Dosing & Uses
Dosage Forms & Strengths
tablet
- 500mg
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
Load (>2 Months Old)
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (28)
- aminobenzoate potassium
aminobenzoate potassium decreases effects of sulfadiazine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- aminolevulinic acid oral
aminolevulinic acid oral, sulfadiazine. 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
sulfadiazine 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
sulfadiazine increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of antithrombin alfa by plasma protein binding competition. Avoid or Use Alternate Drug. - antithrombin III
sulfadiazine increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of antithrombin III by plasma protein binding competition. Avoid or Use Alternate Drug. - argatroban
sulfadiazine increases effects of argatroban by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of argatroban by plasma protein binding competition. Avoid or Use Alternate Drug. - BCG vaccine live
sulfadiazine decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
- bemiparin
sulfadiazine increases effects of bemiparin by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of bemiparin by plasma protein binding competition. Avoid or Use Alternate Drug. - bivalirudin
sulfadiazine increases effects of bivalirudin by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of bivalirudin by plasma protein binding competition. Avoid or Use Alternate Drug. - cholera vaccine
sulfadiazine, 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.
- dalteparin
sulfadiazine increases effects of dalteparin by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of dalteparin by plasma protein binding competition. Avoid or Use Alternate Drug. - enoxaparin
sulfadiazine increases effects of enoxaparin by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of enoxaparin by plasma protein binding competition. Avoid or Use Alternate Drug. - erdafitinib
sulfadiazine will increase the level or effect of erdafitinib by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with strong CYP2C9 inhibitors, monitor closely for adverse reactions and consider decreasing dose accordingly. If strong CYP2C9 inhibitor is discontinued, consider increasing erdafitinib dose in the absence of any drug-related toxicities.
- fondaparinux
sulfadiazine increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of fondaparinux by plasma protein binding competition. Avoid or Use Alternate Drug. - heparin
sulfadiazine increases effects of heparin by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of heparin by plasma protein binding competition. Avoid or Use Alternate Drug. - ivosidenib
ivosidenib will decrease the level or effect of sulfadiazine 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, sulfadiazine. Other (see comment). Contraindicated. Comment: This combination may form an insoluble precipitate in the urine, decreasing the effects of both agents.
- methotrexate
sulfadiazine increases toxicity of methotrexate by plasma protein binding competition. Avoid or Use Alternate Drug.
- methyl aminolevulinate
sulfadiazine, 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
sulfadiazine 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
sulfadiazine 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
sulfadiazine increases effects of phenindione by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of phenindione by plasma protein binding competition. Avoid or Use Alternate Drug. - pretomanid
sulfadiazine, 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
sulfadiazine increases effects of protamine by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of protamine by plasma protein binding competition. Avoid or Use Alternate Drug. - siponimod
sulfadiazine will increase the level or effect of siponimod by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with drugs that cause moderate CYP2C9 AND a moderate or strong CYP3A4 inhibition is not recommended. Caution if siponimod coadministered with moderate CYP2C9 inhibitors alone.
- tretinoin
sulfadiazine, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.
- tretinoin topical
sulfadiazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.
- typhoid vaccine live
sulfadiazine decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
Monitor Closely (56)
- alpelisib
alpelisib will decrease the level or effect of sulfadiazine by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.
- apalutamide
apalutamide will decrease the level or effect of sulfadiazine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Coadministration of apalutamide, a weak CYP2C9 inducer, with drugs that are CYP2C9 substrates can result in lower exposure to these medications. Evaluate for loss of therapeutic effect if medication must be coadministered.
- bazedoxifene/conjugated estrogens
sulfadiazine 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
sulfadiazine, 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 sulfadiazine by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.
- chlorpropamide
sulfadiazine increases levels of chlorpropamide by plasma protein binding competition. Use Caution/Monitor.
- conjugated estrogens
sulfadiazine 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
sulfadiazine decreases effects of cyclosporine by unknown mechanism. Use Caution/Monitor. Increased nephrotoxicity with this combination.
sulfadiazine, cyclosporine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Use Caution/Monitor. - dapsone topical
sulfadiazine increases toxicity of dapsone topical by decreasing metabolism. Modify Therapy/Monitor Closely. May induce methemoglobinemia .
- diclofenac
sulfadiazine will increase the level or effect of diclofenac by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Do not exceed diclofenac dose of 50 mg BID
- digoxin
sulfadiazine will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.
- dronabinol
sulfadiazine will increase the level or effect of dronabinol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Dronabinol is a CYP2C9 substrate.
- eluxadoline
sulfadiazine increases levels of eluxadoline by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP2C9/10 inhibitors.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF decreases levels of sulfadiazine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Elvitegravir is a moderate CYP2C9 inducer.
- estradiol
sulfadiazine 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
sulfadiazine 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
sulfadiazine 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
sulfadiazine 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
sulfadiazine increases levels of glimepiride by plasma protein binding competition. Use Caution/Monitor.
- glipizide
sulfadiazine increases levels of glipizide by plasma protein binding competition. Use Caution/Monitor.
- glyburide
sulfadiazine increases levels of glyburide by plasma protein binding competition. Use Caution/Monitor.
sulfadiazine increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism. - insulin aspart
sulfadiazine 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
sulfadiazine 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
sulfadiazine, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.
sulfadiazine 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
sulfadiazine, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.
- insulin detemir
sulfadiazine 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
sulfadiazine 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
sulfadiazine 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
sulfadiazine, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.
sulfadiazine 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
sulfadiazine 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
sulfadiazine 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
sulfadiazine 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
sulfadiazine 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
sulfadiazine 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.
- lacosamide
sulfadiazine increases levels of lacosamide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Consider decreasing lacosamide dose when coadministered with strong CYP2C9 inhibitors.
- lesinurad
sulfadiazine will increase the level or effect of lesinurad by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.
- levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
sulfadiazine 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, sulfadiazine. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C9 substrates. .
- mestranol
sulfadiazine 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, sulfadiazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive photosensitizing effects.
- nateglinide
sulfadiazine increases levels of nateglinide by plasma protein binding competition. Use Caution/Monitor.
- nitisinone
nitisinone will increase the level or effect of sulfadiazine 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.
- ospemifene
sulfadiazine increases levels of ospemifene by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- porfimer
sulfadiazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.
- promazine
promazine increases toxicity of sulfadiazine by unspecified interaction mechanism. Use Caution/Monitor. Enhanced myelosuppression.
- repaglinide
sulfadiazine increases levels of repaglinide by plasma protein binding competition. Use Caution/Monitor.
- rucaparib
rucaparib will increase the level or effect of sulfadiazine by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C9 substrates, if clinically indicated.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
sulfadiazine decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.
- sparsentan
sparsentan will decrease the level or effect of sulfadiazine 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.
- terbinafine
sulfadiazine will increase the level or effect of terbinafine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- tetracaine
tetracaine, sulfadiazine. Other (see comment). Use Caution/Monitor. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered.
- tolazamide
sulfadiazine increases levels of tolazamide by plasma protein binding competition. Use Caution/Monitor.
- tolbutamide
sulfadiazine increases levels of tolbutamide by plasma protein binding competition. Use Caution/Monitor.
- valoctocogene roxaparvovec
sulfadiazine 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, sulfadiazine. 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.
- warfarin
sulfadiazine will increase the level or effect of warfarin by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Mechanism of interaction may be caused by CYP2C9 inhibition and protein-binding displacement. If coadministered, consider decreasing warfarin dose by 10-20%.
Minor (47)
- amiloride
amiloride increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- aminohippurate sodium
sulfadiazine, 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 sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- aspirin rectal
aspirin rectal increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- balsalazide
sulfadiazine 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 sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown. - bendroflumethiazide
bendroflumethiazide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- biotin
sulfadiazine 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 sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- chlorthalidone
chlorthalidone increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- choline magnesium trisalicylate
choline magnesium trisalicylate increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- cyclopenthiazide
cyclopenthiazide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- diflunisal
diflunisal increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- drospirenone
drospirenone increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- ethacrynic acid
ethacrynic acid increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- ethotoin
sulfadiazine increases levels of ethotoin by decreasing metabolism. Minor/Significance Unknown.
- fosphenytoin
sulfadiazine increases levels of fosphenytoin by decreasing metabolism. Minor/Significance Unknown.
- furosemide
furosemide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- indapamide
indapamide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- indomethacin
indomethacin increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- isocarboxazid
isocarboxazid increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- linezolid
linezolid increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- mesalamine
mesalamine increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- metolazone
metolazone increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- mineral oil
mineral oil decreases levels of sulfadiazine by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- pantothenic acid
sulfadiazine 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 sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- phenytoin
sulfadiazine increases levels of phenytoin by decreasing metabolism. Minor/Significance Unknown.
- primaquine
primaquine, sulfadiazine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hemolysis in G6PD deficient pts.
- probenecid
probenecid increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- pyridoxine
sulfadiazine 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)
sulfadiazine 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
sulfadiazine, pyrimethamine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased bone marrow toxicity.
- salicylates (non-asa)
salicylates (non-asa) increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- salsalate
salsalate increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- selegiline transdermal
selegiline transdermal increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- spironolactone
spironolactone increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- sulfasalazine
sulfasalazine increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- thiamine
sulfadiazine 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 sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- tranylcypromine
tranylcypromine increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- triamterene
triamterene increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
- verteporfin
sulfadiazine, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- willow bark
willow bark increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.
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
Warnings
Contraindications
Hypersensitivity to drug or excipients
Infants <2 months except as adjunctive therapy with pyrimethamine treating congenital toxoplasmosis
Pregnancy at term and during nursing period
Cautions
Remove adverse drug reactions and move guidance on dosing to administration
Sulfonamides are not for use in the treatment of group A betahemolytic streptococcal infections; in an established infection, therapy will not eradicate the streptococcus and, therefore, will not prevent sequelae such as rheumatic fever and glomerulonephritis
Deaths associated with administration of sulfonamides reported from hypersensitivity reactions, agranulocytosis, aplastic anemia, and other blood dyscrasias
The presence of clinical signs, including sore throat, fever, pallor, purpura, or jaundice may be early indications of serious blood disorders
The frequency of renal complications is considerably lower in patients receiving the more soluble sulfonamides
Sulfonamides should be given with caution to patients with impaired renal or hepatic function and to those with severe allergy or bronchial asthma
Hemolysis may occur in individuals deficient in glucose-6-phosphate dehydrogenase
This reaction is dose-related; adequate fluid intake must be maintained in order to prevent crystalluria and stone formation
Instruct patients to drink an eight-ounce glass of water with each dose of medication and at frequent intervals throughout the day
Caution patients to report promptly onset of sore throat, fever, pallor, purpura or jaundice when taking this drug, since these may be early indications of serious blood disorders
Pregnancy & Lactation
Pregnancy
The safe use of sulfonamides in pregnancy has not been established
The teratogenic potential of most sulfonamides has not been thoroughly investigated in either animals or humans
Animal data
- A significant increase in the incidence of cleft palate and other bony abnormalities in offspring observed when certain sulfonamides of the short, intermediate, and long acting types were given to pregnant rats and mice in high oral doses (7 to 25 times the human therapeutic dose)
Lactation
Sulfadiazine is contraindicated for use in nursing mothers because sulfonamides cross the placenta, are excreted in breast milk, and may cause kernicterus
Because of potential for serious adverse reactions in nursing infants from sulfadiazine, a decision should be made whether to discontinue nursing or to discontinue drug, taking into account importance of drug to mother
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.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
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| sulfadiazine oral - | 500 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
sulfadiazine oral
SULFADIAZINE - ORAL
(sull-fuh-DYE-uh-zeen)
USES: This medication is used to treat and prevent a wide variety of infections. Sulfadiazine belongs to the class of drugs known as sulfa antibiotics. It works by stopping the growth of bacteria and other organisms.This antibiotic treats only certain types of infections. It will not work for viral infections (such as common cold, flu). Unnecessary use or misuse of any antibiotic can lead to its decreased effectiveness.This medication should not be used in infants younger than 2 months because of the risk of serious side effects, unless treatment is for a very serious infection (congenital toxoplasmosis).
HOW TO USE: Take this medication by mouth with a full glass of water (8 ounces or 240 milliliters) as directed by your doctor. Drink plenty of fluids during treatment with this medication unless your doctor advises you otherwise. This will help prevent unlikely side effects such as crystals appearing in the urine and kidney stones.The dosage is based on your medical condition, weight, and response to treatment.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication for the full time prescribed, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Nausea, vomiting, diarrhea, loss of appetite, or headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as depression, hallucinations), signs of kidney problems (such as change in the amount of urine, crystals in the urine, painful urination), lump/growth/swelling in the front of the neck (goiter), signs of low blood sugar (such as shaking, dizziness, blurred vision, unusual hunger).This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.Get medical help right away if you have any very serious side effects, including: headache that is severe or doesn't go away, confusion, neck stiffness, seizures.This medication may rarely cause serious (possibly fatal) allergic reactions and other side effects such as a severe peeling skin rash (such as Stevens-Johnson syndrome), blood disorders (such as agranulocytosis, aplastic anemia), liver damage, or lung injury. Get medical help right away if you notice any of the following: cough that doesn't go away, nausea/vomiting that doesn't stop, skin rash/blisters, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing, signs of a new infection (such as sore throat that doesn't go away, fever), pale skin, easy bleeding/bruising, yellowing eyes/skin, unusual tiredness, dark urine, stomach/abdominal pain, joint pain.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking sulfadiazine, tell your doctor or pharmacist if you are allergic to it; or to sulfa medications; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain metabolic disorders (porphyria, G6PD deficiency), kidney disease, liver disease, severe allergies, asthma, diabetes, blood disorders (such as anemia due to folate vitamin deficiency), decreased bone marrow function (bone marrow suppression).Sulfadiazine may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using sulfadiazine before having any immunizations/vaccinations.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Get medical help right away if you get sunburned or have skin blisters/redness.Older adults may be more sensitive to the side effects of the drug, especially skin reactions and blood disorders.During pregnancy, this medication should be used only when clearly needed. This medication should not be used near the expected delivery date because of possible harm to the unborn baby. Discuss the risks and benefits with your doctor.This drug passes into breast milk. While there have been no reports of harm to healthy infants, this drug may have undesirable effects on infants who are ill or premature or have certain disorders (jaundice, high blood levels of bilirubin, G6PD deficiency). Breastfeeding is not recommended in infants with these conditions. Consult your doctor before breastfeeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: methenamine, methotrexate, PABA taken by mouth, warfarin.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: dizziness, drowsiness, blood in the urine, fever, loss of consciousness.
NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.If you are using this medication for an extended period, lab and/or medical tests (such as complete blood count, kidney function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised November 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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