erythromycin base/sulfisoxazole (Rx)

Brand and Other Names:Pediazole

Dosing & Uses

AdultPediatric

Not prescribed for adults

Dosage Forms & Strengths

erythromycin/sulfisoxazole

oral suspension

  • (200mg/600mg)/5mL

H. influenzae Acute Otitis Media

<2 months: Contraindicated

>2 months: 50 mg/kg/day (erythromycin) or 150 mg/kg/day (sulfisoxazole) PO divided q6-8hr for10 days  

Not to exceed 6 g/day sulfisoxazole

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Interactions

Interaction Checker

and erythromycin base/sulfisoxazole

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              Serious - Use Alternative (27)

              • aminobenzoate potassium

                aminobenzoate potassium decreases effects of sulfisoxazole by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

              • aminolevulinic acid oral

                aminolevulinic acid oral, sulfisoxazole. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

              • aminolevulinic acid topical

                sulfisoxazole increases toxicity of aminolevulinic acid topical by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of photosensitizing drugs may enhance the phototoxic reaction to photodynamic therapy with aminolevulinic acid.

              • antithrombin alfa

                sulfisoxazole increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of antithrombin alfa by plasma protein binding competition. Avoid or Use Alternate Drug.

              • antithrombin III

                sulfisoxazole increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of antithrombin III by plasma protein binding competition. Avoid or Use Alternate Drug.

              • argatroban

                sulfisoxazole increases effects of argatroban by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of argatroban by plasma protein binding competition. Avoid or Use Alternate Drug.

              • BCG vaccine live

                sulfisoxazole decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              • bemiparin

                sulfisoxazole increases effects of bemiparin by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of bemiparin by plasma protein binding competition. Avoid or Use Alternate Drug.

              • bivalirudin

                sulfisoxazole increases effects of bivalirudin by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of bivalirudin by plasma protein binding competition. Avoid or Use Alternate Drug.

              • cholera vaccine

                sulfisoxazole, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

              • dabrafenib

                sulfisoxazole increases levels of dabrafenib by decreasing metabolism. Avoid or Use Alternate Drug. Strong CYP2C8 inhibitors may increase dabrafenib levels.

              • dalteparin

                sulfisoxazole increases effects of dalteparin by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of dalteparin by plasma protein binding competition. Avoid or Use Alternate Drug.

              • enoxaparin

                sulfisoxazole increases effects of enoxaparin by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of enoxaparin by plasma protein binding competition. Avoid or Use Alternate Drug.

              • fondaparinux

                sulfisoxazole increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of fondaparinux by plasma protein binding competition. Avoid or Use Alternate Drug.

              • heparin

                sulfisoxazole increases effects of heparin by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of heparin by plasma protein binding competition. Avoid or Use Alternate Drug.

              • ivosidenib

                ivosidenib will decrease the level or effect of sulfisoxazole by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2C9 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

              • methenamine

                methenamine, sulfisoxazole. Other (see comment). Contraindicated. Comment: This combination may form an insoluble precipitate in the urine, decreasing the effects of both agents.

              • methotrexate

                sulfisoxazole increases toxicity of methotrexate by plasma protein binding competition. Avoid or Use Alternate Drug.

              • methyl aminolevulinate

                sulfisoxazole, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              • microbiota oral

                sulfisoxazole decreases effects of microbiota oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Microbiota oral contains bacterial spores. Antibacterial agents may decrease efficacy if coadministered. Complete antibiotic regimens 2-4 days before initiating microbiota oral. .

              • pexidartinib

                sulfisoxazole and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

              • phenindione

                sulfisoxazole increases effects of phenindione by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of phenindione by plasma protein binding competition. Avoid or Use Alternate Drug.

              • pretomanid

                sulfisoxazole, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

              • protamine

                sulfisoxazole increases effects of protamine by decreasing metabolism. Avoid or Use Alternate Drug.

                sulfisoxazole increases effects of protamine by plasma protein binding competition. Avoid or Use Alternate Drug.

              • tretinoin

                sulfisoxazole, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • tretinoin topical

                sulfisoxazole, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • typhoid vaccine live

                sulfisoxazole decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              Monitor Closely (47)

              • alpelisib

                alpelisib will decrease the level or effect of sulfisoxazole by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.

              • bazedoxifene/conjugated estrogens

                sulfisoxazole will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • bupivacaine implant

                sulfisoxazole, bupivacaine implant. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia.

              • cannabidiol

                cannabidiol will increase the level or effect of sulfisoxazole by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.

              • chlorpropamide

                sulfisoxazole increases levels of chlorpropamide by plasma protein binding competition. Use Caution/Monitor.

              • conjugated estrogens

                sulfisoxazole will decrease the level or effect of conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • cyclosporine

                sulfisoxazole will decrease the level or effect of cyclosporine by unknown mechanism. Use Caution/Monitor.

              • dapsone topical

                sulfisoxazole increases toxicity of dapsone topical by decreasing metabolism. Modify Therapy/Monitor Closely. May induce methemoglobinemia .

              • digoxin

                sulfisoxazole will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                elvitegravir/cobicistat/emtricitabine/tenofovir DF decreases levels of sulfisoxazole by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Elvitegravir is a moderate CYP2C9 inducer.

              • estradiol

                sulfisoxazole will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estrogens conjugated synthetic

                sulfisoxazole will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estropipate

                sulfisoxazole will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • ethinylestradiol

                sulfisoxazole will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • glimepiride

                sulfisoxazole increases levels of glimepiride by plasma protein binding competition. Use Caution/Monitor.

              • glipizide

                sulfisoxazole increases levels of glipizide by plasma protein binding competition. Use Caution/Monitor.

              • glyburide

                sulfisoxazole increases levels of glyburide by plasma protein binding competition. Use Caution/Monitor.

              • insulin aspart

                sulfisoxazole increases effects of insulin aspart by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin aspart protamine/insulin aspart

                sulfisoxazole increases effects of insulin aspart protamine/insulin aspart by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin degludec

                sulfisoxazole, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

                sulfisoxazole increases effects of insulin degludec by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin degludec/insulin aspart

                sulfisoxazole, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

              • insulin detemir

                sulfisoxazole increases effects of insulin detemir by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin glargine

                sulfisoxazole increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin glulisine

                sulfisoxazole increases effects of insulin glulisine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin inhaled

                sulfisoxazole, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

                sulfisoxazole increases effects of insulin inhaled by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin isophane human/insulin regular human

                sulfisoxazole increases effects of insulin isophane human/insulin regular human by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin lispro

                sulfisoxazole increases effects of insulin lispro by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin lispro protamine/insulin lispro

                sulfisoxazole increases effects of insulin lispro protamine/insulin lispro by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin NPH

                sulfisoxazole increases effects of insulin NPH by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • insulin regular human

                sulfisoxazole increases effects of insulin regular human by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

              • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

                sulfisoxazole will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.

              • lumacaftor/ivacaftor

                lumacaftor/ivacaftor, sulfisoxazole. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C9 substrates. .

              • mestranol

                sulfisoxazole will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • methoxsalen

                methoxsalen, sulfisoxazole. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive photosensitizing effects.

              • nateglinide

                sulfisoxazole increases levels of nateglinide by plasma protein binding competition. Use Caution/Monitor.

              • nitisinone

                nitisinone will increase the level or effect of sulfisoxazole by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Nitisinone inhibits CYP2C9. Caution if CYP2C9 substrate coadministered, particularly those with a narrow therapeutic index.

              • paclitaxel

                sulfisoxazole will increase the level or effect of paclitaxel by Other (see comment). Modify Therapy/Monitor Closely. Paclitaxel levels/toxicity may increase when coadministered with CYP2C8 inhibitors

              • paclitaxel protein bound

                sulfisoxazole will increase the level or effect of paclitaxel protein bound by Other (see comment). Modify Therapy/Monitor Closely. Paclitaxel levels/toxicity may increase when coadministered with CYP2C8 inhibitors

              • promazine

                promazine increases toxicity of sulfisoxazole by unspecified interaction mechanism. Use Caution/Monitor. Enhanced myelosuppression.

              • repaglinide

                sulfisoxazole increases levels of repaglinide by plasma protein binding competition. Use Caution/Monitor.

              • rucaparib

                rucaparib will increase the level or effect of sulfisoxazole by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C9 substrates, if clinically indicated.

              • sparsentan

                sparsentan will decrease the level or effect of sulfisoxazole by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C9 inducer) decreases exposure of CYP2C9 substrates and reduces efficacy related to these substrates.

              • tetracaine

                tetracaine, sulfisoxazole. Other (see comment). Use Caution/Monitor. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered.

              • tolazamide

                sulfisoxazole increases levels of tolazamide by plasma protein binding competition. Use Caution/Monitor.

              • tolbutamide

                sulfisoxazole increases levels of tolbutamide by plasma protein binding competition. Use Caution/Monitor.

              • valoctocogene roxaparvovec

                sulfisoxazole and valoctocogene roxaparvovec both increase Other (see comment). Use Caution/Monitor. Medications that may cause hepatotoxicity when combined with valoctogene roxaparvovec may potentiate the risk of elevated liver enzymes. Closely monitor these medications and consider alternative medications in case of potential drug interactions.

              • voclosporin

                voclosporin, sulfisoxazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

              Minor (49)

              • amiloride

                amiloride increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • aminohippurate sodium

                sulfisoxazole, aminohippurate sodium. Other (see comment). Minor/Significance Unknown. Comment: This substance interferes with chemical color development of aminohippurate (PAH) essential to accurate renal clearance analysis.

              • aspirin

                aspirin increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • aspirin rectal

                aspirin rectal increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • balsalazide

                sulfisoxazole will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

                balsalazide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • bendroflumethiazide

                bendroflumethiazide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • biotin

                sulfisoxazole will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • bumetanide

                bumetanide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • chlorothiazide

                chlorothiazide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • chlorthalidone

                chlorthalidone increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • cyclopenthiazide

                cyclopenthiazide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • diflunisal

                diflunisal increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • drospirenone

                drospirenone increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • ethacrynic acid

                ethacrynic acid increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • ethotoin

                sulfisoxazole increases levels of ethotoin by decreasing metabolism. Minor/Significance Unknown.

              • fosphenytoin

                sulfisoxazole increases levels of fosphenytoin by decreasing metabolism. Minor/Significance Unknown.

              • furosemide

                furosemide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • hydrochlorothiazide

                hydrochlorothiazide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • indapamide

                indapamide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • indomethacin

                indomethacin increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • isocarboxazid

                isocarboxazid increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • linezolid

                linezolid increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • mesalamine

                mesalamine increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • methohexital

                sulfisoxazole increases levels of methohexital by plasma protein binding competition. Minor/Significance Unknown.

              • methyclothiazide

                methyclothiazide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • metolazone

                metolazone increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • mineral oil

                mineral oil decreases levels of sulfisoxazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • niacin

                sulfisoxazole will decrease the level or effect of niacin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pantothenic acid

                sulfisoxazole will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • phenelzine

                phenelzine increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • phenytoin

                sulfisoxazole increases levels of phenytoin by decreasing metabolism. Minor/Significance Unknown.

              • primaquine

                primaquine, sulfisoxazole. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hemolysis in G6PD deficient pts.

              • probenecid

                probenecid increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • pyridoxine

                sulfisoxazole will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pyridoxine (Antidote)

                sulfisoxazole will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pyrimethamine

                sulfisoxazole, pyrimethamine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased bone marrow toxicity.

              • salicylates (non-asa)

                salicylates (non-asa) increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • salsalate

                salsalate increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • selegiline transdermal

                selegiline transdermal increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • spironolactone

                spironolactone increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • sulfasalazine

                sulfasalazine increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • thiamine

                sulfisoxazole will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • torsemide

                torsemide increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • tranylcypromine

                tranylcypromine increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • triamterene

                triamterene increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • verteporfin

                sulfisoxazole, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.

              • willow bark

                willow bark increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Abdominal pain and discomfort

              Diarrhea

              Lack or loss of appetite

              Nausea

              Vomiting

              Anxiety

              Arrythmia

              Blood disorders

              Blood or stone formation in urine

              Bluish discoloration of skin

              Chills

              Colitis

              Convulsions

              Cough

              Melena

              Depression

              Dermatitis

              Difficulty/inability to urinate

              Disorientation

              Dizziness

              Drowsiness

              Dystonia

              Exhaustion

              Fainting

              Fatigue

              Fluid retention

              Flushing

              Fever

              Gas

              GI bleeding

              Hallucinations

              Headache

              Hepatitis

              Hives

              Hypoglycemia

              Insomnia

              Itching

              Polyuria

              Stoamtitis

              Redness & swelling of tongue

              Tinnitus

              Sensitivity to light

              Severe allergic reactions

              Severe skin welts or swelling

              Shortness of breath

              Skin rash

              Stevens-Johnson syndrome

              Swelling around the eye

              Temporary hearing loss

              Vertigo

              Weakness

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              Warnings

              Contraindications

              Hypersensitivity to macrolides, sulfonamides, sulfonylureas, thiazides

              Term pregnancy

              Lactation

              Age <2 months

              Porphyria

              G-6-PD deficiency

              Severe hepatic or renal impairment (CrCl <15 mL/min), documented megaloblastic or folate deficiency anemia, obstructive uropathy

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: enters breast milk

              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

              Half-Life: 1-1.5 hr (erythromycin); 4.6-7.8 hr (sulfisoxazole)

              Protein bound: 75-90% (erythromycin); 855 (sulfisoxazole)

              Protein Bound: 75-90%

              Peak Plasma Time of erythromycin: base: 4 hr; ethylsuccinate: 0.5-2.5 hr; delayed with food due to differences in absorption

              Metabolized: in liver by demethylation (erythromycin); conjugated in liver (sulfisoxazole)

              Excretion

              Erythromycin

              • Unchanged drug excreted and concentrated in bile
              • Urine: <5%

              Sulfisoxazole

              • Urine: 50% in urine as unchanged drug

              Mechanism of Action

              Erythromycin: Erythromycin: Macrolide antibiotic; iInhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest

              Sulfisoxazole: Sulfonamide derivative; exerts bacteriostatic action by antagonizing para-aminobenzoic acid (PABA), an essential component in folic acid synthesis

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              Patient Handout

              A Patient Handout is not currently available for this monograph.
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              Formulary

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              Tier Description
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.