sulfadiazine

Generic Name: sulfadiazine (sull fa DYE ah zeen)Brand Names:

What are sulfadiazine?

Sulfadiazine is an antibiotic. It fights bacteria in the body.

Sulfadiazine is used to treat infections such as urinary tract infections, toxoplasmosis, and others.

Sulfadiazine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about sulfadiazine?

Take all of the sulfadiazine that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated.

What should I discuss with my healthcare provider before taking sulfadiazine?

Do not take sulfadiazine without first talking to your doctor if you have ever had an allergic reaction to a diuretic (water pill), a sunscreen containing PABA, or another sulfa medication.

Before taking sulfadiazine, tell your doctor if you have

• kidney disease,

• liver disease,

• a glucose 6-phosphate dehydrogenase deficiency (G6PD deficiency), or

• blood problems.

You may not be able to take sulfadiazine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

It is not known whether sulfadiazine will be harmful to an unborn baby. Do not take sulfadiazine without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether sulfadiazine will be harmful to a nursing infant. Do not take a sulfonamide without first talking to your doctor if you are breast-feeding a baby.

How should I take sulfadiazine?

Take sulfadiazine exactly as directed by your doctor. If you do not understand these instructions, ask your nurse, doctor, or pharmacist to explain them to you.

Take each dose with a full glass of water. Drink several extra glasses of water each day while taking sulfadiazine to decrease the risk of developing kidney stones.

Sulfadiazine should be taken at evenly spaced intervals throughout the day and night to keep the amount of medication in the blood high enough to treat the infection.

It is important to take sulfadiazine regularly to get the most benefit.

Take all of the sulfadiazine that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated.

Contact your doctor if your symptoms do not improve or if they seem to get worse.

Store sulfadiazine at room temperature away from moisture and heat.

See also: Sulfadiazine dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a sulfadiazine overdose include decreased appetite, nausea, vomiting, dizziness, headache, drowsiness, fever, and unconsciousness.

What should I avoid while taking sulfadiazine?

Avoid prolonged exposure to sunlight. Sulfadiazine may increase the sensitivity of the skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Sulfadiazine side effects

If you experience any of the following serious side effects, stop taking sulfadiazine and seek emergency medical attention or contact your doctor immediately:

• an allergic reaction (shortness of breath; closing of the throat; hives; swelling of the lips, face, or tongue; rash; or fainting);

• blood in the urine;

• difficult or painful urination;

• yellowing of the skin or eyes;

• ringing in the ears;

• difficulty breathing, sore throat, or chills;

• a skin rash;

• unusual tiredness or weakness;

• severe watery diarrhea and abdominal cramps; or

• unusual bleeding or bruising.

Other, less serious side effects may be more likely to occur. Continue to take the sulfonamide and talk to your doctor if you experience

• headache, fatigue, or dizziness;

• nausea, vomiting, decreased appetite, or diarrhea; or

• increased skin sensitivity to the sun.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Sulfadiazine Dosing Information

Usual Adult Dose for Rheumatic Fever Prophylaxis:

Secondary prophylaxis of rheumatic fever, if patient is intolerant of penicillin:1 g orally once a day.The optimal duration has not been definitely determined. The American Heart Association recommends that prophylaxis be continued for at least 5 years or until the patient reaches age 21 (whichever is longer) for rheumatic fever without carditis, and for 10 years in patients with carditis but no valvar heart disease. Prophylaxis is recommended for at least 10 years since the last episode or until the patient reaches age 40 for carditis and persistent valvar disease; lifelong prophylaxis may be required.

Usual Adult Dose for Toxoplasmosis:

Toxoplasmic encephalitis: Initial dose: Pyrimethamine 200 mg orally onceMaintenance dose: <60 kg: Sulfadiazine 1 g orally every 6 hours plus pyrimethamine 50 mg orally once a day.>=60 kg: Sulfadiazine 1500 mg orally every 6 hours plus pyrimethamine 75 mg orally once a day.In addition, leucovorin 10 to 20 mg/day orally (may increase up to 50 mg/day). Corticosteroids and anticonvulsants may be given if indicated.Duration: At least 6 weeks, followed by chronic suppressive therapy.

Usual Adult Dose for Toxoplasmosis -- Prophylaxis:

Secondary prophylaxis after acute treatment of toxoplasmic encephalitis:Sulfadiazine, 500 to 1000 mg orally every 6 hours plus pyrimethamine 25 to 50 mg orally once a day plus leucovorin 10 to 25 mg orally once a day.Duration: Lifelong in HIV-infected patients. Discontinuation may be considered if the patient has maintained CD4+ T-lymphocyte counts >200 cells/microL following HAART (e.g., >6 months) and has no symptoms of toxoplasmosis. Some experts would also recommend an MRI of the brain.

Usual Pediatric Dose for Rheumatic Fever Prophylaxis:

Secondary prophylaxis of rheumatic fever, if patient is intolerant of penicillin:> 2 months and <=27 kg: 500 mg orally once a day.>27 kg: 1 g orally once a day.The optimal duration has not been definitely determined. The American Heart Association recommends that prophylaxis be continued for at least 5 years or until the patient reaches age 21 (whichever is longer) for rheumatic fever without carditis, and for 10 years in patients with carditis but no valvar heart disease. Prophylaxis is recommended for at least 10 years since the last episode or until the patient reaches age 40 for carditis and persistent valvar disease; lifelong prophylaxis may be required.

Usual Pediatric Dose for Toxoplasmosis:

Congenital toxoplasmosis: Initial dose: Pyrimethamine 2 mg/kg orally once a day for 2 daysMaintenance dose: Sulfadiazine 50 mg/kg orally twice a day plus pyrimethamine 1 mg/kg orally once a day plus leucovorin 10 mg orally or IM once a day.Duration: 12 months. After 2 to 6 months, decrease pyrimethamine to 1 mg/kg orally 3 times a week.Acute acquired toxoplasmosis:Initial dose: Pyrimethamine 2 mg/kg (maximum 50 mg) orally once a day for 3 days.Maintenance dose: Sulfadiazine 25 to 50 mg/kg (maximum 1 to 1.5 g/dose) orally every 6 hours plus pyrimethamine 1 mg/kg (maximum 25 mg) orally once a day plus leucovorin 10 to 25 mg orally once a day.Duration: At least 6 weeks, followed by chronic suppressive therapy.

Usual Pediatric Dose for Toxoplasmosis -- Prophylaxis:

Secondary prophylaxis after acute treatment of toxoplasmic encephalitis:Sulfadiazine 85 to 120 mg/kg/day (maximum adult dose, 4 to 6 g/day) orally in 2 to 4 divided doses plus pyrimethamine, 1 mg/kg or 15 mg/m2 (maximum dose 25 mg) orally once a day plus leucovorin 5 mg orally every 3 days.Duration: Lifelong in HIV-infected patients.

What other drugs will affect sulfadiazine?

Before taking a sulfonamide, tell your doctor if you are taking any of the following medicines:

• cyclosporine (Neoral, Sandimmune);

• methotrexate (Rheumatrex, Trexall);

• warfarin (Coumadin);

• an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Glynase, Micronase, Diabeta), chlorpropamide (Diabinese), tolbutamide (Orinase), or tolazamide (Tolinase); or

• phenytoin (Dilantin).

You may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with sulfadiazine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your pharmacist has additional information about sulfadiazine written for health care professionals that you may read.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.03. Revision Date: 4/12/2009 4:35:59 PM.