Interacting drugs- summary

  Sulphadoxine +

 Antifolic drugs eg /pyrimethamine/ methotrexate, Sulfonamides TMP-- SMZ-

do not use while the patient is receiving sulfonamide  for antimalarial prophylaxis  

Falciparium malaria 

Stevens-Jhonson syndrome, generalised toxic epidermolysis, fatal hepatic failure(rare). GI symptoms, feeling of fullness, stomatisis, rash, pruritis, Hair loss, leucopenia, Thrombocytopenia, megablastic anaemia, Fatigue, headache, Fever, polyneuritis, Orthostatic hypotension.

Severe renal impairment, severe liver parachymal damage, blood dyscrasias, hypersensitivity to components, megaloblastic anaemia due to folate deficiency, pregnancy at term and during lactation, infants less than 2 months old.

Special precautions:

Impaired renal or hepatic function, folate deficiency, severe allergy or bronchial asthma, G6PD deficiency.

Indications:

Falciparium malaria

Dosage::

Acute attacks- Adults - 2 to 3 tablets Prophylaxis- 1 tablet once daily

Pharmacology:

Sulfadoxime/pyremethamine is an antimalarial agent which acts by reciprocal potentiation of its components, acheived by a sequential blockade of two enzymes involved in the biosynthesis of folinic acid within the parasites.

Pharmacokinetics:

Both are orally absorbed and excreted mainly by the kidneys. Following a single tablet, sufodoxime peak plasma concentrations of 51 to 76mc/ml are acheived in 2.5 to 6 hours and pyrimethine peak plasma concentration of 0.13 to 0.4mcg/ml are reached in 1.5 to 8 hours.

Report not available

Pregnancy:

Use during pregnancy only if potential benefits outweigh the potential risk to the fetus.

Lactation:

Both drugs appear in breast milk. Discontinue nursing during therapy.

Children:

Do not give to infants below 2 months of age.