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- Antiprotozoal
Indications
- Treatment and secondary prophylaxis of toxoplasmosis in immunodeficient patients, in combination with sulfadiazine or clindamycin
- Primary prophylaxis of toxoplasmosis in immunodeficient patients, in combination with dapsone (only if co-trimoxazole cannot be used)
- Second-line treatment of isosporiasis in immunodeficient patients (only if co-trimoxazole cannot be used)
Forms and strengths
- 25 mg tablet
Dosage and duration
Treatment of toxoplasmosis
- Adult: 2 doses of 100 mg on D1, then 75 to 100 mg once daily for at least 6 weeks
Secondary prophylaxis of toxoplasmosis
- Adult: 25 to 50 mg once daily, as long as necessary
Primary prophylaxis of toxoplasmosis
- Adult: 50 to 75 mg once weekly, as long as necessary
Treatment of isosporiasis
- Adult: 50 to 75 mg once daily for 10 days
Contra-indications, adverse effects, precautions
- Do not administer to patients with severe renal or hepatic impairment.
- May cause: gastrointestinal disturbances, seizures, leucopenia, thrombocytopenia, megaloblastic anaemia due to folic acid deficiency.
- Administer calcium folinate to prevent folic acid deficiency.
- Avoid if possible combination with other folate antagonists: co-trimoxazole, methotrexate (increased risk of folic acid deficiency).
- Monitor combination with zidovudine (increased risk of zidovudine-associated haematotoxicity).
- Pregnancy: CONTRA-INDICATED during the first trimester
- Breast-feeding: no contra-indication; however avoid concomitant administration of other folate antagonists.
Remarks
- The combination of sulfadoxine/pyrimethamine is used for the treatment of uncomplicated falciparum malaria.
Storage
Below 25 °C