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Can sulfasalazine affect fertility, pregnancy or breastfeeding?

We suggest you speak to your doctor as soon as possible if you're planning a family, if you become pregnant or if you're thinking of breastfeeding.

However, guidelines state that it's safe for women to continue using sulfasalazine when trying for a baby and during pregnancy. It's often recommended that you continue sulfasalazine throughout pregnancy to prevent a flare-up of your condition. You should also take folic acid tablets (5 mg daily) as sulfasalazine can reduce levels of folic acid in the body.

Sulfasalazine can cause a fall in sperm count, leading to a temporary decrease in male fertility but must not be relied upon for contraception. The effect on sperm count is reversed if treatment is stopped, and research hasn't shown this to be a problem. You should discuss this with your rheumatologist, but current guidelines advise that it's not necessary for men to stop sulfasalazine before trying to father a baby. However, if you're on sulfasalazine and you've been trying for a baby for a year or more, you should discuss this with your doctor and arrange to see a fertility specialist to rule out other problems.

Sulfasalazine is considered safe to use if you're breastfeeding unless your baby is premature or at risk of jaundice. Speak to your rheumatology team if you're concerned about this.

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