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Sulfasalazine is a drug that is used primarily for treating ulcerative colitis. It is a prodrug, that is, it is not active in its ingested form. It is broken down by bacteria in the colon into 5-aminosalicylic acid (5-ASA), and sulfapyridine. (5-ASA is also marketed as mesalamine (Lialda, Rowasa, Pentasa, Canasa Apriso, and Asacol.) The 5-ASA has therapeutic benefit, but it is not clear if sulfapyridine adds any additional therapeutic benefit. The inflammation of ulcerative colitis and other inflammatory diseases is caused, in part, by excessive production of chemicals (for example, prostaglandins) that produce inflammation. Prostaglandins are produced by two enzymes, cyclooxygenase and lipoxygenase, and these enzymes are over-active in individuals with ulcerative colitis. 5-ASA may reduce inflammation by blocking the activity of cyclooxygenase and lipoxygenase thereby reducing the production of prostaglandins. Sulfasalazine was approved by the FDA in 1950.
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