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sulfadiazine (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 500mg
more...

Load

2-4 g PO

Maintenance

2-4 g/day divided 3-6x/day PO

Prophylaxis of Recurrent Rheumatic Fever

>30 kg: 1 g/day

<30 kg: 500 mg/day

Toxoplasmosis

Given with Pyrimethamine & Folinic Acid

1-1.5 g QID us. for 3-4 weeks

Prophylaxis (in patients with HIV): 0.5-1 g q6hr with pyrimethamine (25-75 mg/day PO) & folinic acid (10-25 mg/day PO)

Other Information

Asymptomatic meningococcal carriers: 1 g BID x2 days

Monitor: renal function, CBC

Other Indications & Uses

Burkholderia pseudomallei, Chlamydia trachomatis,Nocardia asteroides & brasiliensis, Mycobacterium smegmatis, Mycobacterium chelonae, Mycobacterium fortuitum

First Line:Mycobacterium smegmatis, Nocardia asteroides & brasiliensis

Dosage Forms & Strengths

tablet

  • 500mg
more...

Load (>2 Months Old)

75 mg/kg PO OR 

2 g/sq.meter PO

Maintenance (>2 Months Old)

150 mg/kg/day divided q4- 6hr PO, OR 

4 g/sq. meter/day divided q4 -6hr PO

No more than 6 g/day

Toxoplasmosis

Given with pyrimethamine and folinic acid

100-200 mg/kg/day divided q6hr PO x3-4 weeks 

Infants <2 months old: 25 mg/kg/day divided QID PO

Prophylaxis (in patients with HIV): 85-120 mg/kg/day divided BID, TID or QID with pyrimethamine (1 mg/kg or 15 mg/sq.meter daily-maximum dose 25 mg) & folinic acid (5 mg every third day)

Congenital Toxoplasmosis

Given with pyrimethamine and folinic acid

100 mg/kg/day divided q6hr PO x 12 months 

Other Information

Prophylaxis of recurrent rheumatic fever: see Adult Dosing

Monitor: renal function, CBC

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Interactions

Interaction Checker

sulfadiazine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Diarrhea (33%)

            Headache (33%)

            Reversible oligospermia (33%)

            Anorexia

            Gastric distress

            Nausea

            Photosensitivity

            Vomiting

            1-10%

            Allergic reactions-rash

            Aplastic anemia

            Dizziness

            Hypersensitivity

            Itching

            Thyroid fuction disturbance

            Franulocytopenia

            Thrombocytopenia

            Frequency Not Defined

            Lyell's syndrome

            Sstevens Johnson syndrome

            Rash

            Fever

            Granulocytopenia

            Hemolytic anemia

            Leukopenia

            Hepatitis

            Jaundice

            Hematuria

            Acute nephropathy

            Intestinal nephritis

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            Warnings

            Contraindications (additional)

            Should not be used for group A beta-hemolytic strep infections

            Documented megaloblastic or folate deficiency anemia, obstructive uropathy

            Cautions (additional)

            Drink 250 mL water w/ each dose & frequently throughout day while taking sulfadiazine

            Adverse Drug Reactions

            Lyell's syndrome, stevens Johnson syndrome, itching, rash, photosensitivity, thyroid function disturbance, anorexia, diarrhea, nausea, vomiting, dizziness, fever, headache, aplastic anemia, granulocytopenia, hemolytic anemia, leukopenia, thrombocytopenia, hepatitis, jaundice, hematuria, acute nephropathy, intestinal nephritis

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: enters breast milk; risk of kernicterus if infant <2 mo

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Absorption: well absorbed

            Distribution: sulfadiazine is distributed into most body tissues; appears to cross cell membranes freely; at a plasma concentration of 100 mcg/mL

            Protein Bound: approximately 32-56%

            Elimination: largely in urine; urinary concentrations usually are 10-25 times those attained in serum

            Mechanism of Action

            Exerts bacteriostatic action through competitive antagonism with para-aminobenzoic acid (PABA). Microorganisms that require exogenous folic acid and do not synthesize folic acid are not susceptible to the action of sulfonamides

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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