Which pre-treatment consideration is recommended before starting Sulfasalazine?

• A. G6PD deficiency screening
• B. Liver biopsy
• C. Vaccination prior to therapy
• D. Renal function testing

Answer: (D)

Baseline renal function assessment is essential before initiating sulfasalazine. The drug and its metabolites are cleared by the kidneys, so any preexisting renal impairment can lead to drug accumulation and a higher risk of adverse effects, including nephrotoxicity and other systemic toxicities. Knowing the kidneys are functioning well helps determine safety for starting therapy and provides a reference to monitor changes during treatment, allowing dose adjustments if needed. While vaccination status and G6PD screening are considerations for other therapies or scenarios, they’re not specifically required before sulfasalazine, and a liver biopsy is not indicated.