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Suggest An Alternative To Saaz

Posted on Wed, 9 Apr 2014

Question: I have been taking Salazar for over 6 months now for AS, after using Saaz for around 3 years.....could you please suggest an alternative tablet(NSAID) for taking on regular basis? The alternative tablet should be effective as well. Is it okay to continue taking Salazer for lifetime.....what are the side-effects?

Answered by Dr. Anshul Varshney (24 minutes later)

Brief Answer: Tramadol and etoricoxib Detailed Answer: Dear Friend. Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern. Saaz is sulfasalazine.Serum levels should be monitored every three months at least. Serum levels above 50 μg/l are associated with side effects like depression, temporary infertility, Immune thrombocytopenia, folate deficiency and megaloblastic anemia, hemolytic anemia in people with G6PD deficiency. We can use Saaz for long term if no adverse effects are there. If we talk about the pain killer, the safest one is Tramadol, but it doesn't have anti inflammatory effects. So, when such patients come to me, i give them Tramadol on daily basis at night if pain is there. And if severe stiffness and sever pain is there, i use Etoricoxib for a few days. No NSAID group of drug is totally safe, but Etoricoxib has a better safety profile. This is my personal opinion based on details available here. If you still have any query you may please ask me. Stay Healthy. Dr Anshul Varshney , MD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (35 minutes later)

Hello, doctor! Thanks for your kind response. But I was actually asking about Salazer not Saaz. I was given Saaz initially. I had used it for around 3 years. Then, the doctor stopped it and asked me to take Salazer. Now, I've been taking Salazer for over 6 months. Why would he change from Saaz to Salazer? How is Salazer different from Saaz? I take one Salazer on alternate days. Sometimes there is pain. When it is unbearable, I take Nucoxia 60, which is a Etoricoxib, which you had also suggested. Is Salazer just an anti-inflammatory and not a pain killer? Doctor also gives me Alamin Forte, which I think is a vitamin tablet. Why would he suggest Alamin Forte with Salazer each time I visit him for AS ? Also, please let me know if you are suggesting that Nucoxia 60 is better than Saaz or Salazar for taking on daily basis for long term. If so, what should be the dosage.

Answered by Dr. Anshul Varshney (12 hours later)

Brief Answer: Detail Follows Detailed Answer: Dear Friend Salazar is also Sulphasalazine, i don't know why he switched you from Saaz to Salazar. It might be an extended release preparation, this you can check on the label. Alamnin forte is basically an amino acid preparation, that you can take. Its not a problem if you take that. Yes, Nucoxia is Etoricoxib. It has anti inflammatory as well as analgesic effect. You can take Nucoxia 90 mg as on when required basis. But i would again say that using Tramadol (Ultracet) for pain is safe. Salazar/ Saaz is used for disease control by giving anti inflammatory actions. You can't replace it with Nucoxia. Why don't you discuss with your doctor about using "Biologicals" for treatment of AS? I don't know about your disease severity, still share my opinion with him, as he is following you since long, he will guide you in case you require biologicals. If you have any further query, please ask me, else you may close the discussion and rate it!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (11 hours later)

Thanks doctor, for your XXXXXXX and honest answers. Your answers have been very helpful. This may be my last follow-up, for time being. But I still don't understand why my doctor suggests Alamin M forte. I look thin. So, does he give it because I look weak or to offset the effects of Salazer? Some doctors recommend Phenylbutazone for AS. Why? How is it different from sulfasalazine? Which one is preferred and why? What are "Biologicals" for treatment of AS? How effective will it be? How much does it cost? Once I was suggested injections costing around Rs. 8 lakh for AS. Is it the same?

Answered by Dr. Anshul Varshney (14 hours later)

Brief Answer: details follows Detailed Answer: Dear Friend. Taking that medication doesn't cause any harm you can take. Sulphasalzone is best. Take that. Biologicals are costly. Telling about treatment and its cost requires to know about the disease activity. I would suggest you to discuss with your doctor about that. Stay Healthy.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar