Certainly not the wished for reaction, but not an unknown one.

It started with flu-like symptoms, a day after my first full dose on Friday. 

  • Massive headache
  • Sore throat
  • Running nose and scratchy eyes
  • A phlegmy cough
  • Aching joints and muscles
  • Slight fever (38C)

I thought I’d just picked up a virus at the gym - I’m well practiced at taking on any and all viral infections from public places!

Sunday saw a small rash appear at the back of my neck, easily explained as caused by a irritating velcro seal on my hoody.

But come Monday morning, and I was covered in red spots from head to toe, a few nicely blistered, and feeling like death.

The rash was clearly described in the medication information pamphlet (I’d forgotten about the flu symptoms that appear first).

The rash is the signal to immediately stop taking sulfasalazine, and never try it again.

Severe reaction to sulfasalazine are possible

If further doses are taken, the bad reaction can progress to full blown Stevens-Johnson syndrome, where the skin massively blisters and peels off. Eye and lung damage is a very high risk, as are secondary infections. This is an emergency, typically requiring intensive care. 

There are also other serious conditions caused by hypersensitivity to sulfasalazine.

Luckily, I noticed it early, and saw the doctor immediately.

After checking the rash, both the GP and rheumatologist were happy to keep me on cortisone and antibiotics, under a watchful eye for worsening symptoms for a few days, until a bed becomes available in the rheumatology ward at the hospital.

Important - if you develop a rash, especially with flu symptoms, while on sulfasalazine - stop taking it and immediately see a doctor.

Too close to aspirin?

I’m allergic to aspirin, and develop a rash in reaction to the salicylic acid used in some topical skin treatments for acne.

Sulfasalazine is reasonably closely related to aspirin, which could explain my reaction.

Next steps?

It’s back to hospital on Wednesday for me, to let them see the reaction, do more tests to make sure I’m ok, and work out what medication to try next.

In the meantime, I’m keeping my fluids up, resting, trying not to scratch, and using loads of eye drops.

Maybe I will get at least one crochet blanket finished while I’m there.