sulfadiazine

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

What are sulfadiazine?

Sulfadiazine is an antibiotic that fights bacteria.

Sulfadiazine is used to treat many different types of infection, such as urinary tract infections, ear infections, meningitis, malaria, toxoplasmosis, and others.

Sulfadiazine may also be used for purposes not listed in this medication guide.

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

Do not use sulfadiazine during late pregnancy, just before you deliver.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Do not use if you are breast-feeding a baby.

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

You should not use this medicine if you are allergic to any sulfa drug.

Do not use sulfadiazine during late pregnancy, just before you deliver.

Do not use if you are breast-feeding a baby.

Do not give sulfadiazine to a child younger than 2 months old without a doctor's advice.

To make sure sulfadiazine is safe for you, tell your doctor if you have:

  • kidney disease;

  • liver disease;

  • asthma, severe allergies; or

  • a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency.

FDA pregnancy category C. It is not known whether sulfadiazine will be harmful to an unborn baby. Sulfadiazine can cause severe jaundice that could lead to brain damage in your newborn if you take this medicine just before childbirth. Tell your doctor if you are pregnant.

Sulfadiazine can pass into breast milk and may harm a nursing baby. Do not breast-feed while using sulfadiazine.

How should I take sulfadiazine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take this medicine with a full glass (8 ounces) of water. Drink plenty of liquids while you are taking sulfadiazine to keep your kidneys working properly.

Take your doses at regular intervals to keep a steady amount of the drug in your body at all times.

Do not use sulfadiazine to treat any condition that has not been checked by your doctor.

Do not share this medicine with another person, even if they have the same symptoms you have.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Sulfadiazine will not treat a viral infection such as the flu or a common cold.

Call your doctor if your symptoms do not improve, or if they get worse while using sulfadiazine.

While using sulfadiazine, you may need frequent blood and urine tests.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking sulfadiazine?

Avoid exposure to sunlight or tanning beds. Sulfadiazine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Sulfadiazine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • sudden weakness or ill feeling, fever, chills, sore throat, swollen glands, joint pain, mouth sores, red or swollen gums, trouble swallowing;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • increased or decreased urinating, pain in your side or lower back;

  • hallucinations, seizure (convulsions);

  • liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • severe skin reaction--swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • nausea, vomiting, diarrhea, stomach pain, loss of appetite;

  • headache, ringing in your ears;

  • dizziness, spinning sensation, loss of balance or coordination;

  • numbness, tingling, or burning pain in your hands or feet;

  • sleep problems (insomnia); or

  • depressed mood.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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 once

Maintenance 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 days

Maintenance 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?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with sulfadiazine, especially:

  • methotrexate; or

  • a blood thinner (warfarin, Coumadin, Jantoven).

This list is not complete. Other drugs may interact with sulfadiazine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about sulfadiazine.
  • 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.
  • Disclaimer: 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 1996-2012 Cerner Multum, Inc. Version: 2.01. Revision Date: 2014-05-28, 11:04:50 AM.

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