Sulfadiazine

What is Sulfadiazine

Sulfadiazine is an oral, intermediate-duration sulfonamide antibiotic. It is used in combination with pyrimethamine for the treatment of toxoplasmosis.

Sulfadiazine is also occassionally used to treat other infections due to susceptible organisms. This drug is poorly soluble in urine and causes crystalluria more often than other sulfonamides.

For this reason and because of previous problems with drug supply, sulfadiazine use is generally limited to serious infections.

Sulfadiazine was approved by the FDA in 1941.

Indications & Dosage

1. Actinomyces sp.
2. chancroid
3. Chlamydia trachomatis
4. chlamydial conjunctivitis
5. cystitis
6. Enterobacter sp.
7. Escherichia coli
8. Haemophilus ducreyi
9. Haemophilus influenzae (beta-lactamase negative)
10. Haemophilus influenzae (beta-lactamase positive)
11. Klebsiella sp.
12. malaria
13. meningitis
14. meningococcal infection prophylaxis
15. Neisseria meningitidis
16. Nocardia sp.
17. nocardiosis
18. otitis media
19. Paracoccidioides brasiliensis
20. paracoccidioidomycosis
21. Plasmodium falciparum
22. Proteus mirabilis
23. Proteus vulgaris
24. pyelonephritis
25. rheumatic fever prophylaxis
26. Staphylococcus aureus (MSSA)
27. Toxoplasma gondii
28. toxoplasmic encephalitis
29. toxoplasmosis
30. toxoplasmosis prophylaxis
31. trachoma
32. urinary tract infection (UTI)

Side Effects

1. abdominal pain
2. agranulocytosis
3. anaphylactoid reactions
4. anorexia
5. anuria
6. aplastic anemia
7. arthralgia
8. ataxia
9. chills
10. crystalluria
11. depression
12. diarrhea
13. diuresis
14. edema
15. erythema multiforme
16. exfoliative dermatitis
17. fever
18. goiter
19. hallucinations
20. headache
21. hemolysis
22. hemolytic anemia
23. hepatitis
24. hypoglycemia
25. hypoprothrombinemia
26. insomnia
27. leukopenia
28. lupus-like symptoms
29. methemoglobinemia
30. myocarditis
31. nausea
32. nephrolithiasis
33. oliguria
34. pancreatitis
35. periarteritis
36. peripheral neuropathy
37. photosensitivity
38. pruritus
39. purpura
40. renal tubular obstruction
41. seizures
42. serum sickness
43. Stevens-Johnson syndrome
44. stomatitis
45. thrombocytopenia
46. tinnitus
47. toxic epidermal necrolysis
48. urticaria
49. vertigo
50. vomiting

Monitoring Parameters

• CBC
• glucose-6-phosphate dehydrogenase (G6PD) activity

Contraindications

• bone marrow suppression
• breast-feeding
• colitis
• dehydration
• diarrhea
• G6PD deficiency
• geriatric
• GI disease
• hepatic disease
• infants
• inflammatory bowel disease
• neonates
• porphyria
• pregnancy
• pseudomembranous colitis
• renal failure
• renal impairment
• streptococcal infection
• sulfonamide hypersensitivity
• sunlight (UV) exposure
• ulcerative colitis

Interactions

• Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
• Acarbose
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetohexamide
• Albiglutide
• Alogliptin; Metformin
• Alpha-glucosidase Inhibitors
• Aminosalicylate sodium, Aminosalicylic acid
• Amoxicillin
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amoxicillin; Clavulanic Acid
• Ampicillin
• Ampicillin; Sulbactam
• Articaine; Epinephrine
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benzocaine
• Benzocaine; Butamben; Tetracaine
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bromocriptine
• Bupivacaine
• Bupivacaine Liposomal
• Bupivacaine; Lidocaine
• Canagliflozin
• Canagliflozin; Metformin
• Chloroprocaine
• Chlorpropamide
• Choline Salicylate; Magnesium Salicylate
• Colchicine; Probenecid
• Cyclosporine
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Dapsone
• Dicloxacillin
• Dienogest; Estradiol valerate
• Dipeptidyl Peptidase-4 Inhibitors
• Diphenhydramine; Naproxen
• Dulaglutide
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Esomeprazole; Naproxen
• Estradiol
• Estradiol Cypionate; Medroxyprogesterone
• Exenatide
• Fenoprofen
• Fluvastatin
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Hydrochlorothiazide, HCTZ; Losartan
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Incretin Mimetics
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Lamivudine, 3TC; Zidovudine, ZDV
• Lansoprazole; Naproxen
• Lidocaine
• Linagliptin; Metformin
• Liraglutide
• Lixisenatide
• Losartan
• Magnesium Salicylate
• Meglitinides
• Mepivacaine
• Mepivacaine; Levonordefrin
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methenamine
• Methenamine; Sodium Acid Phosphate
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methotrexate
• Methoxsalen
• Miglitol
• Naproxen
• Naproxen; Pseudoephedrine
• Naproxen; Sumatriptan
• Omeprazole; Amoxicillin; Rifabutin
• Oral Contraceptives
• Oxacillin
• Penicillamine
• Penicillin G
• Penicillin G Benzathine
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Penicillin V
• Pexidartinib
• Photosensitizing agents (topical)
• Piperacillin
• Piperacillin; Tazobactam
• Porfimer
• Pramlintide
• Prilocaine
• Prilocaine; Epinephrine
• Probenecid
• Pyrimethamine
• Pyrimethamine; Sulfadoxine
• Rabies Vaccine
• Riluzole
• Ropivacaine
• Salicylates
• Salsalate
• Semaglutide
• SGLT2 Inhibitors
• Sodium Iodide
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Sulfonylureas
• Tetracaine
• Thiazolidinediones
• Tolazamide
• Tolbutamide
• Typhoid Vaccine
• Verteporfin
• Voriconazole
• Warfarin
• Zidovudine, ZDV