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Information about Sulfadoxine-Pyrimethamine

The combination of sulfadoxine and pyrimethamine is used in the treatment and prophylaxis of chloroquine resistant strains of malaria and the treatment of toxoplasmosis.

Liver safety of Sulfadoxine-Pyrimethamine

Sulfadoxine-pyrimethamine has been linked with rare cases of idiosyncratic liver injury which resembles the hepatotoxicity associated with sulfonamides.

Mechanism of action of Sulfadoxine-Pyrimethamine

Pyrimethamine (pir" i meth' a meen) is a diamino-pyrimidine and anti-folate, similar in structure and activity to proguanil, which has potent inibitory activity against malaria parasites as well as Toxoplasma gondii. Pyrimethamine has profound antimalarial synergy with sulfonamides and has been widely used in combination with sulfadoxine (sul" fa dox' een) as prophylaxis and treatment of chloroquine-resistant malaria. In recent years, this combination has been replaced by other approaches, partially because of the frequency of hypersensitivity reactions including hepatotoxicity. However, it is still used for treatment of malaria (particularly in Africa) and for prophylaxis against chloroquine-resistant malaria in patients with contraindications to other agents.

Brand name for Sulfadoxine-Pyrimethamine

This combination is available under the brand name of Fansidar in tablets that combine 25 mg of pyrimethamine with 500 mg of sulfadoxine.

Dosage and administration for Sulfadoxine-Pyrimethamine

Pyrimethamine is also available separately as 25 mg tables in generic forms and under the commerical name Daraprim for use in therapy of toxoplasmosis in combination with a sulfonamide. Pyrimethamine should not be used alone, either for treatment of toxoplasmosis or malaria.

The following links are to individual drug records.

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