Pyrimethamine + Sulfadoxine

Name	Pyrimethamine + Sulfadoxine
Classes	Antiinfective Agent Antimalarial Agent Antimalarial Combination
Diseases	Infectious Disease Malaria

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Pyrimethamine + Sulfadoxine

Pyrimethamine + Sulfadoxine is a combination drug that belongs to the class of antimalarials. Pyrimethamine is a folate antagonist that inhibits dihydrofolate reductase enzyme in the malarial parasite, which is essential for DNA synthesis, and thus, inhibits the growth of the parasite. Sulfadoxine is a sulfa drug that inhibits dihydropteroate synthetase enzyme in the malarial parasite, which is also involved in the synthesis of folic acid. The combination of both drugs leads to a synergistic effect, resulting in a potent antimalarial activity.

Indication and Usage

Pyrimethamine + Sulfadoxine is indicated for the treatment of acute uncomplicated malaria caused by Plasmodium falciparum or Plasmodium vivax in patients who are unable to tolerate other antimalarial medications or in areas where other antimalarials have shown resistance.

Malaria

Dosage & Administration (How to take this medication)

The dosage and administration of Pyrimethamine + Sulfadoxine are based on the patient's weight and age.

Adults and children over 12 years of age: A single oral dose of 3 tablets (25 mg Pyrimethamine and 500 mg Sulfadoxine) is recommended for the treatment of uncomplicated malaria.
Children 6 to 12 years of age: A single oral dose of 1.5 tablets (12.5 mg Pyrimethamine and 250 mg Sulfadoxine) is recommended for the treatment of uncomplicated malaria.
Children 2 to 6 years of age: A single oral dose of 0.75 tablets (6.25 mg Pyrimethamine and 125 mg Sulfadoxine) is recommended for the treatment of uncomplicated malaria.

Side effect

The following adverse reactions have been reported with the use of Pyrimethamine + Sulfadoxine:

Nausea	Vomiting	Abdominal Pain	Dizziness
Rash	Anemia	Erythema	Liver problems

Precaution/Good to know

Severe reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, have led to fatalities associated with the administration of Pyrimethamine + Sulfadoxine. If there is a skin rash, a significant reduction in the count of any formed blood elements is noticed, or active bacterial or fungal infections occur, Pyrimethamine + Sulfadoxine prophylaxis must be discontinued immediately.
Pyrimethamine + Sulfadoxine should be used with caution in patients with a history of liver or kidney disease.
This drug may cause anemia, leukopenia, or thrombocytopenia, which can lead to serious health problems. The patient's blood counts should be monitored regularly.
Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency may experience hemolytic anemia when using Pyrimethamine + Sulfadoxine.
Pyrimethamine + Sulfadoxine should be used with caution in patients with a history of allergies to sulfa drugs.
This drug should not be used in pregnant women unless the benefits outweigh the risks. The use of Pyrimethamine + Sulfadoxine in the first trimester of pregnancy is contraindicated due to the risk of fetal abnormalities.
Breastfeeding women should not use this drug.
Pyrimethamine + Sulfadoxine should be used with caution in patients with a history of epilepsy, as it may cause seizures.
This drug may cause dizziness or drowsiness, and patients should be advised not to operate heavy machinery or drive until they know how the drug affects them.
Patients should avoid exposure to direct sunlight or use protective clothing and sunscreen when taking Pyrimethamine + Sulfadoxine.

Repeated prophylactic use of Pyrimethamine + Sulfadoxine is contraindicated in patients with renal or hepatic failure or with blood dyscrasias;
Patients with documented megaloblastic anemia due to folate deficiency;
Infants less than 2 months of age;
Prophylactic use of Pyrimethamine + Sulfadoxine in pregnancy at term and during the nursing period.