level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.digoxinMonitor Closely (2)sulfasalazine decreases levels of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Sulfasalazine >2 g/day. sulfasalazine and digoxin both increase serum potassium. Use Caution/Monitor.dobutamineMonitor Closely (1)sulfasalazine increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.dong quaiMonitor Closely (1)sulfasalazine and dong quai both increase anticoagulation. Use Caution/Monitor.dopexamineMonitor Closely (1)sulfasalazine increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.doxazosinMonitor Closely (1)sulfasalazine decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.drospirenoneMonitor Closely (1)drospirenone and sulfasalazine both increase serum potassium. Modify Therapy/Monitor Closely.duloxetineMonitor Closely (1)duloxetine, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.eltrombopagMonitor Closely (1)eltrombopag increases levels of sulfasalazine by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.eluxadolineMonitor Closely (1)eluxadoline increases levels of sulfasalazine by decreasing metabolism. Use Caution/Monitor. Eluxadoline may increase the systemic exposure of coadministered BCRP substrates. .enalaprilMonitor Closely (2)enalapril, sulfasalazine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. sulfasalazine decreases effects of enalapril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.encorafenibMonitor Closely (1)encorafenib will increase the level or effect of sulfasalazine by Other (see comment). Modify Therapy/Monitor Closely. Encorafenib (a BCRP inhibitor) may increase the concentration and toxicities of BCRP substrates. Closely monitor for signs and symptoms of increased exposure and consider adjusting the dose of these substrates.enoxaparinMonitor Closely (1)enoxaparin and sulfasalazine both increase anticoagulation. Modify Therapy/Monitor Closely.ephedrineMonitor Closely (1)sulfasalazine increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrineMonitor Closely (1)sulfasalazine increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrine racemicMonitor Closely (1)sulfasalazine increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.eplerenoneMinor (1)sulfasalazine decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.epoprostenolMonitor Closely (1)sulfasalazine and epoprostenol both increase anticoagulation. Use Caution/Monitor.eprosartanMonitor Closely (3)sulfasalazine decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. eprosartan and sulfasalazine both increase serum potassium. Use Caution/Monitor. eprosartan, sulfasalazine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.escitalopramMonitor Closely (1)escitalopram, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.esmololMonitor Closely (2)sulfasalazine decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. esmolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.ethacrynic acidMonitor Closely (1)sulfasalazine increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.ethanolMinor (1)ethanol increases toxicity of sulfasalazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.etodolacMonitor Closely (2)etodolac and sulfasalazine both increase anticoagulation. Use Caution/Monitor. etodolac and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)etodolac will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.fennelMonitor Closely (1)sulfasalazine and fennel both increase anticoagulation. Use Caution/Monitor.fenoprofenMonitor Closely (2)fenoprofen and sulfasalazine both increase anticoagulation. Use Caution/Monitor. fenoprofen and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)fenoprofen will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.feverfewMonitor Closely (1)sulfasalazine and feverfew both increase anticoagulation. Use Caution/Monitor.Minor (1)sulfasalazine decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.fludrocortisoneMonitor Closely (1)sulfasalazine, fludrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)fludrocortisone decreases levels of sulfasalazine by increasing renal clearance. Minor/Significance Unknown.fluoxetineMonitor Closely (1)fluoxetine, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.flurbiprofenMonitor Closely (2)flurbiprofen and sulfasalazine both increase anticoagulation. Use Caution/Monitor. flurbiprofen and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)flurbiprofen will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.fluvoxamineMonitor Closely (1)fluvoxamine will increase the level or effect of sulfasalazine by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by plateletsfolic acidMinor (1)sulfasalazine decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.fondaparinuxMonitor Closely (1)fondaparinux and sulfasalazine both increase anticoagulation. Modify Therapy/Monitor Closely.formoterolMonitor Closely (1)sulfasalazine increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.forskolinMonitor Closely (1)sulfasalazine and forskolin both increase anticoagulation. Use Caution/Monitor.fosinoprilMonitor Closely (2)fosinopril, sulfasalazine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. sulfasalazine decreases effects of fosinopril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.fostamatinibMonitor Closely (1)fostamatinib will increase the level or effect of sulfasalazine by decreasing metabolism. Use Caution/Monitor. Concomitant use of fostamatinib may increase concentrations of BCRP substrate drugs. Monitor for toxicities of BCRP substrate drug that may require dosage reduction when given concurrently with fostamatinib.fostemsavirMonitor Closely (1)fostemsavir will increase the level or effect of sulfasalazine by Other (see comment). Modify Therapy/Monitor Closely. Fostemsavir inhibits BCRP transporters. If possible, avoid coadministration or modify dose of BCRP substrate coadministered with fostemsavir. furosemideMonitor Closely (1)sulfasalazine increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)sulfasalazine decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.ganciclovirMinor (1)sulfasalazine will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.garlicMonitor Closely (1)sulfasalazine and garlic both increase anticoagulation. Use Caution/Monitor.gentamicinMonitor Closely (1)sulfasalazine increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)sulfasalazine increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.gingerMonitor Closely (1)sulfasalazine and ginger both increase anticoagulation. Use Caution/Monitor.ginkgo bilobaMonitor Closely (1)sulfasalazine and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.glecaprevir/pibrentasvirMonitor Closely (1)glecaprevir/pibrentasvir will increase the level or effect of sulfasalazine by decreasing metabolism. Use Caution/Monitor. Glecaprevir/pibrentasvir may increase plasma concentration of BCRP substrates.glimepirideMonitor Closely (1)sulfasalazine increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)sulfasalazine increases effects of glimepiride by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.glipizideMonitor Closely (1)sulfasalazine increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)sulfasalazine increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.glyburideMonitor Closely (1)sulfasalazine increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)sulfasalazine increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.griseofulvinMonitor Closely (1)griseofulvin decreases levels of sulfasalazine by unknown mechanism. Use Caution/Monitor.heparinMonitor Closely (1)heparin and sulfasalazine both increase anticoagulation. Modify Therapy/Monitor Closely.horse chestnut seedMonitor Closely (1)sulfasalazine and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.hydralazineMonitor Closely (1)sulfasalazine decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.hydrochlorothiazideMonitor Closely (1)sulfasalazine increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)hydrochlorothiazide will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.hydrocortisoneMonitor Closely (1)sulfasalazine, hydrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)hydrocortisone decreases levels of sulfasalazine by increasing renal clearance. Minor/Significance Unknown.ibuprofenMonitor Closely (2)ibuprofen and sulfasalazine both increase anticoagulation. Use Caution/Monitor. ibuprofen and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.ibuprofen IVMonitor Closely (3)ibuprofen IV will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor. ibuprofen IV and sulfasalazine both increase anticoagulation. Use Caution/Monitor. ibuprofen IV and sulfasalazine both increase serum potassium. Use Caution/Monitor.idecabtagene vicleucelSerious - Use Alternative (2)sulfasalazine, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. idecabtagene vicleucel, sulfasalazine. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.imidaprilMinor (1)sulfasalazine decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.indapamideMonitor Closely (1)sulfasalazine increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)indapamide will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.indomethacinMonitor Closely (2)indomethacin and sulfasalazine both increase anticoagulation. Use Caution/Monitor. indomethacin and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)indomethacin will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.insulin aspartMinor (1)sulfasalazine increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.insulin detemirMinor (1)sulfasalazine increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.insulin glargineMinor (1)sulfasalazine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.insulin glulisineMinor (1)sulfasalazine increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.insulin lisproMinor (1)sulfasalazine increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.insulin NPHMinor (1)sulfasalazine increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.insulin regular humanMinor (1)sulfasalazine increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.irbesartanMonitor Closely (3)irbesartan, sulfasalazine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. sulfasalazine decreases effects of irbesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. irbesartan and sulfasalazine both increase serum potassium. Use Caution/Monitor.isoproterenolMonitor Closely (1)sulfasalazine increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.ketoprofenMonitor Closely (2)ketoprofen and sulfasalazine both increase anticoagulation. Use Caution/Monitor. ketoprofen and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)ketoprofen will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.ketorolacMonitor Closely (2)ketorolac and sulfasalazine both increase anticoagulation. Use Caution/Monitor. ketorolac and sulfasalazine both increase serum potassium. Use Caution/Monitor.Serious - Use Alternative (1)sulfasalazine, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ketorolac will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.ketorolac intranasalMonitor Closely (2)ketorolac intranasal and sulfasalazine both increase anticoagulation. Use Caution/Monitor. ketorolac intranasal and sulfasalazine both increase serum potassium. Use Caution/Monitor.Serious - Use Alternative (1)sulfasalazine, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ketorolac intranasal will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.L-methylfolateMonitor Closely (1)sulfasalazine decreases effects of L-methylfolate by Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Signs of folate deficiency reported.Minor (1)sulfasalazine decreases levels of L-methylfolate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.labetalolMonitor Closely (2)sulfasalazine decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. labetalol and sulfasalazine both increase serum potassium. Use Caution/Monitor.lasmiditanSerious - Use Alternative (1)lasmiditan increases levels of sulfasalazine by Other (see comment). Avoid or Use Alternate Drug. Comment: Lasmiditan inhibits BCRP in vitro. Avoid coadministration of lasmiditan with BCRP substrates.leniolisibSerious - Use Alternative (1)leniolisib will increase the level or effect of sulfasalazine by Other (see comment). Avoid or Use Alternate Drug. Leniolisib, a BCRP inhibitor, may increase systemic exposure of BCRP substrateslevalbuterolMonitor Closely (1)sulfasalazine increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.levomilnacipranMonitor Closely (1)levomilnacipran, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.lisinoprilMonitor Closely (2)lisinopril, sulfasalazine. Either increases toxicity of the other by Other