Sulphadiazine + Trimethoprim

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Generic Name of Sulphadiazine + Trimethoprim - Learn More

Sulphadiazine + Trimethoprim

Sulphadiazine + Trimethoprim Precaution - What You Need to Know

Before using Sulfadiazine + Trimethoprim, it is crucial for patients to consult their healthcare provider. The following precautions should be considered:

- Hypersensitivity: Patients should inform their doctor if they have a history of allergy to sulfonamides or trimethoprim, as it may cause allergic reactions like rash, itching, fever, or more severe reactions like anaphylaxis. A skin rash is a common initial sign of a potential allergic reaction.
- Kidney and Liver Function: This combination medication should be used cautiously in individuals with renal or hepatic impairment. Sulfadiazine and trimethoprim are excreted through the kidneys, so dosage adjustments may be necessary in patients with renal dysfunction.
- Blood Disorders: Sulfadiazine + Trimethoprim may cause blood abnormalities, including anemia or low white blood cell counts (leukopenia). It should be used with caution in patients with existing blood disorders like megaloblastic anemia due to folate deficiency.
- Pregnancy and Lactation: This combination is generally avoided during pregnancy, particularly in the first trimester, due to the potential risk of birth defects. It can also pass into breast milk, so it should only be used during breastfeeding when the benefits outweigh the risks.
- Folate Deficiency: Patients who are deficient in folate should use this combination with caution. Trimethoprim can interfere with folate metabolism, exacerbating the deficiency. Folate supplementation may be required in these cases.

Sulphadiazine + Trimethoprim Indication - Uses and Benefits

Sulfadiazine + Trimethoprim is a combination antibiotic used to treat various bacterial infections, including:

- Urinary Tract Infections (UTIs): It is commonly prescribed to treat UTIs, including cystitis (bladder infection) and pyelonephritis (kidney infection), by targeting the bacteria that cause these conditions.
- Respiratory Infections: It is also used in the treatment of pneumonia caused by Pneumocystis jirovecii, a fungal infection that primarily affects immunocompromised individuals, such as those with HIV/AIDS.
- Ear Infections: It can be effective in treating otitis media (middle ear infections) caused by susceptible bacteria.
- Gastrointestinal Infections: Sulfadiazine and Trimethoprim can be used to treat some gastrointestinal infections, including enteritis (intestinal inflammation) caused by specific bacteria.
- Toxoplasmosis: Sulfadiazine is often used in combination with pyrimethamine to treat toxoplasmosis, a parasitic infection that can cause serious complications in individuals with weakened immune systems.

Sulphadiazine + Trimethoprim Contraindications - Important Warnings

Sulfadiazine + Trimethoprim should not be used in the following situations:

- Hypersensitivity to Sulfonamides: It is contraindicated in patients with a known allergy to sulfonamides or trimethoprim. Allergic reactions can include rash, fever, or, more rarely, severe conditions such as Stevens-Johnson syndrome.
- Severe Renal or Hepatic Impairment: This combination is contraindicated in patients with severe kidney or liver failure because it can accumulate in the bloodstream, increasing the risk of toxicity.
- Blood Disorders: It should be avoided in patients with a history of blood disorders, such as megaloblastic anemia, bone marrow suppression, or leukopenia, due to the risk of exacerbating these conditions.
- Pregnancy (First Trimester): This combination is not recommended during the first trimester of pregnancy due to potential teratogenic effects, including the risk of birth defects.
- Newborns: It should not be used in newborns, particularly those who are less than 2 months old, due to the risk of kernicterus (brain damage caused by bilirubin accumulation) in infants.

Sulphadiazine + Trimethoprim Side Effects - What to Expect

Common side effects associated with Sulfadiazine + Trimethoprim include:

- Gastrointestinal Symptoms: Nausea, vomiting, and loss of appetite are common side effects.
- Skin Reactions: A rash is one of the most common side effects. In rare cases, severe reactions like Stevens-Johnson syndrome can occur.
- Blood Disorders: Patients may experience low blood counts, including leukopenia, anemia, or thrombocytopenia. Symptoms such as unusual bruising, fatigue, or fever should be reported to a healthcare provider.
- Hyperkalemia: Trimethoprim may increase potassium levels, especially in patients with kidney dysfunction or those taking medications that affect potassium balance.

Serious side effects, although rare, include:

- Severe Allergic Reactions: Anaphylaxis, angioedema, or SJS can occur, which require immediate discontinuation of the drug.
- Liver Toxicity: In some rare cases, it may lead to hepatic dysfunction or hepatitis.
- Kernicterus: In newborns or infants, this medication can lead to kernicterus, a serious condition that can result in brain damage.

Sulphadiazine + Trimethoprim Pregnancy Category ID - Safety Information

13

Sulphadiazine + Trimethoprim Mode of Action - How It Works

The combination of Sulfadiazine and Trimethoprim works synergistically to inhibit bacterial folic acid synthesis at different stages:

- Sulfadiazine: It is a sulfonamide antibiotic that inhibits dihydropteroate synthetase, a bacterial enzyme that is involved in the synthesis of folic acid. Folic acid is essential for bacterial DNA replication, and by inhibiting its production, sulfadiazine prevents bacterial growth.
- Trimethoprim: It inhibits the enzyme dihydrofolate reductase, which is responsible for converting dihydrofolate to tetrahydrofolate, another key form of folic acid. This action blocks bacterial DNA synthesis, leading to bacteriostasis or the prevention of bacterial growth.

Together, these two drugs provide a bacteriostatic effect, preventing the bacteria from reproducing and allowing the immune system to eliminate the infection.

Sulphadiazine + Trimethoprim Drug Interactions - What to Avoid

Sulfadiazine + Trimethoprim can interact with various drugs, including:

- Methotrexate: Trimethoprim can enhance the effects of methotrexate, increasing the risk of toxicity and bone marrow suppression. Patients on methotrexate should be closely monitored when using this combination.
- Warfarin: This combination may enhance the anticoagulant effect of warfarin, leading to an increased risk of bleeding. Regular monitoring of international normalized ratio (INR) is recommended.
- Phenytoin: Sulfadiazine can increase phenytoin levels, potentially leading to toxicity. Serum phenytoin levels should be monitored.
- Oral Contraceptives: Although Sulfadiazine + Trimethoprim is not a common interaction, it may reduce the effectiveness of oral contraceptives in some cases. Additional contraception methods should be considered.
- Folate Antagonists: Patients receiving folate antagonists (e.g., methotrexate) may be at increased risk of bone marrow suppression or megaloblastic anemia due to the folate-blocking effects of trimethoprim.

Sulphadiazine + Trimethoprim Adult Dose - Recommended Dosage

The typical dosing of Sulfadiazine + Trimethoprim for adults is as follows:

- For Urinary Tract Infections (UTIs): The usual dose is 1 tablet (containing 800 mg of sulfadiazine and 160 mg of trimethoprim) every 12 hours for 10–14 days.
- For Pneumocystis Pneumonia: The dose is typically 1 tablet (800 mg sulfadiazine + 160 mg trimethoprim) every 6 hours for 14–21 days.
- For other infections, the dosing regimen should be followed as prescribed by a healthcare provider depending on the type and severity of the infection.

Sulphadiazine + Trimethoprim Child Dose - Dosage for Children

The pediatric dose varies based on age and weight. Typical dosing for children is:

- For children 2 months and older, the usual dose is 5 mg/kg of trimethoprim and 25 mg/kg of sulfadiazine divided into two doses per day. The course typically lasts 7–10 days for uncomplicated infections.

As with adults, the safety of this medication in younger infants or those with kidney dysfunction requires careful consideration and medical consultation.

Always seek professional guidance before using Sulfadiazine + Trimethoprim, as a healthcare provider will adjust the dosage and monitor for side effects or drug interactions.

Sulphadiazine + Trimethoprim Renal Dose - Dosage for Kidney Conditions

For patients with renal impairment, the dosage of Sulfadiazine + Trimethoprim should be reduced. In cases of creatinine clearance < 15 mL/min, the drug should be used with caution, and a reduced dose may be necessary.