Sulphadiazine -

Potentiates antidiabetic effect of sulphonylureas Action antagonised by p-amino-benzoic acid and procaine group of local anesthetics

Trimethoprim-

Potentiates effect of phenytoin, digoxin, prcainamide , warfarin

Reduces renal excretion of zalcitabine, zidovudine, and lammivudine dapsone , rifampicin increase risk of nephrotoxocity when given with cyclosporin

Severe hyperkalemia when given with ACE ihibitors,

Depression of bone marrow function, risk of megalblastic anemia with other folate inhibitors eg. pyrimethamine, methotrexate

Hyponatremia if receiving diuretics concurently

Potentiates oral anticoagulants, methotrexate, phenytoin

Ascorbic acid and hexamine may precipitate crystalluria

Metabolism of hypoglycaemicas may be inhibited

Urinary tract infections

Nausea, vomiting, anoexia, diarrhoea Hypersensitivity , skin reactions Lumbar pain, haematuria Ooliguria, anuria, Crystallization in urine, Thrombocytopenia, leucopenia, eosinophillia Neonatal jaundice and kemicterius

Stevens- Johnson syndrome Agranulocytosis Jaundice n newborn Mild GI disturbances, Pruritus, skin rash, Sulphonamide like reactions Disturbances in liver enzyme,values, Cholestatic jaundice rised serum creatinine & BUN Fever, anaphylaxis Aseptic meningitis Haemologic disturbances,

Photosensitivity, Induce hyperkalemia particularly in HIV patients being treated for pneumocytis carnii pneumonia or in the elderly

Hypersensitivity Severe renal/hepatic impairment Blood dyscrasis, porphyrias,

Serious hematogical disorders megakloblastic anemia scondary tofolate depletion Infants < 2mths Pregnancy (at term ) Lactation

Special precautions-

Elderly, adequate fluid intake G6PD deficiency, AIDS Actual or possible folated defeciency Child with fragile X chromosome associated with mental retardation

Discontinue in case of skn rash

Perform regular haematolgical exam.

Urinary tract infections

Dosage-

2 tabs as a single dose every 24 hours

Obseve caution if required to be given during pregnancy and lactation