Indications |
Oral Susceptible infections Adult: Initially, 2-4 g/day. May increase up to 6 g/day, given in divided doses. Child: Start with 75 mg/kg, subsequently, 150 mg/kg in divided doses. Max: 6 g/day. Renal impairment: Dosage reduction may be necessary. Oral Prophylaxis of rheumatic fever Adult: >30 kg: 1 g once daily; <30 kg: 500 mg once daily. Child: <30 kg: 0.5 g every 24 hr; >30 kg: 1 g/day. Renal impairment: Dosage reduction may be necessary. Oral Nocardiosis Adult: 4-8 g daily for at least 6 wk. May continue for many mth to prevent relapse of infection. Renal impairment: Dosage reduction may be necessary. Oral Toxoplasmosis Adult: Including immunocompromised patients: 4-6 g/day in 4 divided doses for at least 6 wk. Subsequently, 2-4 g/day, to be continued indefinitely. Child: For congenital toxoplasmosis: <2 mth: 50 mg/kg bid for 12 mth. Renal impairment: Dosage reduction may be necessary. Oral Prophylaxis of toxoplasmosis in patients with HIV infection Adult: 0.5-1 g every 6 hr, to be taken with oral pyrimethamine (25-50 mg daily) and oral leucovorin (10-25 mg/day). Child: 85-120 mg/kg/day, given in 2-4 divided doses with oral pyrimethamine (1 mg/kg/day; max: 25 mg/day) and oral leucovorin (5 mg once every 3 days). Renal impairment: Dosage reduction may be necessary. |
Contraindications |
Hypersensitivity; severe renal/hepatic impairment, blood dyscrasias, porphyrias, pregnancy (at term), lactation. |
Warnings / Precautions |
Elderly, maintain adequate fluid intake to reduce risk of crystalluria, G6PD deficiency, AIDS. Renal/hepatic impairment, history of allergy or asthma. Discontinue treatment if patient develops rash. Conduct CBC and urinalyses using microscopic examination during prolonged therapy. May exacerbate lupus erythematosus. Infants <2 mth. |
Adverse Reactions |
Nausea, vomiting, anorexia and diarrhoea. Hypersensitivity, skin reactions; lumbar pain, haematuria, oliguria, anuria, crystallisation in urine, thrombocytopenia, leucopenia, eosinophilia, neonatal jaundice and kernicterus. Potentially Fatal: Stevens-Johnson syndrome; agranulocytosis, thrombocytopenia, jaundice in newborn. |
Drug Interactions |
Potentiates antidiabetic effect of sulphonylureas. Action antagonised by PABA and procaine group of local anaesthetics. Potentiates oral anticoagulants, methotrexate and phenytoin. May decrease serum levels of ciclosporin. Ascorbic acid and hexamine may increase risk of crystalluria. See Below for More sulfadiazine Drug Interactions |
Lab Interactions |
Interferes with estimation of urinary glucose, urobilinogen, urea and creatinine. |
Mechanism of Actions |
Sulfadiazine is a short-acting sulfonamide derivative with bacteriostatic action through competitive inhibition of bacterial synthesis of folic acid. Susceptible organisms include E.coli, Klebsiella, Enterobacter, Proteus mirabilis, P.vulgaris, S.aureus, Toxoplasma, N.meningitidis, H.influenzae. Absorption: Readily absorbed from the GI tract. Blood concentrations peak 3-6 hr after a single dose. Distribution: 20-55% bound to plasma proteins. Distributes into CSF within 4 hr of an oral dose. Excretion: Half-life: About 10 hr; prolonged in renal impairment. About 50% of a single oral dose is excreted in the urine within 24 hr. |
ATC Classification |
J01EC02 - sulfadiazine ; Belongs to the class of intermediate-acting sulfonamides. Used in the systemic treatment of infections. |
Available As |
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Sulphadiazine
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Sulphadiazine Containing Brands
Sulphadiazine is used in following diseases
Drug - Drug Interactions of Sulphadiazine
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