloudy urine
• chest discomfort, tightness, or pain
• chills
• cough
• cough producing mucus
• diarrhea
• difficult or labored breathing
• difficulty with swallowing
• dizziness
• feeling of warmth
• fever
• frequent urge to urinate
• hives, itching, or skin rash
• hoarseness
• loss of appetite
• lower back or side pain
• nausea
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• redness of the face, neck, arms, and occasionally, upper chest
• runny nose
• sore throat
• stomach pain
• swollen, painful, or tender lymph glands in the neck, armpit, or groin
• unusual tiredness or weakness

Rare

• Hives or welts
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
• noisy breathing
• swelling of the mouth or throat

Incidence not known

• Agitation
• arm, back, or jaw pain
• chest heaviness
• confusion
• decreased urine
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• drowsiness
• dry mouth
• extra heartbeat
• fainting
• flushed, dry skin
• fruit-like breath odor
• headache
• increased hunger
• increased thirst
• increased urination
• irritability
• lightheadedness
• muscle pain or cramps
• nervousness
• nightmares
• numbness or tingling in the hands, feet, or lips
• pounding in the ears
• rapid, deep breathing
• restlessness
• seeing, hearing, or feeling things that are not there
• seizures
• slow or fast heartbeat
• stomach cramps
• sweating
• unexplained weight loss
• unusual feeling of excitement
• vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Body aches or pain
• congestion
• voice changes

Less common

• Difficult, burning, or painful urination
• earache
• headache, severe and throbbing
• muscle or bone pain
• pain
• redness or swelling in the ear
• redness, swelling, or soreness of the tongue
• sneezing
• stuffy nose
• swelling
• tenderness
• trouble in holding or releasing urine
• trouble sleeping

Rare

• Sleepiness or unusual drowsiness

Incidence not known

• Bad, unusual, or unpleasant (after) taste
• change in taste
• feeling of constant movement of self or surroundings
• gagging
• rough, scratchy sound to voice
• sensation of spinning
• tightness in the throat

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Frequently asked questions

• Can you use an expired inhaler?
• Does either Ventolin or albuterol contain steroids?
• Does coffee help with asthma?
• What is albuterol sulfate and can I take it if I''m allergic to sulfa?
• How do you use the ProAir Digihaler?

View more FAQ

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Generic name: sulfasalazine (oral route) [ sul-fa-SAL-a-zeen ]
Drug classes: 5-aminosalicylates, Antirheumatics

Medically reviewed by Drugs.com. Last updated on Oct 14, 2022.

Commonly used brand name(s)

In the U.S.

• Azulfidine
• Azulfidine Entabs
• Sulfazine
• Sulfazine EC

In Canada

• alti-sulfaSALAzine
• Salazopyrin

Available Dosage Forms:

• Tablet
• Tablet, Enteric Coated

Therapeutic Class: Gastrointestinal Agent

Chemical Class: Salicylate, Non-Aspirin

Uses for alti-sulfaSALAzine

Sulfasalazine is used to treat and prevent acute attacks of mild to moderate ulcerative colitis. It works inside the bowels by helping to reduce the inflammation and other symptoms of the disease.

Sulfasalazine enteric-coated tablets are used to treat adults and children with rheumatoid arthritis in patients who have not been helped by or who cannot tolerate other medicines (eg, salicylates or NSAIDs) for rheumatoid arthritis.

This medicine is available only with your doctor''s prescription.

Before using alti-sulfaSALAzine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of sulfasalazine tablets and enteric-coated tablets to treat ulcerative colitis in children younger than 2 years of age. Safety and efficacy have not been established in children younger than 2 years of age.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of sulfasalazine enteric-coated tablets to treat juvenile rheumatoid arthritis in children. However, safety and efficacy have not been established in children younger than 6 years of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sulfasalazine in the elderly.

Breastfeeding

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Ketorolac
• Methenamine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aceclofenac
• Acemetacin
• Amoxicillin
• Amtolmetin Guacil
• Azathioprine
• Balsalazide
• Bismuth Subsalicylate
• Bromfenac
• Bufexamac
• Capmatinib
• Celecoxib
• Choline Magnesium Trisalicylate
• Choline Salicylate
• Clonixin
• Darolutamide
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Dipyrone
• Droxicam
• Enasidenib
• Encorafenib
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Furosemide
• Ibuprofen
• Indomethacin
• Ketoprofen
• Leflunomide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Magnesium Salicylate
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Mercaptopurine
• Mesalamine
• Midostaurin
• Morniflumate
• Nabumetone
• Naproxen
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Olsalazine
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Phenyl Salicylate
• Piketoprofen
• Piroxicam
• Porfimer
• Proglumetacin
• Propyphenazone
• Proquazone
• Rofecoxib
• Salicylamide
• Salicylic Acid
• Salsalate
• Sodium Salicylate
• Sulindac
• Tafamidis
• Tenoxicam
• Teriflunomide
• Tiaprofenic Acid
• Tolfenamic Acid
• Tolmetin
• Trolamine Salicylate
• Valdecoxib

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aminolevulinic Acid
• Cyclosporine
• Digoxin
• Eltrombopag
• Warfarin

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy to sulfa drugs or salicylates or
• Bowel blockage or
• Porphyria (enzyme problem) or
• Urinary bladder blockage—Should not be used in patients with these conditions.

• Blood or bone marrow problems (eg, agranulocytosis, aplastic anemia) or
• Heart disease or
• Kidney disease or
• Liver disease or
• Lung or breathing problems (eg, bronchial asthma)—Use with caution. May make these conditions worse.

• Glucose-6-phosphate dehydrogenase (G6PD) deficiency (a hereditary metabolic disorder affecting red blood cells)—May cause hemolytic anemia (blood disorder) in patients with this condition.

• Infection—May decrease your body''s ability to fight infection.

Proper use of alti-sulfaSALAzine

This section provides information on the proper use of a number of products that contain sulfasalazine. It may not be specific to alti-sulfaSALAzine. Please read with care.

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

It is best to take this medicine right after meals, at evenly spaced times throughout the day and night. Try not to let more than 8 hours go by between doses, even at night.

Swallow the enteric-coated tablet whole. Do not crush, break, or chew it.

Drink extra fluids so you will pass more urine while you are using this medicine. This may help prevent kidney problems.

Keep using this medicine for the full time of treatment, even if you begin to feel better after a few days. Do not miss any doses.

While using this medicine, part of the enteric-coated tablet may pass into your stools. This is normal and is nothing to worry about.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor''s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For treatment of ulcerative colitis:
  • For oral dosage form (enteric-coated tablets):
    • Adults—At first, 500 to 1000 milligrams (mg) every 6 to 8 hours per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 4000 mg per day.
    • Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 40 to 60 milligrams (mg) per kilogram (kg) of body weight per day, divided into 3 to 6 doses.
    • Children 2 to 5 years of age—Dose must be determined by your doctor.
    • Children younger than 2 years of age—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • Adults—At first, 500 to 1000 milligrams (mg) every 6 to 8 hours per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 4000 mg per day.
    • Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 40 to 60 milligrams (mg) per kilogram (kg) of body weight per day, divided into 3 to 6 doses.
    • Children 2 to 5 years of age—Dose must be determined by your doctor.
    • Children younger than 2 years of age—Use and dose must be determined by your doctor.
• For maintenance treatment of ulcerative colitis:
  • For oral dosage form (enteric-coated tablets):
    • Adults—2000 milligrams (mg) per day.
    • Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 30 milligrams (mg) per kilogram (kg) of body weight per day, divided into 4 doses.
    • Children 2 to 5 years of age—Dose must be determined by your doctor.
    • Children younger than 2 years of age—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • Adults—2000 milligrams (mg) per day.
    • Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 30 milligrams (mg) per kilogram (kg) of body weight per day, divided into 4 doses.
    • Children 2 to 5 years of age—Dose must be determined by your doctor.
    • Children younger than 2 years of age—Use and dose must be determined by your doctor.
• For treatment of rheumatoid arthritis:
  • For oral dosage form (enteric-coated tablets):
    • Adults—At first, 500 mg to 1000 milligrams (mg) per day, divided into 2 doses. Your doctor may increase your dose as needed. However, the dose is usually not more than 3000 mg per day.
    • Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 30 to 50 milligrams (mg) per kilogram (kg) of body weight per day, divided into 2 doses. Your doctor may increase your dose as needed. However, the dose is usually not more than 2000 mg per day.
    • Children younger than 6 years of age—Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using alti-sulfaSALAzine

It is very important that your doctor check your or your child''s progress at regular visits. This will allow your doctor to check if the medicine is working properly. Blood and urine tests will be needed to check for unwanted effects.

Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Check with your doctor right away if you or your child have a fever and sore throat, pale skin, unusual bruising or bleeding, or unusual tiredness or weakness. These may be symptoms of a blood problem.

This medicine may decrease the amount of sperm men make and affect their ability to have children. If you plan to have children, talk with your doctor before using this medicine.

This medicine may increase your risk of developing infections. Avoid being near people who are sick or have infections while you are using this medicine. Wash your hands often. Tell your doctor if you have any kind of infection before you start using this medicine. Also tell your doctor if you have ever had an infection that would not go away or an infection that kept coming back.

Call your doctor right away if you start to have a cough that would not go away, weight loss, night sweats, fever, chills, runny or stuffy nose, headache, blurred vision, or feeling generally ill. These may be signs that you have an infection.

Call your doctor right away if you have difficulty breathing or swallowing, a fast heartbeat, itching, rash, or skin redness, or swelling of the face, throat, or tongue. These may be symptoms of an allergic reaction to this medicine.

This medicine may cause serious skin reactions, including exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). Check with your doctor right away if you have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, trouble breathing, unusual bleeding or bruising, or unusual tiredness or weakness.

Sulfasalazine may cause blood problems. These problems may result in a greater chance of certain infections, slow healing, and bleeding of the gums. Therefore, you should be careful when using regular toothbrushes, dental floss, and toothpicks. Dental work should be delayed until your blood counts have returned to normal. Check with your medical doctor or dentist if you have any questions about proper oral hygiene (mouth care) during treatment.

Sulfasalazine may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

• Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.
• Wear protective clothing, including a hat. Also, wear sunglasses.
• Apply a sun block product that has a skin protection factor (SPF) of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your health care professional.
• Apply a sun block lipstick that has an SPF of at least 15 to protect your lips.
• Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction from the sun, check with your doctor.

Your skin or urine may turn an orange or yellow color while you or your child are using this medicine. This is normal and nothing to worry about.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Alti-sulfaSALAzine side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Aching of joints
• fever
• headache (continuing)
• increased sensitivity of the skin to sunlight
• skin rash or itching
• vomiting

Less common

• Back, leg, or stomach pains
• bleeding gums
• bluish color of the fingernails, lips, skin, palms, or nail beds
• chills
• dark urine
• difficulty breathing
• fever
• general body swelling
• headache
• loss of appetite
• nausea
• nosebleeds
• pale skin
• sore throat
• trouble breathing
• unusual bleeding or bruising
• unusual tiredness or weakness
• yellowing of the eyes or skin

Less common or rare

• Aching of muscles
• black, tarry stools
• blistering, peeling, or loosening of the skin
• bloating
• blood in the urine or stools
• bloody diarrhea
• bluish fingernails, lips, or skin
• chest pain or tightness
• constipation
• cough
• difficulty with swallowing
• dizziness
• fainting spells
• fast heartbeat
• general feeling of discomfort or illness
• general tiredness and weakness
• hives
• indigestion
• inflammation of the joints
• irregular heartbeat
• light-colored stools
• muscle aches
• muscle cramps or spasms
• muscle pain or stiffness
• painful or difficult urination
• pains in the stomach, side, or abdomen, possibly radiating to the back
• pinpoint red spots on the skin
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rash
• red skin lesions, often with a purple center
• red, irritated eyes
• redness, blistering, peeling, or loosening of the skin
• sores, ulcers, or white spots in the mouth or on the lips
• swollen or painful glands
• upper right abdominal or stomach pain

Incidence not known

• Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Decreased weight
• stomach upset

Less common

• Welts

Less common or rare

• Discoloration of the skin or urine
• hair loss or thinning of the hair
• swelling or inflammation of the mouth

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer