pyrimethamine/sulfadoxine (Fansidar, Sudox)

Indications

• prophylaxis & treatment of Plasmodium falciparum malaria when chloroquine-resistance is suspected

Contraindications

Caution:

• discontinue use at 1st sign of rash
• hemolysis occurs in patients with G6PD deficiency

Dosage

• Acute malaria:
  • adults: 2-3 tabs PO
  • children 9-14 years: 2 tabs PO
  • children 4-8 years: 1 tab PO
  • children 1-3 years: 1/2 tab PO
  • 2-11 months: 1/4 tab PO
• Malaria prophylaxis: 1 tab PO weekly.

Tablet: 25 mg pyrimethamine, 500 mg sulfadoxine.

Pharmacokinetics

elimination: kidney

Adverse effects

• common (> 10%)
  • megaloblastic anemia, leukopenia, thrombocytopenia, pancytopenia, photosensitivity, hypersensitivity, atrophic glossitis, ataxia, tremors, seizures, headache, vomiting, gastritis
• less common (1-10%)
  • Stevens-Johnson syndrome, hepatitis
• uncommon (< 1%)
  • crystalluria, thyroid dysfunction, erythema multiforme, toxic epidermal necrolysis, rash, anorexia, glossitis, hepatic necrosis, respiratory failure
• hemolysis occurs in patients with G6PD deficiency

• drug adverse effects of antimalarials

More general terms

• antimalarial
• pharmacologic combination

Additional terms

• malaria

Components

• pyrimethamine (Daraprim)
• sulfadoxine (Fanasil)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=65404