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
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