Lack of interaction between sulphasalazine and cimetidine in patients with rheumatoid arthritis

The interaction between sulphasalazine and cimetidine has been studied, a drug combination which is quite likely in view of the higher incidence of peptic ulceration in patients with RA. Nine patients with RA on sulphasalazine (group I) were given cimetidine 400 mg three times daily and followed up for 18 weeks. In addition, five patients on sulphasalazine alone (group II), who served as a control group, were also followed up in the same manner as group I. Monitoring included assessment of disease activity and haematological variables, and measurement of plasma and urinary levels of sulphapyridine and its metabolites. There was no significant change in either the haematological parameters or sulphapyridine pharmacokinetics upon administration of cimetidine. We therefore conclude that cimetidine may be safely used in patients with RA who are being treated with sulphasalazine.