(see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. sulfasalazine decreases effects of lisinopril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.lisocabtagene maraleucelSerious - Use Alternative (2)sulfasalazine, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. lisocabtagene maraleucel, sulfasalazine. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.lithiumMonitor Closely (1)sulfasalazine increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.lornoxicamMonitor Closely (2)lornoxicam and sulfasalazine both increase anticoagulation. Use Caution/Monitor. lornoxicam and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)lornoxicam will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.losartanMonitor Closely (3)losartan, 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 losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. losartan and sulfasalazine both increase serum potassium. Use Caution/Monitor.measles, mumps, rubella and varicella vaccine, liveSerious - Use Alternative (1)sulfasalazine, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.meclofenamateMonitor Closely (2)meclofenamate and sulfasalazine both increase anticoagulation. Use Caution/Monitor. meclofenamate and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)meclofenamate will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.mefenamic acidMonitor Closely (2)mefenamic acid and sulfasalazine both increase anticoagulation. Use Caution/Monitor. mefenamic acid and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)mefenamic acid will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.meloxicamMonitor Closely (2)meloxicam and sulfasalazine both increase anticoagulation. Use Caution/Monitor. meloxicam and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.mesalamineMonitor Closely (1)mesalamine, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.Minor (1)sulfasalazine will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.metaproterenolMonitor Closely (1)sulfasalazine increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.methazolamideMonitor Closely (1)methazolamide, sulfasalazine. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.methotrexateSerious - Use Alternative (1)sulfasalazine increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug.methyclothiazideMonitor Closely (1)sulfasalazine increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)methyclothiazide will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.methylprednisoloneMonitor Closely (1)sulfasalazine, methylprednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)methylprednisolone decreases levels of sulfasalazine by increasing renal clearance. Minor/Significance Unknown.metolazoneMonitor Closely (1)sulfasalazine increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)metolazone will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.metoprololMonitor Closely (2)sulfasalazine decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. metoprolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.milnacipranMonitor Closely (1)milnacipran, 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.mistletoeMonitor Closely (1)sulfasalazine increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.moexiprilMonitor Closely (2)moexipril, 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 moexipril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.moxisylyteMonitor Closely (1)sulfasalazine decreases effects of moxisylyte by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.mycophenolateMonitor Closely (1)sulfasalazine will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.nabumetoneMonitor Closely (2)nabumetone and sulfasalazine both increase anticoagulation. Use Caution/Monitor. nabumetone and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)nabumetone will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.nadololMonitor Closely (2)sulfasalazine decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. nadolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.nafcillinMonitor Closely (1)sulfasalazine decreases effects of nafcillin by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.naproxenMonitor Closely (2)naproxen and sulfasalazine both increase anticoagulation. Use Caution/Monitor. naproxen and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)naproxen will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.nebivololMonitor Closely (2)sulfasalazine decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. nebivolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.nefazodoneMonitor Closely (1)nefazodone, 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.neomycin POMinor (1)sulfasalazine increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.nettleMonitor Closely (1)sulfasalazine increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.noni juiceMinor (1)sulfasalazine and noni juice both increase serum potassium. Minor/Significance Unknown.norepinephrineMonitor Closely (1)sulfasalazine increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.ofloxacinMinor (1)ofloxacin, sulfasalazine. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.olmesartanMonitor Closely (3)olmesartan, 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 olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. olmesartan and sulfasalazine both increase serum potassium. Use Caution/Monitor.oteseconazoleMonitor Closely (1)oteseconazole will increase the level or effect of sulfasalazine by Other (see comment). Modify Therapy/Monitor Closely. Otesezonale, a BCRP inhibitor, may increase the effects and risk of toxicities of BCRP substrates. Use lowest starting dose of BCRP substrate, or consider reducing BCRP substrate dose.oxaprozinMonitor Closely (2)oxaprozin and sulfasalazine both increase anticoagulation. Use Caution/Monitor. oxaprozin and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)oxaprozin will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.panax ginsengMonitor Closely (1)sulfasalazine and panax ginseng both increase anticoagulation. Use Caution/Monitor.parecoxibMonitor Closely (2)parecoxib and sulfasalazine both increase anticoagulation. Use Caution/Monitor. parecoxib and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)parecoxib will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.paromomycinMinor (1)sulfasalazine increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.paroxetineMonitor Closely (1)paroxetine, 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.pau d'arcoMonitor Closely (1)sulfasalazine and pau d'arco both increase anticoagulation. Use Caution/Monitor.pegaspargaseMonitor Closely (1)pegaspargase increases effects of sulfasalazine by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.pemetrexedSerious - Use Alternative (1)sulfasalazine increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Interrupt dosing in all patients taking NSAIDs with long elimination half-lives for at least 5d before, the day of, and 2d following pemetrexed administration. If coadministration of an NSAID is necessary, closely monitor patients for toxicity, especially myelosuppression, renal toxicity, and GI toxicity.penbutololMonitor Closely (2)sulfasalazine decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. penbutolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.perindoprilMonitor Closely (2)perindopril, 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 perindopril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.pexidartinibSerious - Use Alternative (1)sulfasalazine and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.phenindioneMonitor Closely (1)phenindione and sulfasalazine both increase anticoagulation. Modify Therapy/Monitor Closely.phenoxybenzamineMonitor Closely (1)sulfasalazine decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.phentolamineMonitor Closely (1)sulfasalazine decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.phytoestrogensMonitor Closely (1)sulfasalazine and phytoestrogens both increase anticoagulation. Use Caution/Monitor.pindololMonitor Closely (2)sulfasalazine decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. pindolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.pirbuterolMonitor Closely (1)sulfasalazine increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.piroxicamMonitor Closely (2)piroxicam and sulfasalazine both increase anticoagulation. Use Caution/Monitor. piroxicam and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)piroxicam will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.pivmecillinamMonitor Closely (2)pivmecillinam, sulfasalazine. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. pivmecillinam, sulfasalazine. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.ponatinibMonitor Closely (1)ponatinib increases levels of sulfasalazine by Other (see comment). Use Caution/Monitor.potassium acid phosphateMonitor Closely (1)sulfasalazine and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.potassium chlorideMonitor Closely (1)sulfasalazine and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.potassium citrateMonitor Closely (1)sulfasalazine and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.prazosinMonitor Closely (1)sulfasalazine decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.prednisoloneMonitor Closely (1)sulfasalazine, prednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)prednisolone decreases levels of sulfasalazine by increasing renal clearance. Minor/Significance Unknown.prednisoneMonitor Closely (1)sulfasalazine, prednisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)prednisone decreases levels of sulfasalazine by increasing renal clearance. Minor/Significance Unknown.pretomanidSerious - Use Alternative (1)sulfasalazine, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.probenecidMonitor Closely (2)sulfasalazine will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor. sulfasalazine decreases effects of probenecid by unknown mechanism. Use Caution/Monitor.propranololMonitor Closely (2)sulfasalazine decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. propranolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.protamineMonitor Closely (1)protamine and sulfasalazine both increase anticoagulation. Modify Therapy/Monitor Closely.quinaprilMonitor Closely (2)quinapril, 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 quinapril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.ramiprilMonitor Closely (2)ramipril, 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 ramipril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.regorafenibMonitor Closely (1)regorafenib will increase the level or effect of sulfasalazine by Other (see comment). Modify Therapy/Monitor Closely. Regorafenib likely inhibits BCRP (ABCG2) transport. Coadministration with a BCRP substrate may increase systemic exposure to the substrate and related toxicity.reishiMonitor Closely (1)sulfasalazine and reishi both increase anticoagulation. Use Caution/Monitor.ropeginterferon alfa 2bSerious - Use Alternative (1)ropeginterferon alfa 2b, sulfasalazine. Either increases toxicity of the other