SULFADOXINE AND PYRIMETHAMINE

Brand & Generic Names

Fansidar

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? No
• Drug class: Antiprotozoal

Uses

• Treats malaria (plasmodium faciparum).
• Helps prevent malaria when traveling to areas where it exists.
• Also used to prevent isosporiasis in patients with acquired immunodeficiency disease.

Dosage & Usage Information

How to take:
Tablets--Swallow with liquid. If you can't swallow whole, crumble tablet and take with liquid or food. Instructions to take on empty stomach mean 1 hour before or 2 hours after eating.

When to take:
Follow doctor's instructions.

If you forget a dose:
Take as soon as you remember. If close to time for next dose, skip this one and wait for next scheduled dose. Don't double dose.

What drug does:
The sulfa component kills bacteria; the pyrimethamine works to kill malaria organisms in red blood cells or human tissue.

Time lapse before drug works:
2 to 6 hours.

Don't take with:
Any other medicines (including over-the-counter drugs such as cough and cold medicines, laxatives, antacids, diet pills, caffeine, nose drops or vitamins) without consulting your doctor.
Mefloquine.

Overdose

SYMPTOMS:
Appetite loss, sore throat and fever, seizure, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose Section.

Common:

• Loss or change of taste; diarrhea; skin rash; pale skin; sore throat; sore, red tongue; mouth ulcers; fever; excessive bleeding; tiredness, light sensitivity. headache, nausea.

Infrequent:

Aching joints, fever, skin blisters or peeling, jaundice (yellow skin and eyes).

Rare:

Bloody urine, back pain, swollen neck.

Warnings & Precautions

Don't take if:
You know you are allergic to sulfa drugs, furosemide, thiazide diuretics, carbonase anhydrase inhibitors.

Before you start, consult your doctor:

• If you have AIDS.
• If you have anemia, seizures, G6PD* deficiency, liver disease, porphyria, kidney disease.
• If you can't tolerate sulfa drugs.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons. You may need smaller doses for shorter periods of time.

Pregnancy:
Use birth control so you won't get pregnant while in an endemic malaria area. Should not be taken during pregnancy if it can possibly be avoided. Consult doctor.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Don't use in infants under 2 months old.

Prolonged use:
Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check complete blood counts (white blood cell count, platelet count, red blood cell count, hemoglobin, hematocrit) and urinalyses.

Skin & sunlight:
Increased sensitivity to sunlight.

Driving, piloting or hazardous work:
Avoid if you feel confused, drowsy or dizzy.

Discontinuing:
Don't discontinue for 4 to 6 weeks after you leave endemic malaria areas.

Others:

• Advise any doctor or dentist whom you consult that you take this medicine.
• May affect results in some medical tests.
• Sleep under mosquito netting while in endemic areas. Wear long-sleeved shirts and long pants.
• Report to your doctor if you develop any symptoms of illness while you take this medicine--even if the symptoms seem minor.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticoagulants*	Increased risk of toxicity.
Anticonvulsants*	Increased risk of toxicity.
Antidiabetics*	Increased risk of toxicity.
Bone marrow depressants*	Increased risk of bleeding or other
	toxic symptoms.
Clozapine	Toxic effect on the central nervous
	system.
Contraceptives*,	Reduced reliability of the pill.
Hepatotoxic medicines*	Increased risk of liver toxicity.
Methenamine	Increased risk of kidney toxicity.
Methotrexate	Increased risk of toxicity.
Zidovudine	Increased risk of liver toxicity.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Nausea and vomiting. Avoid.
Beverages:	No special problems expected.
Cocaine:	Increased likelihood of adverse
	reactions or seizures. Avoid.
Foods:	No special problems expected.
Marijuana:	Increased likelihood of adverse
	reactions. Avoid.
Tobacco:	No special problems expected.